coverage for employees and their families if 
the employee elects dependent coverage. 
‘‘(ii) LIMITATION.—An employer shall 
not be liable under subparagraph (B) for 
more than 10 percent of each employee’s 
annual wages. 
‘‘(2) EMPLOYERS WITH AT LEAST 500 EMPLOY-
EES.— 
‘‘(A) IN GENERAL.—An employer with at 
least 500 employees, a majority of whose wages 
fall below an amount equal to 300 percent of 
the poverty line applicable to a family of the 
size involved, shall comply with the require-
ments applicable to an employer under para-
graph (1). 
‘‘(B) OTHER EMPLOYERS.— 
‘‘(i) IN GENERAL.—An employer with 
at least 500 employees that is not de-
scribed in subparagraph (A) shall, at the 
option of the employer, either— 
‘‘(I) comply with the require-
ments applicable to an employer 
under paragraph (1); or 
‘‘(II) provide health insurance 
coverage to all employees and their
families (if the employee elects de-
pendent coverage) that meets the re-
quirements of section 2213 and the 
employer contribution required under 
paragraph (1)(B). 
‘‘(ii) ADDITIONAL
EMPLOYER
CON-
TRIBUTION.—An employer that elects to 
comply with clause (i)(I) shall contribute 
an additional 1 percent of payroll into the 
State-designated purchasing pool in which 
it participates. 
‘‘(3) RULE
OF
CONSTRUCTION.—Nothing in 
this title shall be construed as prohibiting a labor or-
ganization from collectively bargaining for an em-
ployer contribution that is greater than the contribu-
tion that is required under paragraph (1)(B) or, as 
applicable, for health insurance benefits that are 
greater than the coverage required under paragraph 
section 2203(a). 
‘‘(4) PART-TIME
EMPLOYEES.—An employer 
shall be responsible for meeting the requirements 
under this subsection for all employees of the em-
ployer. 
‘‘(5) MULTIEMPLOYER FAMILIES.—In the case 
of a family with more than 1 employer, the employ-
ers of individuals within the family shall apportion 
their contributions in accordance with rules estab-
lished by the State. 
‘‘(b) NONAPPLICABILITY.—This section shall not 
apply— 
‘‘(1) to any State that establishes a single 
payor system; or 
‘‘(2) to any State that established a universal 
phase (phase II) plan through an approved adden-
dum to an expansion phase (phase I) plan. 
‘‘(c) PRIVATE CAUSE OF ACTION.— 
‘‘(1) LIABILITY.—An employer that fails to 
comply with the requirements of subsection (a) or 
otherwise takes adverse action against an employee 
for the purpose of interfering with the attainment of 
any right to which the employee may be entitled to 
under this title, shall be liable to the employee af-
fected. 
‘‘(2) AMOUNT.—The amount of the liability de-
scribed in paragraph (1) shall be an amount equal 
to— 
‘‘(A) the contributions that otherwise 
would have been made by the employer on be-
half of the employee under this section;
‘‘(B) an additional amount as liquidated 
damages; and 
‘‘(C) consequential damages for reasonably 
foreseeable injuries resulting from such action. 
‘‘(3) JURISDICTION; EQUITABLE RELIEF.— 
‘‘(A) JURISDICTION.—An action under this 
subsection may be maintained against any em-
ployer in any Federal or State court of com-
petent jurisdiction by any 1 or more employees. 
‘‘(B) EQUITABLE RELIEF.—In addition to 
the damages described in paragraph (2), a 
court may enjoin any act or practice that vio-
lates this title. 
‘‘(4) ATTORNEY’S FEES.—If a plaintiff or plain-
tiffs prevail in an action brought under this sub-
section, the court shall, in addition to any judgment 
awarded to the plaintiff or plaintiffs, award the rea-
sonable attorney’s fees and costs associated with the 
bringing of the action. 
‘‘SEC. 2215. ALLOTMENTS. 
‘‘(a) STATE ALLOTMENTS.—Subsections (a) and (b) 
of section 2204 apply to a universal phase (phase II) plan 
under this part in the same manner as such subsections 
apply to an expansion phase (phase I) plan under part 
A.
‘‘(b) SPECIAL RULE FOR EXPANSION PHASE (PHASE 
I) PLANS.—A State that operated an expansion phase 
(phase I) plan and converted such plan to a universal 
phase (phase II) plan pursuant to section 2211(b)(2)(B) 
shall continue to be eligible for the enhanced Federal par-
ticipation rate determined under section 2204(c). 
‘‘(c) GRANTS TO INDIAN TRIBES, NATIVE HAWAIIAN 
ORGANIZATIONS, 
AND
ALASKA
NATIVE
ORGANIZA-
TIONS.—Section 2204(d) applies to a universal phase 
(phase II) plan under this part. 
