```

[Congressional Record Volume 141, Number 81 (Tuesday, May 16, 1995)]
[Senate]
[Pages S6750-S6752]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. HATFIELD:
  S. 806. A bill to amend the Public Health Service Act to provide 
grants to entities in rural areas that design and implement innovative 
approaches to improve the availability and quality of health care in 
such rural areas, and for other purposes; to the Committee on Finance.

                the rural health improvement act of 1995

 Mr. HATFIELD. Mr. President, during the last several years, 
Americans have heard a lot about the need to reform our health care 
system. Health care costs are soaring out of control--far outpacing the 
rate of inflation--and nearly 38 million Americans are without health 
care insurance. Solutions for reform are complex and will go through 
much debate and consensus building before implemented on a national 
level.
  While local and regional health care systems have rushed to 
consolidate and integrate their services and resources over the last 
decade, rural entities, due to their shortage of physicians, the 
vulnerability of their hospitals, their geographical and technical 
isolation, and the demographics of their patient populations, have been 
largely unable to adjust in a similar way. As public concern over the 
national health care crisis grows and legislative bodies and 
policymaking agencies scramble to devise and implement far-reaching 
health care reform, the special health care needs of rural America must 
not be neglected.
  Today I am reintroducing the Rural Health Improvement Act because I 
feel, given the current direction of the health care reform debate, 
that it provides an essential transition into comprehensive health care 
reform. Now, more than ever, health providers in rural communities are 
joining with their urban counterparts to create networks to assure that 
health care is accessible in rural areas. There are a number of 
obstacles, however, that create a disincentive for providers to 
participate in these efforts. I believe that the legislation that I am 
introducing today will remove these obstacles and help rural 
communities position themselves for comprehensive health care reform.
  Mr. President, the Rural Health Improvement Act will help our rural 
communities in the following ways. First, this legislation provides 
grants to allow rural and urban providers to develop rural health 
extension networks to facilitate the delivery of health care in rural 
communities. It allows existing networks such as area health education 
centers to compete for these grants in order to prevent needless 
duplication and to assure that successful programs will have the 
ability to expand their capabilities. The goal of the rural health 
extension networks grant is to facilitate resource sharing within the 
network by providing education and training for health care providers 
in rural areas, creating linkages between rural and urban providers 
through the use of telecommunications and other consultative projects, 
and assisting rural providers in
 developing cooperative approaches to health care delivery.

  Second, my bill provides grants for the creation of rural managed 
care cooperatives which will enhance the economic viability of health 
care providers in rural areas. The idea of health cooperatives in rural 
areas is not new. In 1929, the first health maintenance organization in 
the United States was developed in rural Elk City, OK, by the Farmers' 
Cooperative. Since 1929, there have been several attempts to create 
rural health cooperatives, however, they have suffered because they 
lacked sufficient startup support. My bill provides this startup 
support.
  These cooperatives will be made up of health providers of all types 
including, but not limited to, hospitals, physicians, rural health 
clinics, nurse practitioners, physician assistants, and public health 
departments. By establishing an effective case management and 
reimbursement system designed to support the financial needs of rural 
hospitals and health care systems, cooperatives will provide an 
effective framework for negotiating contracts with payers and assuring 
a defined level of quality. The cooperatives will also help rural 
practitioners with a portion of their payments on malpractice premiums.
  Due to the concerns about possible antitrust problems that might 
arise in the formation of the rural health extension networks and the 
rural managed care cooperatives, the bill includes language which would 
protect providers who participate in these entities from antitrust law. 
This exemption from antitrust law should facilitate the development of 
network and cooperatives in rural areas.
  Third, the bill allows the Secretary of Health and Human Services to 
award competitive grants to develop and implement mental health 
outreach programs in rural areas. The bill emphasizes the needs of the 
elderly and children in rural areas. Grant recipients are encouraged to 
form relationships with rural managed care cooperatives to enhance the 
delivery of these services.
  Fourth, my bill provides stipend grants under the Area Health 
Education Centers [AHEC] Program to health care providers and trainees 
in rural communities as an incentive to provide health care services in 
those areas. While the stipends envisioned in this legislation will not 
completely relieve the financial burden young providers face, 
especially physicians, it is my hope that they will provide enough of 
an incentive to attract and retain health care providers in rural 
areas.
  It has been 20 years since the AHEC Program was enacted and we now 
have a network of 48 AHEC Programs in 38 States. In my own State of 
Oregon, we have an excellent statewide AHEC program with five centers 
now operating to meet the challenges of both rural and urban areas. 
State studies have shown that AHEC's have an excellent record in 
addressing the primary health care profession needs of underserved 
areas. In fact, since AHEC's inception more than 1.5 million students, 
residents, and preceptors have been trained in medicine, allied health, 
dentistry, nursing, and pharmacy.
