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(iii) the physical and financial condi-
tion of the project;
(iv) the occupancy profile of the
project, including the income, family size,
race, and ethnic origin of the tenants, and
the rents paid by those tenants;
(v) a description of actions undertaken
pursuant to this section, including a de-
scription of the effectiveness of such actions
and any impediments to the transfer or sale
of the projects;
(vi) a description of the extent to
which the demonstration program has dis-
placed tenants of the project;
(vii) a description of the impact to
which the demonstration program has af-
fected the localities and communities in
which the projects are located; and
(viii) a description of the extent to
which the demonstration program has af-
fected the owners of the projects; and
(B) a description of any of the functions
performed in connection with this section that
are transferred or contracted out to public or
private entities or to State entities.
HR 3666 EAS
Ω42æPage 41, after line 8 insert:
SEC. 213. HAWAIIAN HOME LANDS.—Section 282 of
the Cranston-Gonzalez National Affordable Housing Act (42
U.S.C. 12832) is amended by adding at the end the follow-
ing new sentence: ‘‘The Secretary may waive this section
in connection with the use of funds made available under
this title on lands set aside under the Hawaiian Homes
Commission Act, 1920 (42 Stat. 108).’’.
Ω43æPage 41, after line 8 insert:
SEC. 214. INVOLUNTARY SEPARATIONS.—In order to
avoid or minimize the need for involuntary separations due
to a reduction in force, departmental restructuring, reorga-
nization, transfer of function, or similar action affecting
the Department of Housing and Urban Development, the
Secretary shall establish a program under which separation
pay, subject to the availability of appropriated funds, may
be offered to encourage employees to separate from service
voluntarily, whether by retirement or resignation: Provided,
That payments to individual employees shall not exceed
$25,000: Provided further, That in addition to any other
payments which it is required to make under subchapter
III of chapter 83 or chapter 84 of title 5, United States
Code, HUD shall remit to the Office of Personnel Manage-
ment for deposit in the Treasury of the United States to
the credit of the Civil Service Retirement and Disability
HR 3666 EAS
Fund on amount equal to 15 percent of the final basic pay
of each employee who is covered under subchapter III of
chapter 83 or chapter 84 of title 5 to whom a voluntary
separation incentive has been paid under this paragraph.
Ω44æPage 41, after line 8 insert:
SEC. 215. REQUIREMENT FOR HUD TO MAINTAIN
PUBLIC NOTICE AND COMMENT RULEMAKING.—The Sec-
retary of Housing and Urban Development shall maintain
all current requirements under part 10 of the Department
of Housing and Urban Development’s regulations (24 CFR
part 10) with respect to the Department’s policies and pro-
cedures for the promulgation and issuance of rules, includ-
ing the use of public participation in the rulemaking proc-
ess.
Ω45æPage 41, after line 8 insert:
SEC. 216. COMMUNITY DEVELOPMENT BLOCK GRANTS.
Section 102(a)(6)(D) of the Housing and Community
Development Act of 1974 (42 U.S.C. 5302(a)(6)(D)) is
amended—
(1) in clause (iv), by striking ‘‘or’’ at the end;
(2) in clause (v), by striking the period at the
end and inserting ‘‘; or’’; and
(3) by adding at the end the following new
clause:
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‘‘(vi) has entered into a local cooperation
agreement with a metropolitan city that received
assistance under section 106 because of such clas-
sification, and has elected under paragraph (4)
to have its population included with the popu-
lation of the county for the purposes of qualify-
ing as an urban county, except that to qualify
as an urban county under this clause, the county
must—
‘‘(I) have a combined population of not
less than 210,000, excluding any metropoli-
tan city located in the county that is not re-
linquishing its metropolitan city classifica-
tion, according to the 1990 decennial census
of the Bureau of the Census of the Depart-
ment of Commerce;
‘‘(II) including any metropolitan cities
located in the county, have had a decrease
in population of 10,061 from 1992 to 1994,
according to the estimates of the Bureau of
the Census of the Department of Commerce;
and
‘‘(III) have had a Federal naval instal-
lation that was more than 100 years old
closed by action of the Base Closure and Re-
HR 3666 EAS
alignment Commission appointed for 1993
under the Base Closure and Realignment
Act of 1990, directly resulting in a loss of
employment by more than 7,000 Federal
Government civilian employees and more
than 15,000 active duty military personnel,
which naval installation was located within
1 mile of an enterprise community des-
ignated by the Secretary pursuant to section
1391 of the Internal Revenue Code of 1986,
which enterprise community has a popu-
lation of not less than 20,000, according to
the 1990 decennial census of the Bureau of
the Census of the Department of Com-
merce.’’.
Ω46æPage 41, after line 8 insert:
SEC. 217. FAIR HOUSING AND FREE SPEECH.
None of the amounts made available under this Act
may be used during fiscal year 1997 to investigate or pros-
ecute under the Fair Housing Act any otherwise lawful ac-
tivity engaged in by one or more persons, including the fil-
ing or maintaining of a nonfrivolous legal action, that is
engaged in solely for the purpose of achieving or preventing
action by a government official or entity, or a court of com-
petent jurisdiction.
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Ω47æPage 41, after line 8 insert:
SEC. 218. MORTGAGE INSURANCE.
None of the funds appropriated under this Act may
be used to give final approval to any proposal to provide
mortgage insurance 
having 
a 
value 
in 
excess 
of
$250,000,000 for any project financing for which may be
guaranteed under section 220 of the National Housing Act
(12 U.S.C. 1715k), unless the Secretary has transmitted to
the President pro tempore of the Senate and the Speaker
of the House the Secretary’s justification for such guarantee
and no final approval shall be given until the justification
has laid before the Congress for a period of not less than
30 days.
Ω48æPage 44, line 2, strike out ø$365,000,000¿ and in-
sert: $400,500,000
Ω49æPage 44, line 10, strike out ø$40,000,000¿ and in-
sert: $59,000,000
Ω50æPage 44, line 14, strike out ø$201,000,000¿ and in-
sert: $215,000,000
Ω51æPage 44, line 19, after ‘‘program)’’ insert: , of which
not more than $40,000,000 may be used to administer, re-
imburse or support any national service program author-
ized under section 121(d)(2) of such Act (42 U.S.C.