‘‘(d) APPROPRIATION.— 
‘‘(1) IN GENERAL.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated to carry out this title such sums as may be 
necessary for fiscal year 2008 and each fiscal year 
thereafter. 
‘‘(2) BUDGET AUTHORITY.—Paragraph (1) con-
stitutes budget authority in advance of appropria-
tions Acts and represents the obligation of the Fed-
eral Government to provide States, Indian tribes, 
Native Hawaiian organizations, and Alaska Native 
organizations with the allotments determined under 
this section and the grants for administrative and 
outreach activities under section 2205(a)(1)(B) (as 
applied to this part under section 2216(a)).
‘‘SEC. 2216. ADMINISTRATION; DEFINITIONS. 
‘‘(a) ADMINISTRATION.—The provisions of section 
2205 (other than subsection (c) of such section) apply to 
a universal phase (phase II) plan under this part in the 
same manner as such provisions apply to an expansion 
phase (phase I) plan under part A. 
‘‘(b) DEFINITIONS.— 
‘‘(1) APPLICATION OF SECTION 2206.—The defi-
nitions set forth in section 2206 apply to a universal 
phase (phase II) plan under this part in the same 
manner as such provisions apply to an expansion 
phase (phase I) plan under part A except that for 
purposes of this part, the definition of ‘eligible resi-
dents of a State’ set forth in section 2206(2) shall 
be applied without regard to subparagraphs (A)(ii) 
and (B). 
‘‘(2) UNIVERSAL PHASE (PHASE II) PLAN.—In 
this title, the term ‘universal phase (phase II) plan’ 
means the State universal health insurance coverage 
plan submitted under section 2211(b).’’. 
SEC. 202. CONSUMER PROTECTIONS. 
Title XXII of the Social Security Act, as amended 
by section 201, is amended by adding at the end the fol-
lowing:
‘‘PART C—CONSUMER PROTECTIONS 
‘‘SEC. 2221. HOME CARE STANDARDS. 
‘‘In order to ensure that home care services are pro-
vided in a consumer-directed manner, a State partici-
pating under part A, and, effective January 1, 2008, all 
States under part B, shall satisfy the Secretary that any 
health plan that provides home care services under this 
title creates, or contracts with, a viable entity other than 
the consumer or individual provider to provide effective 
billing, payments for services, tax withholding, unemploy-
ment insurance, and workers compensation coverage, and 
to serve as the statutory employer of the home care pro-
vider. Recipients of such services shall retain the right to 
independently select, hire, terminate, and direct the work 
of the home care provider. 
‘‘SEC. 2222. CONSUMER PROTECTION IN THE EVENT OF 
TERMINATION OR SUSPENSION OF SERVICES. 
‘‘A State participating under part A, and, effective 
January 1, 2008, all States under part B, shall satisfy 
the Secretary that any health plan providing services 
under this title shall ensure that enrollees will receive con-
tinued health services in the event that the plan’s health 
care services are terminated or suspended, including as 
the result of the plan filing for bankruptcy relief under 
title 11, United States Code, or the failure of the plan
to provide payments to providers, lockouts, work stop-
pages, or other labor management problems. 
‘‘SEC. 2223. CONSUMER PROTECTION THROUGH DISCLO-
SURE OF INFORMATION. 
‘‘(a) IN GENERAL.—A State participating under part 
A, and, effective January 1, 2008, all States under part 
B, shall satisfy the Secretary that any health care provider 
that provides services to individuals under this title shall 
provide to the State information regarding the identity, 
employment location, and qualifications of health care 
workers providing services under— 
‘‘(1) the licensure of the provider; or 
‘‘(2) a contract between the provider and a 
health plan or the State. 
‘‘(b) AVAILABILITY TO PUBLIC.—A health care pro-
vider shall make the information described in subsection 
(a) available to the public. 
‘‘SEC. 2224. CONSUMER PROTECTION THROUGH NOTICE OF 
CHANGES IN HEALTH CARE DELIVERY. 
‘‘A State participating under part A, and, effective 
January 1, 2008, all States under part B, shall describe 
how the State will provide, at a minimum, the following 
protections:
‘‘(1) Adequate advance notice to the public, the 
affected health care workers, and labor organizations 
representing such workers, of a pending— 
‘‘(A) facility or operating unit closure; 
‘‘(B) sale, merger, or consolidation of a fa-
cility or operating unit; 
‘‘(C) transfer of work from 1 facility or en-
tity to another facility or entity; or 
‘‘(D) reduction of services. 