  Finally, this year I have included a nonrefundable tax credit for 
qualified providers in rural and underserved areas. This tax credit is 
similar to the tax credit proposed in health care reform legislation 
last session. Under this provision qualified providers will be eligible 
for a tax credit if they serve in rural or underserved areas for 5 
years. A similar tax credit program in Oregon has enjoyed great 
success. In a recent survey by the Oregon Office of Rural Health, rural 
providers indicated that the Oregon Tax Credit Program is the most 
important program offered that keeps them practicing in rural areas.
  Mr. President, our rural communities are facing a crisis in health 
care delivery. Nationwide, 141 rural community hospitals closed between 
1989 and 1993. In Oregon, five rural hospitals have closed since 1986 
and several other rural facilities are threatened with imminent 
closure. These hospitals simply cannot compete with their urban 
counterparts. I believe my legislation will give rural health care 
providers the tools to build rural health care delivery systems which 
meet the health needs of their communities. This is the first step in 
developing an infrastructure of providers who will support and sustain 
comprehensive health care reform and provide health care access for all 
Americans.
  [[Page S6751]] I'd like to take a moment to thank the National Rural 
Health Care Association, the Oregon Office of Rural Health, the Oregon 
Association of Hospitals, the Oregon Medical Association, the Oregon 
Nurses Association, and the Oregon AHEC Program Office for their 
support in developing this innovative legislation.
  I urge my colleagues to take a careful look at this bill and consider 
it as a transition into comprehensive health care reform that can help 
our rural communities now.
                                 ______

      By Mr. BREAUX:
  S. 808. A bill to extend the deadline for the conversion of the 
vessel M/V Twin Drill, and for other purposes; to the Committee on 
Commerce, Science, and Transportation.

                       m/v twin drill legislation

 Mr. BREAUX. Mr. President, I am introducing a bill today to 
extend the deadline for the completion of the conversion of the vessel 
M/V Twin Drill. This vessel is what is known as a SWATH or small 
waterplane area twin hull vessel of advanced design that provides for 
an unusually smooth operating platform. This vessel currently 
undergoing initial conversion in Louisiana to ready her for a complete 
conversion to a U.S.-flag day cruise service.
  Under terms of section 601(d) of Public Law 103-206 the M/V Twin 
Drill was granted full coastwise privileges provided that the cost of 
major conversion work on the vessel in a U.S. shipyard was more than 
three times the purchase value of the vessel. Furthermore, the owners 
were required to commit to build a new vessel entirely within a U.S. 
shipyard. These requirements were to have been completed by certain 
dates. A number of delays resulted from the discovery of additional 
work that was necessary because of unknown conditions on the vessel 
slowed the project to the point where it will now be impossible to 
complete the conversion by the statutory deadline.
  Given the significant investment to date, and the progress already 
made, it is only reasonable that we provide some additional time for 
this shipyard work to be completed. This will cost the Government 
nothing, but it will mean immediate jobs at the shipyard and long-term 
employment opportunities onboard the Twin Drill. Failure to act would 
also mean foregone job opportunities in the construction and operation 
of the new vessel as well. A similar provision was passed by the House 
of Representatives last fall as part of the Coast Guard authorization 
legislation which we were not able to act on before the end of the last 
session. It is time we finish the job and I urge my colleagues to 
support this legislation.
                                 ______

      By Mr. LAUTENBERG (for himself, Mr. Helms, and Mr. Bradley):
  S. 809. A bill to amend the Trade Act of 1974 to limit the 
eligibility for treatment under the generalized system of preferences 
in the case of countries that support international acts of terrorism, 
and for other purposes; to the Committee on Finance.

              the trade act of 1974 amendment act of 1995

 Mr. LAUTENBERG. Mr. President, I introduce a bill that would 
make our Nation's Generalized System of Preferences Development Program 
conform with out foreign aid program when it comes to eliminating 
benefits for countries that sponsor terrorism. I am pleased that 
Senators Helms and Bradley are original cosponsors of this legislation.
  Under this bill, a country would automatically lose its GSP benefits 
once the Secretary of State makes a determination under the Export 
Administration Act of 1979 that ``the government of that country has 
repeatedly provided support for acts of international terrorism.'' 
Under the Foreign Assistance Act of 1961, once the Secretary makes this 
determination and a country is added to the State Department's so-
called ``terrorism list,'' it is no longer eligible to receive foreign 
assistance from the United States. Likewise, state sponsors of 
terrorism should be precluded from importing products into this country 
duty free under the GSP Program.
  But they are not.
  Syria is a case in point. Syria was designated by the State 
Department as a state-sponsor of terrorism on December 29, 1979, which 
made it ineligible to receive foreign assistance. Nonetheless, Syria 
continued to import products into the U.S. duty free under the GSP 
Program until August 16, 1992. At that time, Syria's eligibility was 
suspended due to concerns about workers' rights--not a concern about 
terrorism.