12581(d)(2))
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Ω52æPage 44, line 20, strike out ø$5,000,000¿ and insert:
$5,500,000
Ω53æPage 45, line 7, strike out ø$17,500,000¿ and insert:
$18,000,000
Ω54æPage 45, line 12, strike out ø$41,500,000¿ and in-
sert: $43,000,000
Ω55æPage 46, lines 21 and 22, strike out ø(increased by
$1,411,000)¿
Ω56æPage 46, line 22, strike out ø$634,000¿ and insert:
$700,000
Ω57æPage 48, lines 3 and 4, strike out ø$540,000,000 (re-
duced by $1,500,000)¿ and insert: $545,000,000
Ω58æPage 
48, 
lines 
and 
22, 
strike 
out
ø$1,703,000,000 (increased by $1,500,000)¿ and insert:
$1,713,000,000
Ω59æPage 49, line 11, strike out ø$107,220,000¿ and in-
sert: $27,220,000
Ω60æPage 49, line 11, strike out all after ‘‘expended’’
down to and including ‘‘limitation’’ in line 24
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Ω61æPage 50, line 9, strike out ø$2,201,200,000¿ and in-
sert: $1,394,245,000 (of which $100,000,000 shall not be-
come available until September 1, 1997)
Ω62æPage 50, line 10, strike out ø$1,951,200,000¿ and
insert: $1,144,245,000
Ω63æPage 50, line 24, strike out ø$59,000,000¿ and in-
sert: $64,000,000
Ω64æPage 51, line 13, strike out all after ‘‘1997’’ down
to and including ‘‘obligation’’ in line 17
Ω65æPage 51, line 17, strike out all after ‘‘obligation’’
down to and including ‘‘Jersey’’ in line 22
Ω66æPage 52, lines 8 and 9, strike out ø$46,500,000 (in-
creased by $20,000,000)¿ and insert: $60,000,000
Ω67æPage 53, line 5, strike out ø$2,768,207,000¿ and in-
sert: $2,815,207,000
Ω68æPage 53, line 6, strike out ø$1,800,000,000¿ and in-
sert: $1,976,000,000
Ω69æPage 53, line 19, after ‘‘address’’ insert: water sup-
ply and
Ω70æPage 53, line 20, strike out all after ‘‘Villages;’’ down
to and including ‘‘Act;’’ in line 24
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Ω71æPage 54, line 7, after ‘‘programs’’ insert: : Provided
further, That notwithstanding any other provision of law,
beginning in fiscal year 1997 the Administrator may make
grants to States, from funds available for obligation in the
State under title II of the Federal Water Pollution Control
Act, as amended, for administering the completion and
closeout of the State’s construction grants program, based
on a budget annually negotiated with the State
Ω72æPage 54, line 8, strike out ø$1,800,000,000¿ and in-
sert: $1,976,000,000
Ω73æPage 54, line 10, strike out ø$450,000,000¿ and in-
sert: $1,275,000,000
Ω74æPage 54, line 11, strike out all after ‘‘funds’’ down
to and including ‘‘amended’’ in line 15
Ω75æPage 54, line 15, after ‘‘amended’’ insert: : Provided
further, That the funds made available in Public Law 103–
327 for a grant to the City of Bangor, Maine, in accordance
with House Report 103–715, shall be available for a grant
to that city for meeting combined sewer overflow require-
ments
Ω76æPage 54, line 15, after ‘‘amended’’ insert: : Provided
further, That, notwithstanding any other provision of law,
a State that did not receive, in fiscal year 1996, grants
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under title VI of the Federal Water Pollution Control Act,
as amended, that obligated all the funds allotted to it from
the $725,000,000 that became available for that purpose on
August 1, 1996, may receive reallotted funds from the fiscal
year 1996 appropriation, provided the State receives such
grants in fiscal year 1997
Ω77æPage 56, strike out lines 3 through 9
Ω78æPage 57, line 2, strike out ø$2,250,000¿ and insert:
$2,436,000
Ω79æPage 57, line 7, strike out ø$1,120,000,000¿ and in-
sert: $1,320,000,000
Ω80æPage 57, line 10, after ‘‘expended’’ insert: : Provided,
That no money appropriated for the Federal Emergency
Management Agency may be expended for the repair of
yacht harbors or golf courses except for debris removal: Pro-
vided further, That no money appropriated for the Federal
Emergency Management Agency may be expended for tree
or shrub replacement except in public parks: Provided fur-
ther, That any funds used for repair of any recreational
facilities shall be limited to debris removal and the repair
of recreational buildings only
Ω81æPage 58, line 12, strike out ø$168,000,000¿ and in-
sert: $166,733,000
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Ω82æPage 58, line 16, strike out ø$4,533,000¿ and insert:
$4,673,000
Ω83æPage 59, line 5, strike out ø$209,101,000¿ and in-
sert: $199,101,000
Ω84æPage 59, line 21, after ‘‘1998.’’ insert: The first sen-
tence of section 1376(c) of the National Flood Insurance Act
of 1968, as amended (42 U.S.C. 4026), is amended by strik-
ing all after ‘‘this subchapter’’ and inserting ‘‘such sums
as may be necessary through September 30, 1997 for studies
under this title.’’.
Ω85æPage 60, line 4, after ‘‘1994.’’ insert: Section 1319
of the National Flood Insurance Act of 1968, as amended
(42 U.S.C. 4026), is amended by striking out September
30, 1996.’’ and inserting ‘‘September 30, 1997.’’.
Ω86æPage 62, strike out lines 18 and 19
Ω87æPage 62, line 23, strike out all after ‘‘Acts’’ over to
and including ‘‘Acts’’ in line 8 on page 63 and insert: :
Provided further, That notwithstanding any other provision
of law, the Consumer Information Center may accept and
deposit to this account, during fiscal year 1997 and here-
after, gifts for the purpose of defraying its costs of printing,
publishing, and distributing consumer information and
educational materials and undertaking other consumer in-
HR 3666 EAS
formation activities; may expend those gifts for those pur-
poses, in addition to amounts appropriated or otherwise
made available; and the balance shall remain available for
expenditure for such purpose
Ω88æPage 64, line 10, strike out ø$5,662,100,000¿ and
insert: $5,762,100,000
Ω89æPage 66, after line 19 insert:
In order to avoid or minimize the need for involuntary
separations due to a reduction in force, installation closure,
reorganization, transfer of function, or similar action af-
fecting the National Aeronautics and Space Administra-
tion, the Administrator shall establish a program under
which separation pay, subject to the availability of appro-
priated funds, may be offered to encourage employees to sep-
arate from service voluntarily, whether by retirement or res-
ignation: Provided, That payments to individual employees
shall not exceed $25,000: Provided further, That in addition
to any other payments which it is required to make under
subchapter III of chapter 83 or chapter 84 of title 5, United
States Code, NASA shall remit to the Office of Personnel
Management for deposit in the Treasury of the United
States to the credit of the Civil Service Retirement and Dis-
ability Fund an amount equal to 15 percent of the final
basic pay of each employee who is covered under subchapter
III of chapter 83 or chapter 84 of title 5 to whom a vol-
HR 3666 EAS
untary separation incentive has been paid under this para-
graph.
Ω90æPage 
67, 
lines 
and 
17, 
strike 
out
ø$2,422,000,000 (increased by $9,110,000)¿ and insert:
$2,432,000,000
Ω91æPage 68, line 20, strike out ø$612,000,000¿ and in-
sert: $624,000,000
Ω92æPage 69, line 13, strike out ø(reduced by
$9,110,000)¿
Ω93æPage 70, line 7, strike out ø$50,000,000¿ and insert:
$49,900,000
Ω94æPage 71, line 4, after ‘‘Provided,’’ insert: That this
provision does not apply to accounts that do not contain
an object classification for travel: Provided further,
Ω95æPage 78, after line 15 insert:
SEC. 421. (a) The purpose of this section is to provide
for the special needs of certain children of Vietnam veterans
who were born with the birth defect spina bifida, possibly
as the result of the exposure of one or both parents to herbi-
cides during active service in the Republic of Vietnam dur-
ing the Vietnam era, through the provision of health care
and monetary benefits.
HR 3666 EAS
(b)(1) Part II of title 38, United States Code, is
amended by inserting after chapter 17 the following new
chapter:
‘‘CHAPTER 18—BENEFITS FOR CHILDREN
OF VIETNAM VETERANS WHO ARE
BORN WITH SPINA BIFIDA
‘‘Sec.
‘‘1801. Definitions.
‘‘1802. Spina bifida conditions covered.
‘‘1803. Health care.
‘‘1804. Vocational training and rehabilitation.
‘‘1805. Monetary allowance.
‘‘1806. Effective date of awards.
‘‘§ 1801. Definitions
‘‘For the purposes of this chapter—
‘‘(1) The term ‘child’, with respect to a Vietnam
veteran, means a natural child of the Vietnam vet-
eran, regardless of age or marital status, who was
conceived after the date on which the veteran first en-
tered the Republic of Vietnam during the Vietnam
era.
‘‘(2) The term ‘Vietnam veteran’ means a vet-
eran who performed active military, naval, or air
service in the Republic of Vietnam during the Viet-
nam era.
‘‘§ 1802. Spina bifida conditions covered
‘‘This chapter applies with respect to all forms and
manifestations of spina bifida except spina bifida occulta.
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‘‘§ 1803. Health care
‘‘(a) In accordance with regulations which the Sec-
retary shall prescribe, the Secretary shall provide a child
of a Vietnam veteran who is suffering from spina bifida
with such health care as the Secretary determines is needed
by the child for the spina bifida or any disability that is
associated with such condition.
‘‘(b) The Secretary may provide health care under this
section directly or by contract or other arrangement with
any health care provider.
‘‘(c) For the purposes of this section—
‘‘(1) The term ‘health care’—
‘‘(A) means home care, hospital care, nurs-
ing home care, outpatient care, preventive care,
habilitative and rehabilitative care, case man-
agement, and respite care; and
‘‘(B) includes—
‘‘(i) the training of appropriate mem-
bers of a child’s family or household in the
care of the child; and
‘‘(ii) the provision of such pharma-
ceuticals, supplies, equipment, devices, ap-
pliances, assistive technology, direct trans-
portation costs to and from approved
sources of health care, and other materials
as the Secretary determines necessary.
HR 3666 EAS
‘‘(2) The term ‘health care provider’ includes
specialized spina bifida clinics, health care plans, in-
surers, organizations, institutions, and any other en-
tity or individual who furnishes health care that the
Secretary determines authorized under this section.