‘‘(2) A right of first refusal for similar vacant 
positions with— 
‘‘(A) the resulting entity, in the case of a 
health care worker whose position was elimi-
nated following a merger of the worker’s origi-
nal employer with a new entity; or 
‘‘(B) the contractor, in the case of a health 
care worker whose position was eliminated fol-
lowing the contracting out of the work the 
worker formerly performed.’’. 
TITLE III—PATIENT 
PROTECTIONS 
SEC. 301. INCORPORATION OF CERTAIN PROTECTIONS. 
(a) INCORPORATION.—The provisions of the following 
bills are hereby enacted into law:
(1) S. 1052 of the 107th Congress, as passed 
by the Senate on June 29, 2001. 
(2) H.R. 2340 of the 107th Congress, as intro-
duced on June 27, 2001. 
(b) PUBLICATION.—In publishing this Act in slip 
form and in the United States Statutes at Large pursuant 
to section 112, of title 1, United States Code, the Archivist 
of the United States shall include after the date of ap-
proval at the end appendixes setting forth the texts of the 
bills referred to in subsection (a) of this section. 
TITLE IV—HEALTH CARE QUAL-
ITY, PATIENT SAFETY, AND 
WORKFORCE STANDARDS 
SEC. 401. HEALTH CARE QUALITY, PATIENT SAFETY, AND 
WORKFORCE STANDARDS INSTITUTE. 
(a) ESTABLISHMENT.— 
(1) INSTITUTE.—There is established within 
the Agency for Healthcare Research and Quality, an 
institute to be known as the Health Care Quality, 
Patient Safety, and Workforce Standards Institute 
(in this section referred to as the ‘‘Institute’’). 
(2) DIRECTOR.—The Secretary of Health and 
Human Services shall appoint a director of the Insti-
tute. The director shall administer the Institute and 
carry out the duties of the director under this sec-
tion subject to the authority, direction, and control 
of the Secretary. 
(b) MISSION.—The mission of the Institute is to— 
(1) demonstrate how patient safety issues and 
workplace conditions are linked to quality patient 
care and the reduction of the incidence of medical 
errors; and 
(2) reduce the incidence of medical errors and 
improve patient safety and quality of care. 
(c) DUTIES.—In carrying out the mission of the In-
stitute, the director of the Institute shall— 
(1) work closely with the director of the Agency 
for Healthcare Research and Quality to ensure that 
issues related to workplace conditions are reflected 
in the activities conducted by such agency in order 
to reduce the incidence of medical errors and im-
prove patient safety and quality of care, including— 
(A) the establishment of national goals; 
(B) the development and implementation 
of a research agenda; 
(C) the development and promotion of best 
practices; 
(D) the development of performance and 
staffing standards in consultation with the
Health Care Financing Administration and 
other Federal agencies, as appropriate; and 
(E) the development and dissemination of 
information, educational and training materials, 
and other criteria as it relates to the delivery of 
quality care; 
(2) provide recommendations to the Secretary 
of Health and Human Services and other Federal 
agencies with responsibility for health care quality 
and the development of standards that impact on 
the delivery of quality patient care on standards re-
lated to workplace conditions and patient safety; 
(3) support the activities of the Health Care Fi-
nancing Administration related to the development 
of new or revised conditions of participation under 
the medicare and medicaid programs and subsequent 
rulemaking on issues related to workplace condi-
tions, medical errors, and patient safety and quality 
of care; and 
(4) conduct other activities determined appro-
priate by the director of the Institute. 
(d) WORKPLACE CONDITIONS.—For purposes of this 
section, the term ‘‘workplace conditions’’ shall include 
issues related to— 
(1) health care worker staffing;
(2) hours of work; 
(3) confidentiality and whistleblower protec-
tions; 
(4) employee participation in decisionmaking 
roles that contribute to improved quality of care and 
the reduction of the incidence of medical errors; 
(5) workforce training; and 
(6) the impact of health care delivery restruc-
turing on communities and health care workers. 
(e) DEFINITION OF HEALTH CARE WORKER.— 
(1) IN
GENERAL.—In this section, the term 
‘‘health care worker’’ means an individual employed 
by an employer that provides— 
(A) health care services; or 
(B) necessary related services, including 
administrative, food service, janitorial, or main-
tenance service to an entity that provides such 
health care services. 
(2) HEALTH
CARE
SERVICES.—In paragraph 
(1), the term ‘‘health care services’’ includes med-
ical, surgical, mental health, and substance abuse 
services, whether provided on an in-patient or out-
patient basis. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to the Institute such
sums as may be necessary to carry out the purposes of 
this section. 
SEC. 402. HEALTH CARE QUALITY, PATIENT SAFETY, AND 
WORKFORCE STANDARDS ADVISORY COM-
MITTEE. 