  Technically, the GSP law prohibits the President from designating a 
country GSP eligible ``if such country aids or abets, by granting 
sanctuary from prosecution to any individual or group which has 
committed an act of international terrorism.'' But the law did nothing 
to prohibit Syria, a country our Government already recognized as a 
state-sponsor of terrorism, from benefiting from the United States 
Government's GSP Development Program. That is why I am proposing a 
change in the law.
  Mr. President, once the Secretary of State determines that a country 
sponsors terrorism it ought to automatically lose its GSP benefits, 
just as it loses its foreign assistance. There is no sensible rationale 
for barring foreign assistance for state sponsors of terrorism while 
providing GSP benefits to those same state sponsors of terrorism. Like 
foreign aid, GSP is a benefit, not a right. It is development program 
with goals that are similar to those of the foreign aid program. Both 
programs ought to be governed by the same terrorism standard.
  When it comes to fighting terrorism, our Government needs to speak 
with one voice. We need to make it crystal clear that the benefits of 
American friendship are not provided to countries that, by their 
presence on the terrorist list, have been found to have a consistent 
pattern of state support for terrorism.
  Mr. President, by making the GSP Program conform with the foreign aid 
program when it comes to providing benefits to countries that support 
terrorism, this bill would add an important element of consistency to 
our antiterrorism foreign policy.
  I urge my colleagues to support this bill.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 809

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

     SECTION 1. LIMITATION ON DESIGNATION AS BENEFICIARY 
                   DEVELOPING COUNTRY.

       Section 502(b)(6) of the Trade Act of 1974 (19) U.S.C. 
     2462(b)(6)) is amended to read as follows:
       ``(6) if--
       ``(A) such country aids or abets, by granting sanctuary 
     from prosecution to any individual or group which committed 
     an act of international terrorism, or
       ``(B) the Secretary of State makes a determination with 
     respect to such country under section 6(j)(1)(A) of the 
     Export Administration Act of 1979; and''.
                                 ______

      By Mr. HOLLINGS (for himself and Mr. Thurmond):
  S. 810. A bill to direct the Secretary of the Interior to remove from 
the Coastal Barrier Resources System a tract of land in South Carolina 
that was added to the System without notice to the county in which the 
tract is located, and for other purposes; to the Committee on Commerce, 
Science, and Transportation.

       the coastal barrier resources system fairness act of 1995

  Mr. HOLLINGS. Mr. President, I rise today to introduce the Coastal 
Barrier Resources System Fairness Act of 1995. The bill is aimed at 
correcting a mistake in the Coastal Barrier Resource System. Without 
this correction, a portion of Colleton County, SC, will remain in the 
Coastal Barrier Resources System even though the county never had an 
opportunity to voice their objection to their inclusion.
  In 1980 Congress directed the Secretary of the Interior to study and 
propose a Coastal Barrier Resources System. The aim was to create a 
system made up of relatively undeveloped low-lying coastal lands which, 
because of their susceptibility to flooding, would not be eligible for 
Federal flood insurance. Practically speaking, to be included in the 
CBRS means you can't sell or develop your property.
  Soon after the passage of the 1980 act, the Department of the 
Interior created a study group charged with promulgating an inventory 
of coastal 
[[Page S6752]] properties--properties to be included in the CBRS. By 
the end of 1988, the study group had completed its work and the 
Department of the Interior submitted the CBRS proposal to Congress.
  This proposed inventory was the culmination of 8 years work and 
included suggestions made during two public comment periods. The first 
public comments were made following the release of an initial draft 
inventory in 1985. Additional comments were made following the release 
of a second draft in the spring of 1987. The Department of the Interior 
received numerous comments on these draft inventories and incorporated 
many in their final report to Congress. This final report was the basis 
for the Coastal Barrier Resources System adopted in 1990.
  I recite this history because without an understanding of it, Mr. 
President, one can't understand the intent of my legislation.
  While the Department of the Interior was drafting this proposed 
system, a strip of coastal South Carolina was being annexed by Colleton 
County from Charleston County. Unfortunately, this annexation occurred 
in 1987 in the midst of the 1987 CBRA comment period. Unfortunately, 
the notice of this second draft inventory was not received by Colleton 
County. The county never received any notice. It appears, the draft 
inventory was provided to Charleston County, not Colleton County. In 
fact, the maps currently on file at the Department of the Interior, 
still, incorrectly show this tract in Charleston County--not Colleton 
County. Thus, the citizens of Colleton County, never having had an 
opportunity to comment on these proposed changes, now find this tract 
included in the CBRS. And for all practical purposes off limits for 
development.
  This bill corrects that mistake. It rights that wrong. It does not 
drastically redraft the Coastal Barrier Resources System nor withdraw 
any lands included in the 1985 draft. The bill simply returns a small 
portion of Edisto Island, SC, to its 1985 status.
  I urge my colleagues to support this bill.
  

                          ____________________
```