‘‘(3) The term ‘home care’ means outpatient
care, habilitative and rehabilitative care, preventive
health services, and health-related services furnished
to an individual in the individual’s home or other
place of residence.
‘‘(4) The term ‘hospital care’ means care and
treatment for a disability furnished to an individual
who has been admitted to a hospital as a patient.
‘‘(5) The term ‘nursing home care’ means care
and treatment for a disability furnished to an indi-
vidual who has been admitted to a nursing home as
a resident.
‘‘(6) The term ‘outpatient care’ means care and
treatment of a disability, and preventive health serv-
ices, furnished to an individual other than hospital
care or nursing home care.
‘‘(7) The term ‘preventive care’ means care and
treatment furnished to prevent disability or illness,
including periodic examinations, immunizations, pa-
tient health education, and such other services as the
HR 3666 EAS
Secretary determines necessary to provide effective
and economical preventive health care.
‘‘(8) The term ‘habilitative and rehabilitative
care’ means such professional, counseling, and guid-
ance services and treatment programs (other than vo-
cational training under section 1804 of this title) as
are necessary to develop, maintain, or restore, to the
maximum extent practicable, the functioning of a dis-
abled person.
‘‘(9) The term ‘respite care’ means care furnished
on an intermittent basis for a limited period to an
individual who resides primarily in a private resi-
dence when such care will help the individual to con-
tinue residing in such private residence.
‘‘§ 1804. Vocational training and rehabilitation
‘‘(a) Pursuant to such regulations as the Secretary
may prescribe, the Secretary may provide vocational train-
ing under this section to a child of a Vietnam veteran who
is suffering from spina bifida if the Secretary determines
that the achievement of a vocational goal by such child is
reasonably feasible.
‘‘(b) Any program of vocational training for a child
under this section shall be designed in consultation with
the child in order to meet the child’s individual needs and
HR 3666 EAS
shall be set forth in an individualized written plan of voca-
tional rehabilitation.
‘‘(c)(1) A vocational training program for a child
under this section—
‘‘(A) shall consist of such vocationally oriented
services and assistance, including such placement and
post-placement services and personal and work ad-
justment training, as the Secretary determines are
necessary to enable the child to prepare for and par-
ticipate in vocational training or employment; and
‘‘(B) may include a program of education at an
institution of higher education if the Secretary deter-
mines that the program of education is predomi-
nantly vocational in content.
‘‘(2) A vocational training program under this sub-
section may not include the provision of any loan or sub-
sistence allowance or any automobile adaptive equipment.
‘‘(d)(1) Except as provided in paragraph (2) and sub-
ject to subsection (e)(2), a vocational training program
under this section may not exceed 24 months.
‘‘(2) The Secretary may grant an extension of a voca-
tional training program for a child under this section for
up to 24 additional months if the Secretary determines that
the extension is necessary in order for the child to achieve
a vocational goal identified (before the end of the first 24
HR 3666 EAS
‘‘§ 1806. Effective date of awards
‘‘The effective date for an award of benefits under this
chapter shall be fixed in accordance with the facts found,
but shall not be earlier than the date of receipt of applica-
tion for the benefits.’’.
(2) The tables of chapters before part I and at the be-
ginning of part II of such title are each amended by insert-
ing after the item referring to chapter 17 the following new
item:
‘‘18. Benefits for Children of Vietnam Veterans Who Are
Born With Spina Bifida .......................................... 1801’’.
(c) Section 5312 of title 38, United States Code, is
amended—
(1) in subsection (a)—
(A) by striking out ‘‘and the rate of in-
creased pension’’ and inserting in lieu thereof ‘‘,
the rate of increased pension’’; and
(B) by inserting after ‘‘on account of chil-
dren,’’ the following: ‘‘and each rate of monthly
allowance paid under section 1805 of this title,’’;
and
(2) in subsection (c)(1), by striking out ‘‘and
1542’’ and inserting in lieu thereof ‘‘1542, and 1805’’.
(d) This section and the amendments made by this sec-
tion shall take effect on January 1, 1997.
HR 3666 EAS
SEC. 422. (a) Section 1151 of title 38, United States
Code, is amended—
(1) by striking out the first sentence and insert-
ing in lieu thereof the following:
‘‘(a) Compensation under this chapter and dependency
and indemnity compensation under chapter 13 of this title
shall be awarded for a qualifying additional disability or
a qualifying death of a veteran in the same manner as if
such additional disability or death were service-connected.
For purposes of this section, a disability or death is a quali-
fying additional disability or qualifying death if the dis-
ability or death was not the result of the veteran’s willful
misconduct and—
‘‘(1) the disability or death was caused by hos-
pital care, medical or surgical treatment, or examina-
tion furnished the veteran under any law adminis-
tered by the Secretary, either by a Department em-
ployee or in a Department facility as defined in sec-
tion 1701(3)(A) of this title, and the proximate cause
of the disability or death was—
‘‘(A) carelessness, negligence, lack of proper
skill, error in judgment, or similar instance of
fault on the part of the Department in furnish-
ing the hospital care, medical or surgical treat-
ment, or examination; or
HR 3666 EAS
‘‘(B) an event not reasonably foreseeable; or
‘‘(2) the disability or death was proximately
caused by the provision of training and rehabilitation
services by the Secretary (including by a service-pro-
vider used by the Secretary for such purpose under
section 3115 of this title) as part of an approved re-
habilitation program under chapter 31 of this title.’’;
and
(2) in the second sentence—
(A) by redesignating that sentence as sub-
section (b);
(B) by striking out ‘‘, aggravation,’’ both
places it appears; and
(C) by striking out ‘‘sentence’’ and sub-
stituting in lieu thereof ‘‘subsection’’.
(b)(1) The amendments made by subsection (a) shall
take effect on October 1, 1996.
(2) Section 1151 of title 38, United States Code (as
amended by subsection (a)), shall govern all administrative
and judicial determinations of eligibility for benefits under
such section that are made with respect to claims filed on
or after the effective date set forth in paragraph (1), includ-
ing those based on original applications and applications
seeking to reopen, revise, reconsider, or otherwise readju-
dicate on any basis claims for benefits under such section
HR 3666 EAS
1151 or any provision of law that is a predecessor of such
section.
Ω96æPage 78, strike out lines 16 through 25
Ω97æPage 79, strike out lines 1 through 5
Ω98æPage 79, strike out all after line 5, over to and in-
cluding line 9 on page 80
Ω99æPage 80, strike out all after line 9, over to and in-
cluding line 14 on page 81
Ω100æPage 81, strike out all after line 14, over to and
including line 4 on page 82
Ω101æPage 82, strike out lines 5 through 17
Ω102æPage 82, strike out all after line 17, over to and
including line 4 on page 83
Ω103æPage 83, strike out lines 5 through 16
Ω104æPage 83, strike out lines 17 through 22
Ω105æPage 85, strike out lines 18 through 20 and insert:
SEC. 432. CALCULATION OF DOWNPAYMENT.
Section 203(b) of the National Housing Act (12 U.S.C.
1709(b)) is amended by adding at the end the following new
paragraph:
‘‘(10) ALASKA AND HAWAII.—
HR 3666 EAS
‘‘(A) IN
GENERAL.—Notwithstanding any
other provision of this subsection, with respect to
a mortgage originated in the State of Alaska or
the State of Hawaii, involve a principal obliga-
tion not in excess of the sum of—
‘‘(i) the amount of the mortgage insur-
ance premium paid at the time the mort-
gage is insured; and
‘‘(ii)(I) in the case of a mortgage for a
property with an appraised value equal to
or less than $50,000, 98.75 percent of the
appraised value of the property;
‘‘(II) in the case of a mortgage for a
property with an appraised value in excess
of $50,000 but not in excess of $125,000,
97.65 percent of the appraised value of the
property;
‘‘(III) in the case of a mortgage for a
property with an appraised value in excess
of $125,000, 97.15 percent of the appraised
value of the property; or
‘‘(IV) notwithstanding subclauses (II)
and (III), in the case of a mortgage for a
property with an appraised value in excess
of $50,000 that is located in an area of the
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State for which the average closing cost ex-
ceeds 2.10 percent of the average, for the
State, of the sale price of properties located
in the State for which mortgages have been
executed, 97.75 percent of the appraised
value of the property.