(a) ESTABLISHMENT OF COMMITTEE.—There is es-
tablished a Health Care Quality, Patient Safety, and 
Workforce Standards Committee (in this section referred 
to as the ‘‘Committee’’). 
(b) FUNCTIONS OF COMMITTEE.— 
(1) ADVICE
TO
INSTITUTE.—The Committee 
shall provide advice to the Director of the Health 
Care Quality, Patient Safety, and Workforce Stand-
ards Institute established under section 401 on 
issues related to the duties of the Director. 
(2) INITIAL REPORT.—Not later than December 
31, 2004, the Committee shall submit an initial re-
port to the Secretary that contains— 
(A) recommendations regarding minimal 
workforce standards that are critical for im-
proved health care quality and patient safety; 
and 
(B) recommendations regarding additional 
ways to reduce the incidence of medical errors
and to improve patient safety and quality of 
care. 
(3) FINAL REPORT.—Not later than December 
31, 2005, the Committee shall submit a final report 
to the Secretary of Health and Human Services re-
garding the recommendations contained in the initial 
report required under paragraph (2), including any 
modifications of such recommendations. 
(c) STRUCTURE AND MEMBERSHIP OF THE COM-
MITTEE.— 
(1) STRUCTURE.—The Committee shall be com-
posed of the Director of the Health Care Quality, 
Patient Safety, and Workforce Standards Institute 
established under section 401 and 15 additional 
members who shall be appointed by the Secretary of 
Health and Human Services. 
(2) MEMBERSHIP.— 
(A) IN
GENERAL.—The members of the 
Committee shall be chosen on the basis of their 
integrity, impartiality, and good judgment, and 
shall be individuals who are, by reason of their 
education, experience, and attainments, excep-
tionally qualified to perform the duties of mem-
bers of the Committee.
(B) SPECIFIC MEMBERS.—In making ap-
pointments under paragraph (1), the Secretary 
of Health and Human Services shall ensure 
that the following groups are represented: 
(i) Health care providers and health 
care workers, including labor unions rep-
resenting health care workers. 
(ii) Consumer organizations. 
(iii) Health care institutions. 
(iv) Health education organizations. 
(d) CHAIRMAN.—The Director of the Health Care 
Quality, Patient Safety, and Workforce Standards Insti-
tute established under section 401 shall chair the Com-
mittee. 
TITLE V—IMPROVING MEDICARE 
BENEFITS 
SEC. 501. FULL MENTAL HEALTH AND SUBSTANCE ABUSE 
TREATMENT BENEFITS PARITY. 
Notwithstanding any provision of title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.), beginning 
January 1, 2004, each individual who is entitled to bene-
fits under part A or enrolled under part B of the medicare 
program, 
including 
an 
individual 
enrolled 
in 
a 
Medicare+Choice plan offered by a Medicare+Choice or-
ganization under part C of such program, shall be pro-
vided full mental health and substance abuse treatment 
parity under the medicare program established under such 
title of such Act consistent with title XXII of the Social 
Security Act (as added by this Act). 
TITLE VI—LONG-TERM AND 
HOME HEALTH CARE 
SEC. 601. STUDIES AND DEMONSTRATION PROJECTS TO 
IDENTIFY MODEL PROGRAMS. 
The Secretary of Health and Human Services shall— 
(1) conduct studies and demonstration projects, 
through grant, contract, or interagency agreement, 
that are designed to identify model programs for the 
provision of long-term and home health care serv-
ices; 
(2) report regularly to Congress on the results 
of such studies and demonstration projects; and 
(3) include in such report any recommendations 
for legislation to expand or continue such studies 
and projects. 
TITLE VII—MISCELLANEOUS 
SEC. 701. NONAPPLICATION OF ERISA. 
The provisions of section 514 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 1144) shall 
not apply with respect to health benefits provided under 
a group health plan (as defined in section 733(a) of that
Act (29 U.S.C. 1191b(a))) qualified to offer such benefits 
under an expansion phase (phase I) plan under title XXII 
of the Social Security Act (as added by this Act) or under 
a universal phase (phase II) plan under such title. 
SEC. 702. SENSE OF CONGRESS REGARDING OFFSETS. 
It is the sense of Congress that any sums necessary 
for the implementation of this Act, and the amendments 
made by this Act, should be offset by— 
(1) general revenues available as a result of an 
on-budget surplus for a fiscal year; 
(2) direct savings in health care expenditures 
resulting from the implementation of this Act; and 
(3) reductions in unnecessary Federal tax bene-
fits available only to individuals and large corpora-
tions that are in the maximum tax brackets. 
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