‘‘(B) AVERAGE
CLOSING
COST.—For pur-
poses of this paragraph, the term ‘average closing
cost’ means, with respect to a State, the average,
for mortgages executed for properties that are lo-
cated within the State, of the total amounts (as
determined by the Secretary) of initial service
charges, appraisal, inspection, and other fees (as
the Secretary shall approve) that are paid in
connection with such mortgages.’’.
SEC. 433. DELEGATION OF SINGLE FAMILY MORTGAGE
INSURING AUTHORITY TO DIRECT ENDORSEMENT MORTGA-
GEES.—Title II of the National Housing Act (12 U.S.C.
1707 et seq.) is amended by adding at the end the following
new section:
‘‘DELEGATION OF INSURING AUTHORITY TO DIRECT
ENDORSEMENT MORTGAGEES
‘‘SEC. 256.(a) AUTHORITY.—The Secretary may dele-
gate, to one or more mortgages approved by the Secretary
under the direct endorsement program, the authority of the
Secretary under this Act to insure mortgages involving
HR 3666 EAS
property upon which there is located a dwelling designed
principally for occupancy by 1 to 4 families.
‘‘(b) CONSIDERATIONS.—In determining whether to
delegate authority to a mortgagee under this section, the
Secretary shall consider the experience and performance of
the mortgagee compared to the default rate of all insured
mortgages in comparable markets, and such other factors
as the Secretary determines appropriate to minimize risk
of loss to the insurance funds under this Act.
‘‘(c) ENFORCEMENT OF INSURANCE REQUIREMENTS.—
‘‘(1) IN GENERAL.—If the Secretary determines
that a mortgage insured by a mortgagee pursuant to
delegation of authority under this section was not
originated in accordance with the requirements estab-
lished by the Secretary, and the Secretary pays an in-
surance claim with respect to the mortgage within a
reasonable period specified by the Secretary, the Sec-
retary may require the mortgagee approved under
this section to indemnify the Secretary for the loss.
‘‘(2) FRAUD OR MISREPRESENTATION.—If fraud
or misrepresentation was involved in connection with
the origination, the Secretary may require the mort-
gagee approved under this section to indemnify the
Secretary for the loss regardless of when an insurance
claim is paid.
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‘‘(d) TERMINATION OF MORTGAGEE’S AUTHORITY.—If
a mortgagee to which the Secretary has made a delegation
under this section violates the requirements and procedures
established by the Secretary or the Secretary determines
that other good cause exists, the Secretary may cancel a
delegation of authority under this section to the mortgagee
by giving notice to the mortgagee. Such a cancellation shall
be effective upon receipt of the notice by the mortgagee or
at a later date specified by the Secretary. A decision by
the Secretary to cancel a delegation shall be final and con-
clusive and shall not be subject to judicial review.
‘‘(e) REQUIREMENTS AND PROCEDURES.—Before ap-
proving a delegation under this section, the Secretary shall
issue regulations establishing appropriate requirements and
procedures, including requirements and procedures govern-
ing the indemnification of the Secretary by the Mortgagee.’’.
Ω106æPage 85, strike out lines 21 through 24
Ω107æPage 85, after line 24 insert:
SEC. 434. SENSE OF THE SENATE WITH REGARD TO COMPLI-
ANCE WITH INTERNATIONAL OBLIGATIONS.
(a) FINDINGS.—Congress finds that—
(1) in response to a dispute settlement finding
against the United States by the World Trade Orga-
nization, the United States informed the World Trade
Organization on June 19, 1996, that the United
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States intends to meet its international obligations to
the World Trade Organization with respect to the En-
vironmental Protection Agency’s requirements on im-
ported reformulated and conventional gasoline;
(2) the Environmental Protection Agency has
initiated an open process to examine any and all op-
tions for compliance with international obligations of
the United States in which a key criterion will be
fully protecting public health and the environment;
and
(3) many United States environmental and in-
dustrial organizations are concerned about the ‘‘Regu-
lation of Fuels and Fuel Additives: Individual For-
eign Refinery Baseline Requirements for Reformu-
lated Gasoline’’ proposed on May 3, 1994 (59 Fed.
Reg. 84).
(b) SENSE OF THE SENATE.—It is the sense of the Sen-
ate that, in evaluating any option for compliance with
international obligations, the Administrator of the Envi-
ronmental Protection Agency should—
(1) take fully into account the protection of pub-
lic health and the environment and the international
obligations of the United States as a member of the
World Trade Organization;
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(2) ensure that the compliance review process not
result in the degradation of the gasoline quality re-
quired by the Clean Air Act (42 U.S.C. 7401 et seq.)
with respect to conventional and reformulated gaso-
line;
(3) not recognize individual foreign refiner base-
lines unless the Administrator determines that the is-
sues of auditing, inspection of foreign facilities, and
enforcement have been adequately addressed; and
(4) provide a full and open administrative proc-
ess in the formulation of any final rule.
Ω108æPage 85, after line 24 insert:
SEC. 435. IMPLEMENTATION OF COMPREHENSIVE CON-
SERVATION AND MANAGEMENT PLANS.
Notwithstanding section 320(g) of the Federal Water
Pollution Control Act (33 U.S.C. 1330(g)), funds made
available pursuant to authorization under such section for
fiscal year 1997 and prior fiscal years may be used for im-
plementing comprehensive conservation and management
plans.
Ω109æPage 85, after line 24 insert:
SEC. 436. (a) PLAN.—(1) The Secretary of Veterans
Affairs shall develop a plan for the allocation of health care
resources (including personnel and funds) of the Depart-
ment of Veterans Affairs among the health care Networks
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of the Department so as to ensure that veterans who have
similar economic status and eligibility priority and who
are eligible for medical care have similar access to such care
regardless of the region of the United States in which such
veterans reside.
(2) The plan shall—
(A) reflect, to the maximum extent possible, the
Veterans Integrated Service Network developed by the
Department to account for forecasts in expected work-
load and to ensure fairness to facilities that provide
cost-efficient health care; and
(B) include—
(i) procedures to identify reasons for vari-
ations in operating costs among similar facilities
where Network allocations are based on similar
unit costs for similar services and workload;
(ii) ways to improve the allocation of re-
sources so as to promote efficient use of resources
and provision of quality health care;
(iii) adjustments to unit costs in subsection
(a) to reflect factors which directly influence the
cost of health care delivery within each Network
and where such factors are not under the control
of Network or Department management; and
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(iv) include forecasts in expected workload
and consideration of the demand for VA health
care that may not be reflected in current work-
load projections.
(3) The Secretary shall prepare the plan in consulta-
tion with the Under Secretary of Health of the Department
of Veterans Affairs.
(b) PLAN ELEMENTS.—The plan under subsection (a)
shall set forth—
(1) milestones for achieving the goal referred to
in paragraph (1) of that subsection; and
(2) a means of evaluating the success of the Sec-
retary in meeting the goal.
(c) SUBMITTAL TO CONGRESS.—The Secretary shall
submit to Congress the plan developed under subsection (a)
not later than 180 days after the date of the enactment of
this Act.
(d) IMPLEMENTATION.—The Secretary shall imple-
ment the plan developed under subsection (a) not later than
60 days after submitting the plan to Congress under sub-
section (c), unless within that time the Secretary notifies
Congress that the plan will not be implemented in that time
and includes with the notification an explanation why the
plan will not be implemented in that time.
Ω110æPage 85, after line 24 insert:
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SEC. 437. GAO AUDIT ON STAFFING AND CONTRACT-
ING.—The Comptroller General shall audit the operations
of the Office of Federal Housing Enterprise Oversight con-
cerning staff organization, expertise, capacity, and con-
tracting authority to ensure that the office resources and
contract authority are adequate and that they are being
used appropriately to ensure that the Federal National
Mortgage Association and the Federal Home Loan Mortgage
Corporation are adequately capitalized and operating safe-
ly.
Ω111æPage 85, after line 24 insert:
SEC. 438. None of the funds appropriated or otherwise
made available to the National Aeronautics and Space Ad-
ministration by this Act, or any other Act enacted before
the date of the enactment of this Act, may be used by the
Administrator of the National Aeronautics and Space Ad-
ministration to relocate aircraft of the National Aero-
nautics and Space Administration to Dryden Flight Re-
search Center, California, for purposes of the consolidation
of such aircraft.
Ω112æPage 85, after line 24 insert:
SEC. 439. REVISION
OF NAME
OF JAPAN–UNITED
STATES FRIENDSHIP COMMISSION.—(1)(A) The first sen-
tence of section 4(a) of the Japan–United States Friendship
Act (22 U.S.C. 2903(a)) is amended by striking out
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‘‘Japan–United States Friendship Commission’’ and in-
serting in lieu thereof ‘‘United States–Japan Commission’’.
(B) The section heading of such section is amended to
read as follows:
‘‘UNITED STATES–JAPAN COMMISSION’’.
(2) Subsection (c) of section 3 of that Act (22 U.S.C.
2902) is amended by striking out ‘‘Japan–United States
Friendship Commission’’ and inserting in lieu thereof
‘‘United States–Japan Commission’’.
(3) Any reference to the Japan–United States Friend-
ship Commission in any Federal law, Executive order, reg-
ulation, delegation of authority, or other document shall be
deemed to refer to the United States–Japan Commission.
Ω113æPage 85, after line 24 insert:
SEC. 440. (a) Subject to the concurrence of the Admin-
istrator of the General Services Administration (GSA) and
notwithstanding section 707 of Public Law 103–433, the
Administrator of the National Aeronautics and Space Ad-
ministration may convey to the city of Downey, California,
all right, title, and interest of the United States in and to
a parcel of real property, including improvements thereon,
consisting of approximately 60 acres and known as Parcels
III, IV, V, and VI of the NASA Industrial Plant, Downey,
California.
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(b)(1) DELAY IN PAYMENT OF CONSIDERATION.—After
the end of the 20-year period beginning on the date on
which the conveyance under subsection (a) is completed, the
City of Downey shall pay to the United States an amount
equal to fair market value of the conveyed property as of
the date of the conveyance from NASA.
(2) EFFECT OF RECONVEYANCE BY THE CITY.—If the
City of Downey reconveys all or any part of the conveyed
property during such 20-year period, the City shall pay to
the United States an amount equal to the fair market value
of the reconveyed property as of the time of the reconvey-
ance, excluding the value of any improvements made to the
property by the City.
(3) DETERMINATION OF FAIR MARKET VALUE.—The
Administrator of NASA shall determine fair market value
in accordance with Federal appraisal standards and proce-
dures.
(4) TREATMENT OF LEASES.—The Administrator of
NASA may treat a lease of the property within such 20-
year period as a reconveyance if the Administrator deter-
mines that the lease is being used to avoid application of
paragraph (b)(2).
(5) DEPOSIT OF PROCEEDS.—The Administrator of
NASA shall deposit any proceeds received under this sub-
section in the special account established pursuant to sec-
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tion 204(h)(2) of the Federal Property and Administrative
Services Act of 1949 (40 U.S.C. 485(h)(2)).
(c) The exact acreage and legal description of the real
property to be conveyed under subsection (a) shall be deter-
mined by a survey satisfactory to the Administrator. The
cost of the survey shall be borne by the City of Downey,
California.
(d) The Administrator may require such additional
terms and conditions in connection with the conveyance
under subsection (a) as the Administrator considers appro-
priate to protect the interests of the United States.
(e) If the City at any time after the conveyance of the
property under subsection (a) notifies the Administrator
that the City no longer wishes to retain the property, it
may convey the property under the terms of subsection (b),
or, it may revert all right, title, and interest in and to the
property (including any facilities, equipment, or fixtures
conveyed, but excluding the value of any improvements
made to the property by the City) to the United States, and
the United States shall have the right of immediate entry
onto the property.
Ω114æPage 85, after line 24 insert:
TITLE V
SUPPLEMENTAL
Ω115æPage 85, after line 24 insert:
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DEPARTMENT OF VETERANS AFFAIRS
VETERANS BENEFITS ADMINISTRATION
COMPENSATION AND PENSIONS
For an additional amount for ‘‘Compensation and
Pensions’’, $100,000,000, to be made available upon enact-
ment of this Act, to remain available until expended.
Ω116æPage 85, after line 24 insert:
DEPARTMENT OF HOUSING AND URBAN
DEVELOPMENT
GOVERNMENT NATIONAL MORTGAGE ASSOCIATION
GUARANTEES OF MORTGAGE BACKED SECURITIES LOAN
GUARANTEE PROGRAM ACCOUNT
During fiscal year 1996 and in addition to commit-
ments previously provided, additional commitments to issue
guarantees to carry out section 306 of the National Housing
Act, as amended (12 U.S.C. 1721(g)), shall not exceed
$20,000,000,000.
Ω117æPage 85, after line 24 insert:
TITLE 
VI—NEWBORNS’ 
AND
MOTHERS’ HEALTH PROTEC-
TION ACT OF 1996
SEC. 601. SHORT TITLE.
This title may be cited as the ‘‘Newborns’ and Mothers’
Health Protection Act of 1996’’.
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SEC. 602. FINDINGS.
Congress finds that—
(1) the length of post-delivery inpatient care
should be based on the unique characteristics of each
mother and her newborn child, taking into consider-
ation the health of the mother, the health and stability
of the newborn, the ability and confidence of the
mother and father to care for the newborn, the ade-
quacy of support systems at home, and the access of
the mother and newborn to appropriate follow-up
health care; and
(2) the timing of the discharge of a mother and
her newborn child from the hospital should be made
by the attending provider in consultation with the
mother.
SEC. 603. REQUIRED COVERAGE FOR MINIMUM HOSPITAL
STAY FOLLOWING BIRTH.
(a) IN GENERAL.—Except as provided in subsection
(b), a health plan or an employee health benefit plan that
provides maternity benefits, including benefits for child-
birth, shall ensure that coverage is provided with respect
to a mother who is a participant, beneficiary, or policy-
holder under such plan and her newborn child for a mini-
mum of 48 hours of inpatient length of stay following a
normal vaginal delivery, and a minimum of 96 hours of
inpatient length of stay following a caesarean section, with-
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out requiring the attending provider to obtain authoriza-
tion from the health plan or employee health benefit plan.
(b) EXCEPTION.—Notwithstanding subsection (a), a
health plan or an employee health benefit plan shall not
be required to provide coverage for post-delivery inpatient
length of stay for a mother who is a participant, bene-
ficiary, or policyholder under such plan and her newborn
child for the period referred to in subsection (a) if—
(1) a decision to discharge the mother and her
newborn child prior to the expiration of such period
is made by the attending provider in consultation
with the mother; and
(2) the health plan or employee health benefit
plan provides coverage for post-delivery follow-up care
as described in section 604.
SEC. 604. POST-DELIVERY FOLLOW-UP CARE.
(a) IN GENERAL.—
(1) GENERAL RULE.—In the case of a decision to
discharge a mother and her newborn child from the
inpatient setting prior to the expiration of 48 hours
following a normal vaginal delivery or 96 hours fol-
lowing a caesarean section, the health plan or em-
ployee health benefit plan shall provide coverage for
timely post-delivery care. Such health care shall be
provided to a mother and her newborn child by a reg-
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istered nurse, physician, nurse practitioner, nurse
midwife or physician assistant experienced in mater-
nal and child health in—
(A) the home, a provider’s office, a hospital,
a birthing center, an intermediate care facility,
a federally qualified health center, a federally
qualified rural health clinic, or a State health
department maternity clinic; or
(B) another setting determined appropriate
under regulations promulgated by the Secretary,
in consultation with the Secretary of Health and
Human Services.
The attending provider in consultation with the
mother shall decide the most appropriate location for
follow-up care.
(2) CONSIDERATIONS BY SECRETARY.—In pro-
mulgating regulations under paragraph (1)(B), the
Secretary shall consider telemedicine and other inno-
vative means to provide follow-up care and shall con-
sider care in both urban and rural settings.
(b) TIMELY CARE.—As used in subsection (a), the term
‘‘timely post-delivery care’’ means health care that is pro-
vided—
(1) following the discharge of a mother and her
newborn child from the inpatient setting; and
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(2) in a manner that meets the health care needs
of the mother and her newborn child, that provides for
the appropriate monitoring of the conditions of the
mother and child, and that occurs not later than the
72-hour period immediately following discharge.
(c) CONSISTENCY WITH STATE LAW.—The Secretary
shall, with respect to regulations promulgated under sub-
section (a) concerning appropriate post-delivery care set-
tings, ensure that, to the extent practicable, such regulations
are consistent with State licensing and practice laws.
SEC. 605. PROHIBITIONS.
In implementing the requirements of this title, a health
plan or an employee health benefit plan may not—
(1) deny enrollment, renewal, or continued cov-
erage to a mother and her newborn child who are
participants, beneficiaries or policyholders based on
compliance with this title;
(2) provide monetary payments or rebates to
mothers to encourage such mothers to request less than
the minimum coverage required under this title;
(3) penalize or otherwise reduce or limit the re-
imbursement of an attending provider because such
provider provided treatment to an individual patient
in accordance with this title; or
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(4) provide incentives (monetary or otherwise) to
an attending provider to induce such provider to pro-
vide treatment to an individual policyholder, partici-
pant, or beneficiary in a manner inconsistent with
this title.
SEC. 606. NOTICE.
(a) EMPLOYEE HEALTH BENEFIT PLAN.—An em-
ployee health benefit plan shall provide conspicuous notice
to each participant regarding coverage required under this
Act not later than 120 days after the date of enactment
of this title, and as part of its summary plan description.
(b) HEALTH PLAN.—A health plan shall provide notice
to each policyholder regarding coverage required under this
title. Such notice shall be in writing, prominently posi-
tioned, and be transmitted—
(1) in a mailing made within 120 days of the
date of enactment of this title by such plan to the pol-
icyholder; and
(2) as part of the annual informational packet
sent to the policyholder.
SEC. 607. APPLICABILITY.
(a) CONSTRUCTION.—
(1) IN GENERAL.—A requirement or standard
imposed under this title on a health plan shall be
deemed to be a requirement or standard imposed on
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the health plan issuer. Such requirements or stand-
ards shall be enforced by the State insurance commis-
sioner for the State involved or the official or officials
designated by the State to enforce the requirements of
this title. In the case of a health plan offered by a
health plan issuer in connection with an employee
health benefit plan, the requirements or standards im-
posed under this title shall be enforced with respect to
the health plan issuer by the State insurance commis-
sioner for the State involved or the official or officials
designated by the State to enforce the requirements of
this title.
(2) LIMITATION.—Except as provided in section
608(c), the Secretary shall not enforce the require-
ments or standards of this title as they relate to
health plan issuers or health plans. In no case shall
a State enforce the requirements or standards of this
title as they relate to employee health benefit plans.
(b) ERISA.—Nothing in this title shall be construed
to affect or modify the provisions of section 514 of the Em-
ployee Retirement Income Security Act of 1974 (29 U.S.C.
1144).
(c) EFFECT ON MOTHER.—Nothing in this title shall
be construed to require that a mother who is a participant,
beneficiary, or policyholder covered under this title—
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(1) give birth in a hospital; or
(2) stay in the hospital for a fixed period of time
following the birth of her child.
(d) LEVEL AND TYPE OF REIMBURSEMENTS.—Nothing
in this title shall be construed to prevent a health plan or
an employee health benefit plan from negotiating the level
and type of reimbursement with an attending provider for
care provided in accordance with this title.
SEC. 608. ENFORCEMENT.
(a) HEALTH PLAN ISSUERS.—Each State shall require
that each health plan issued, sold, renewed, offered for sale
or operated in such State by a health plan issuer meet the
standards established under this title. A State shall submit
such information as required by the Secretary demonstrat-
ing effective implementation of the requirements of this
title.
(b) EMPLOYEE HEALTH BENEFIT PLANS.—With re-
spect to employee health benefit plans, the standards estab-
lished under this title shall be enforced in the same manner
as provided for under sections 502, 504, 506, and 510 of
the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1132, 1134, 1136, and 1140). The civil penalties
contained in paragraphs (1) and (2) of section 502(c) of
such Act (29 U.S.C. 1132(c)(1) and (2)) shall apply to any
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information required by the Secretary to be disclosed and
reported under this section.
(c) FAILURE TO ENFORCE.—In the case of the failure
of a State to substantially enforce the standards and re-
quirements set forth in this title with respect to health
plans, the Secretary, in consultation with the Secretary of
Health and Human Services, shall enforce the standards
of this title in such State. In the case of a State that fails
to substantially enforce the standards set forth in this title,
each health plan issuer operating in such State shall be sub-
ject to civil enforcement as provided for under sections 502,
504, 506, and 510 of the Employee Retirement Income Se-
curity Act of 1974 (29 U.S.C. 1132, 1134, 1136, and 1140).
The civil penalties contained in paragraphs (1) and (2) of
section 502(c) of such Act (29 U.S.C. 1132(c)(1) and (2))
shall apply to any information required by the Secretary
to be disclosed and reported under this section.
(d) REGULATIONS.—The Secretary, in consultation
with the Secretary of Health and Human Services, may
promulgate such regulations as may be necessary or appro-
priate to carry out this title.
SEC. 609. DEFINITIONS.
As used in this title:
(1) ATTENDING PROVIDER.—The term ‘‘attend-
ing provider’’ shall include—
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(A) the obstetrician-gynecologists, pediatri-
cians, family physicians, and other physicians
primarily responsible for the care of a mother
and newborn; and
(B) the nurse midwives and nurse practi-
tioners primarily responsible for the care of a
mother and her newborn child in accordance
with State licensure and certification laws.
(2) BENEFICIARY.—The term ‘‘beneficiary’’ has
the meaning given such term under section 3(8) of the
Employee Retirement Income Security Act of 1974
(29 U.S.C. 1002(8)).
(3) EMPLOYEE HEALTH BENEFIT PLAN.—
(A) IN
GENERAL.—The term ‘‘employee
health benefit plan’’ means any employee welfare
benefit plan, governmental plan, or church plan
(as defined under paragraphs (1), (32), and (33)
of section 3 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1002 (1), (32),
and (33))) that provides or pays for health bene-
fits (such as provider and hospital benefits) for
participants and beneficiaries whether—
(i) directly;
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(ii) through a health plan offered by a
health plan issuer as defined in paragraph
(4); or
(iii) otherwise.
(B) RULE
OF
CONSTRUCTION.—An em-
ployee health benefit plan shall not be construed
to be a health plan or a health plan issuer.
(C) ARRANGEMENTS NOT INCLUDED.—Such
term does not include the following, or any com-
bination thereof:
(i) Coverage only for accident, or dis-
ability income insurance, or any combina-
tion thereof.
(ii) Medicare supplemental health in-
surance 
(as 
defined 
under 
section
1882(g)(1) of the Social Security Act).
(iii) Coverage issued as a supplement
to liability insurance.
(iv) Liability insurance, including
general liability insurance and automobile
liability insurance.
(v) Workers compensation or similar
insurance.
(vi) Automobile medical payment in-
surance.
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(vii) Coverage for a specified disease or
illness.
(viii) Hospital or fixed indemnity in-
surance.
(ix) Short-term limited duration insur-
ance.
(x) Credit-only, dental-only, or vision-
only insurance.
(xi) A health insurance policy provid-
ing benefits only for long-term care, nursing
home care, home health care, community-
based care, or any combination thereof.
(4) GROUP PURCHASER.—The term ‘‘group pur-
chaser’’ means any person (as defined under para-
graph (9) of section 3 of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1002(9)) or en-
tity that purchases or pays for health benefits (such
as provider or hospital benefits) on behalf of partici-
pants or beneficiaries in connection with an employee
health benefit plan.
(5) HEALTH PLAN.—
(A) IN GENERAL.—The term ‘‘health plan’’
means any group health plan or individual
health plan.
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(B) GROUP
HEALTH
PLAN.—The term
‘‘group health plan’’ means any contract, policy,
certificate or other arrangement offered by a
health plan issuer to a group purchaser that pro-
vides or pays for health benefits (such as pro-
vider and hospital benefits) in connection with
an employee health benefit plan.
(C) INDIVIDUAL HEALTH PLAN.—The term
‘‘individual health plan’’ means any contract,
policy, certificate or other arrangement offered to
individuals by a health plan issuer that provides
or pays for health benefits (such as provider and
hospital benefits) and that is not a group health
plan.
(D) ARRANGEMENTS NOT INCLUDED.—Such
term does not include the following, or any com-
bination thereof:
(i) Coverage only for accident, or dis-
ability income insurance, or any combina-
tion thereof.
(ii) Medicare supplemental health in-
surance 
(as 
defined 
under 
section
1882(g)(1) of the Social Security Act).
(iii) Coverage issued as a supplement
to liability insurance.
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(iv) Liability insurance, including
general liability insurance and automobile
liability insurance.
(v) Workers compensation or similar
insurance.
(vi) Automobile medical payment in-
surance.
(vii) Coverage for a specified disease or
illness.
(viii) Hospital or fixed indemnity in-
surance.
(ix) Short-term limited duration insur-
ance.
(x) Credit-only, dental-only, or vision-
only insurance.
(xi) A health insurance policy provid-
ing benefits only for long-term care, nursing
home care, home health care, community-
based care, or any combination thereof.
(E) CERTAIN PLANS INCLUDED.—Such term
includes any plan or arrangement not described
in any clause of subparagraph (D) which pro-
vides for benefit payments, on a periodic basis,
for—
(i) a specified disease or illness, or
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(ii) a period of hospitalization,
without regard to the costs incurred or services
rendered during the period to which the pay-
ments relate.
(6) HEALTH PLAN ISSUER.—The term ‘‘health
plan issuer’’ means any entity that is licensed (prior
to or after the date of enactment of this title) by a
State to offer a health plan.
(7) PARTICIPANT.—The term ‘‘participant’’ has
the meaning given such term under section 3(7) of the
Employee Retirement Income Security Act of 1974
(29 U.S.C. 1002(7)).
(8) SECRETARY.—The term ‘‘Secretary’’ unless
otherwise specified means the Secretary of Labor.
SEC. 610. PREEMPTION.
(a) IN GENERAL.—The provisions of sections 603, 605,
and 606 relating to inpatient care shall not preempt a State
law or regulation—
(1) that provides greater protections to patients
or policyholders than those required in this title;
(2) that requires health plans to provide coverage
for at least 48 hours of inpatient length of stay fol-
lowing a normal vaginal delivery, and at least 96
hours of inpatient length of stay following a caesar-
ean section;
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(3) that requires health plans to provide coverage
for maternity and pediatric care in accordance with
guidelines established by the American College of Ob-
stetricians and Gynecologists, the American Academy
of Pediatrics, or other established professional medical
associations; or
(4) that leaves decisions regarding appropriate
length of stay entirely to the attending provider, in
consultation with the mother.
(b) FOLLOW-UP CARE.—The provisions of section 604
relating to follow-up care shall not preempt those provisions
of State law or regulation that provide comparable or great-
er protection to patients or policyholders than those re-
quired under this title or that provide mothers and
newborns with an option of timely post delivery follow-up
care (as defined in section 604(b)) in the home.
(c) EMPLOYEE HEALTH BENEFIT PLANS.—Nothing in
this section affects the application of this title to employee
health benefit plans, as defined in section 609(3).
SEC. 611. REPORTS TO CONGRESS CONCERNING CHILD-
BIRTH.
(a) FINDINGS.—Congress finds that—
(1) childbirth is one part of a continuum of ex-
perience that includes prepregnancy, pregnancy and
prenatal care, labor and delivery, the immediate
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postpartum period, and a longer period of adjustment
for the newborn, the mother, and the family;
(2) health care practices across this continuum
are changing in response to health care financing and
delivery system changes, science and clinical research,
and patient preferences; and
(3) there is a need to—
(A) examine the issues and consequences as-
sociated with the length of hospital stays follow-
ing childbirth;
(B) examine the follow-up practices for
mothers and newborns used in conjunction with
shorter hospital stays;
(C) identify appropriate health care prac-
tices and procedures with regard to the hospital
discharge of newborns and mothers;
(D) examine the extent to which such care
is affected by family and environmental factors;
and
(E) examine the content of care during hos-
pital stays following childbirth.
(b) ADVISORY PANEL.—
(1) IN GENERAL.—Not later than 90 days after
the date of enactment of this title, the Secretary of
Health and Human Services shall establish an advi-
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sory panel (hereafter referred to in this section as the
‘‘advisory panel’’) to—
(A) guide and review methods, procedures,
and data collection necessary to conduct the
study described in subsection (c) that is intended
to enhance the quality, safety, and effectiveness
of health care services provided to mothers and
newborns;
(B) develop a consensus among the members
of the advisory panel regarding the appropriate-
ness of the specific requirements of this title; and
(C) prepare and submit to the Secretary of
Health and Human Services, as part of the re-
port of the Secretary submitted under subsection
(d), a report summarizing the consensus devel-
oped under subparagraph (B) if any, including
the reasons for not reaching such a consensus.
(2) PARTICIPATION.—
(A) DEPARTMENT REPRESENTATIVES.—The
Secretary of Health and Human Services shall
ensure that representatives from within the De-
partment of Health and Human Services that
have expertise in the area of maternal and child
health or in outcomes research are appointed to
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the advisory panel established under paragraph
(1).
(B) REPRESENTATIVES OF PUBLIC AND PRI-
VATE SECTOR ENTITIES.—
(i) IN
GENERAL.—The Secretary of
Health and Human Services shall ensure
that members of the advisory panel include
representatives of public and private sector
entities having knowledge or experience in
one or more of the following areas:
(I) Patient care.
(II) Patient education.
(III) Quality assurance.
(IV) Outcomes research.
(V) Consumer issues.
(ii) REQUIREMENT.—The panel shall
include representatives from each of the fol-
lowing categories:
(I) Health care practitioners.
(II) Health plans.
(III) Hospitals.
(IV) Employers.
(V) States.
(VI) Consumers.
(c) STUDIES.—
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(1) IN GENERAL.—The Secretary of Health and
Human Services shall conduct a study of—
(A) the factors affecting the continuum of
care with respect to maternal and child health
care, including outcomes following childbirth;
(B) the factors determining the length of
hospital stay following childbirth;
(C) the diversity of negative or positive out-
comes affecting mothers, infants, and families;
(D) the manner in which post natal care
has changed over time and the manner in which
that care has adapted or related to changes in
the length of hospital stay, taking into account—
(i) the types of post natal care avail-
able and the extent to which such care is
accessed; and
(ii) the challenges associated with pro-
viding post natal care to all populations,
including vulnerable populations, and solu-
tions for overcoming these challenges; and
(E) the financial incentives that may—
(i) impact the health of newborns and
mothers; and
(ii) influence the clinical decisionmak-
ing of health care providers.
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(2) RESOURCES.—The Secretary of Health and
Human Services shall provide to the advisory panel
the resources necessary to carry out the duties of the
advisory panel.
(d) REPORTS.—
(1) IN GENERAL.—The Secretary of Health and
Human Services shall prepare and submit to the
Committee on Labor and Human Resources of the
Senate and the Committee on Commerce of the House
of Representatives a report that contains—
(A) a summary of the study conducted
under subsection (c);
(B) a summary of the best practices used in
the public and private sectors for the care of
newborns and mothers;
(C) recommendations for improvements in
prenatal care, post natal care, delivery and fol-
low-up care, and whether the implementation of
such improvements should be accomplished by
the private health care sector, Federal or State
governments, or any combination thereof; and
(D) limitations on the databases in exist-
ence on the date of enactment of this title.
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(2) SUBMISSION OF REPORTS.—The Secretary of
Health and Human Services shall prepare and sub-
mit to the Committees referred to in paragraph (1)—
(A) an initial report concerning the study
conducted under subsection (c) and the report re-
quired under subsection (d), not later than 18
months after the date of enactment of this title;
(B) an interim report concerning such
study and report not later than 3 years after the
date of enactment of this title; and
(C) a final report concerning such study
and report not later than 5 years after the date
of enactment of this title.
(e) TERMINATION
OF PANEL.—The advisory panel
shall terminate on the date that occurs 60 days after the
date on which the last report is submitted under this sec-
tion.
SEC. 612. SALE OF GOVERNORS ISLAND, NEW YORK.
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, the Administrator of General Services shall dis-
pose of by sale at fair market value all rights, title, and
interests of the United States in and to the land of, and
improvements to, Governors Island, New York.
(b) RIGHT OF FIRST REFUSAL.—Before a sale is made
under subsection (a) to any other parties, the State of New
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York and the city of New York shall be given the right of
first refusal to purchase all or part of Governors Island.
Such right may be exercised by either the State of New York
or the city of New York or by both parties acting jointly.
(c) PROCEEDS.—Proceeds from the disposal of Gov-
ernors Island under subsection (a) shall be deposited in the
general fund of the Treasury and credited as miscellaneous
receipts.
SEC. 613. SALE OF AIR RIGHTS.
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, the Administrator of General Services shall sell,
at fair market value and in a manner to be determined
by the Administrator, the air rights adjacent to Washington
Union Station described in subsection (b), including air
rights conveyed to the Administrator under subsection (d).
The Administrator shall complete the sale by such date as
is necessary to ensure that the proceeds from the sale will
be deposited in accordance with subsection (c).
(b) DESCRIPTION.—The air rights referred to in sub-
section (a) total approximately 16.5 acres and are depicted
on the plat map of the District of Columbia as follows:
(1) Part of lot 172, square 720.
(2) Part of lots 172 and 823, square 720.
(3) Part of lot 811, square 717.
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(c) PROCEEDS.—Before September 30, 1997, proceeds
from the sale of air rights under subsection (a) shall be de-
posited in the general fund of the Treasury and credited
as miscellaneous receipts.
(d) CONVEYANCE OF AMTRAK AIR RIGHTS.—
(1) GENERAL RULE.—As a condition of future
Federal financial assistance, Amtrak shall convey to
the Administrator of General Services on or before
December 31, 1996, at no charge, all of the air rights
of Amtrak described in subsection (b).
(2) FAILURE TO COMPLY.—If Amtrak does not
meet the condition established by paragraph (1), Am-
trak shall be prohibited from obligating Federal funds
after March 1, 1997.
SEC. 614. EFFECTIVE DATE.
Except as otherwise provided for in this title, the pro-
visions of this title shall apply as follows:
(1) With respect to health plans, such provisions
shall apply to such plans on the first day of the con-
tract year beginning on or after January 1, 1998.
(2) With respect to employee health benefit plans,
such provisions shall apply to such plans on the first
day of the first plan year beginning on or after Janu-
ary 1, 1998.
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TITLE VII—MENTAL HEALTH
PARITY
SEC. 701. SHORT TITLE.
This title may be cited as the ‘‘Mental Health Parity
Act of 1996’’.
SEC. 702. PLAN PROTECTIONS FOR INDIVIDUALS WITH A
MENTAL ILLNESS.
(a) PERMISSIBLE COVERAGE LIMITS UNDER A GROUP
HEALTH PLAN.—
(1) AGGREGATE LIFETIME LIMITS.—
(A) IN GENERAL.—With respect to a group
health plan offered by a health insurance issuer,
that applies an aggregate lifetime limit to plan
payments for medical or surgical services covered
under the plan, if such plan also provides a
mental health benefit such plan shall—
(i) include plan payments made for
mental health services under the plan in
such aggregate lifetime limit; or
(ii) establish a separate aggregate life-
time limit applicable to plan payments for
mental health services under which the dol-
lar amount of such limit (with respect to
mental health services) is equal to or greater
than the dollar amount of the aggregate life-
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time limit on plan payments for medical or
surgical services.
(B) NO LIFETIME LIMIT.—With respect to a
group health plan offered by a health insurance
issuer, that does not apply an aggregate lifetime
limit to plan payments for medical or surgical
services covered under the plan, such plan may
not apply an aggregate lifetime limit to plan
payments for mental health services covered
under the plan.
(2) ANNUAL LIMITS.—
(A) IN GENERAL.—With respect to a group
health plan offered by a health insurance issuer,
that applies an annual limit to plan payments
for medical or surgical services covered under the
plan, if such plan also provides a mental health
benefit such plan shall—
(i) include plan payments made for
mental health services under the plan in
such annual limit; or
(ii) establish a separate annual limit
applicable to plan payments for mental
health services under which the dollar
amount of such limit (with respect to men-
tal health services) is equal to or greater
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than the dollar amount of the annual limit
on plan payments for medical or surgical
services.
(B) NO ANNUAL LIMIT.—With respect to a
group health plan offered by a health insurance
issuer, that does not apply an annual limit to
plan payments for medical or surgical services
covered under the plan, such plan may not apply
an annual limit to plan payments for mental
health services covered under the plan.
(b) RULE OF CONSTRUCTION.—
(1) IN GENERAL.—Nothing in this section shall
be construed as prohibiting a group health plan of-
fered by a health insurance issuer, from—
(A) utilizing other forms of cost contain-
ment not prohibited under subsection (a); or
(B) applying requirements that make dis-
tinctions between acute care and chronic care.
(2) NONAPPLICABILITY.—This section shall not
apply to—
(A) substance abuse or chemical dependency
benefits; or
(B) health benefits or health plans paid for
under title XVIII or XIX of the Social Security
Act.
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(3) STATE LAW.—Nothing in this section shall be
construed to preempt any State law that provides for
greater parity with respect to mental health benefits
than that required under this section.
(c) SMALL EMPLOYER EXEMPTION.—
(1) IN GENERAL.—This section shall not apply
to plans maintained by employers that employ less
than 26 employees.
(2) APPLICATION OF CERTAIN RULES IN DETER-
MINATION OF EMPLOYER SIZE.—For purposes of this
subsection—
(A) APPLICATION
OF
AGGREGATION
RULE
FOR EMPLOYERS.—All persons treated as a sin-
gle employer under subsection (b), (c), (m), or
(o) of section 414 of the Internal Revenue Code
of 1986 shall be treated as 1 employer.
(B) EMPLOYERS NOT IN EXISTENCE IN PRE-
CEDING YEAR.—In the case of an employer which
was not in existence throughout the preceding
calendar year, the determination of whether such
employer is a small employer shall be based on
the average number of employees that it is rea-
sonably expected such employer will employ on
business days in the current calendar year.
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(C) PREDECESSORS.—Any reference in this
subsection to an employer shall include a ref-
erence to any predecessor of such employer.
SEC. 703. DEFINITIONS.
For purposes of this title:
(1) GROUP HEALTH PLAN.—
(A) IN GENERAL.—The term ‘‘group health
plan’’ means an employee welfare benefit plan
(as defined in section 3(1) of the Employee Re-
tirement Income Security Act of 1974) to the ex-
tent that the plan provides medical care (as de-
fined in paragraph (2)) and including items and
services paid for as medical care) to employees or
their dependents (as defined under the terms of
the plan) directly or through insurance, reim-
bursement, or otherwise.
(B) MEDICAL
CARE.—The term ‘‘medical
care’’ means amounts paid for—
(i) the diagnosis, cure, mitigation,
treatment, or prevention of disease, or
amounts paid for the purpose of affecting
any structure or function of the body,
(ii) amounts paid for transportation
primarily for and essential to medical care
referred to in clause (i), and
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(iii) amounts paid for insurance cover-
ing medical care referred to in clauses (i)
and (ii).
(2) HEALTH INSURANCE COVERAGE.—The term
‘‘health insurance coverage’’ means benefits consisting
of medical care (provided directly, through insurance
or reimbursement, or otherwise and including items
and services paid for as medical care) under any hos-
pital or medical service policy or certificate, hospital
or medical service plan contract, or health mainte-
nance organization contract offered by a health insur-
ance issuer.
(3) HEALTH
INSURANCE
ISSUER.—The term
‘‘health insurance issuer’’ means an insurance com-
pany, insurance service, or insurance organization
(including a health maintenance organization, as de-
fined in paragraph (4)) which is licensed to engage
in the business of insurance in a State and which is
subject to State law which regulates insurance (with-
in the meaning of section 514(b)(2) of the Employee
Retirement Income Security Act of 1974), and in-
cludes a plan sponsor described in section 3(16)(B) of
the Employee Retirement Income Security Act of
1974 in the case of a group health plan which is an
employee welfare benefit plan (as defined in section
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3(1) of such Act). Such term does not include a group
health plan.
(4) HEALTH MAINTENANCE ORGANIZATION.—The
term ‘‘health maintenance organization’’ means—
(A) a federally qualified health maintenance
organization (as defined in section 1301(a) of the
Public Health Service Act),
(B) an organization recognized under State
law as a health maintenance organization, or
(C) a similar organization regulated under
State law for solvency in the same manner and
to the same extent as such a health maintenance
organization.
(5) STATE.—The term ‘‘State’’ means each of the
several States, the District of Columbia, Puerto Rico,
the Virgin Islands, Guam, American Samoa, and the
Northern Mariana Islands.
SEC. 704. SUNSET.
Sections 701 through 703 shall cease to be effective on
September 30, 2001.
SEC. 705. FEDERAL EMPLOYEE HEALTH BENEFIT PROGRAM.
For the Federal Employee Health Benefit Program,
sections 701 through 703 will take effect on October 1, 1997.
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SEC. 706. EXEMPTION.
Notwithstanding the provisions of this title, if the pro-
visions of this title result in a 1 percent or greater increase
in the cost of a group health plan’s premiums, the purchaser
is exempt from the provisions of this title.
Attest:
Secretary.
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