instruction:
In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
question:
SECTION 1. PUBLIC HEALTH SERVICE ACT; LIABILITY PROTECTIONS FOR HEALTH-
CENTER PRACTITIONERS PROVIDING SERVICES IN EMERGENCY
AREAS.

(a) In General.--Section 224(g) of the Public Health Service Act
(42 U.S.C. 233(g)) is amended--
(1) in paragraph (1)(B)(ii), by striking ''subparagraph
(C)'' and inserting ''subparagraph (C) and paragraph (6)''; and
(2) by adding at the end the following paragraph:
''(6)(A) Subject to subparagraph (C), paragraph (1)(B)(ii) applies
to health services provided to individuals who are not patients of the
entity involved if, as determined under criteria issued by the
Secretary, the following conditions are met:
''(i) The services are provided by a contractor or employee
of the entity who is a physician or other licensed or certified
health care practitioner and who is otherwise deemed to be an
employee for purposes of paragraph (1)(A) when providing
services with respect to the entity.
''(ii) The services are provided in an emergency area (as
defined in subparagraph (D)).
''(iii) The services of the contractor or employee
(referred to in this paragraph as the 'out-of-area
practitioner') are provided under an arrangement with--
''(I) an entity that is deemed to be an employee
for purposes of paragraph (1)(A) and that serves the
emergency area involved (referred to in this paragraph
as an 'emergency-area entity)'; or
''(II) a Federal agency that has responsibilities
regarding the provision of health services in such area
during the emergency.
''(iv) The purposes of the arrangement are--
''(I) to coordinate, to the extent practicable, the
provision of health services in the emergency area by
the out-of-area practitioner with the provision of
services by the emergency-area entity, or by the
Federal agency, as the case may be;
''(II) to identify a location in the emergency area
to which such practitioner should report for purposes
of providing health services, and to identify an
individual or individuals in the area to whom the
practitioner should report for such purposes; and
''(III) to verify the identity of the practitioner
and that the practitioner is licensed or certified by
one or more of the States.
''(v) With respect to the licensure or certification of
health care practitioners, the provision of services by the
out-of-area practitioner in the emergency area is not a
violation of the law of the State in which the area is located.
''(B) In issuing criteria under subparagraph (A), the Secretary
shall take into account the need to rapidly enter into arrangements
under such subparagraph in order to provide health services in
emergency areas promptly after the emergency begins.
''(C) Subparagraph (A) applies with respect to an act or omission
of an out-of-area practitioner only to the extent that the practitioner
is not immune from liability for such act or omission under the
Volunteer Protection Act of 1997.
''(D) For purposes of this paragraph, the term 'emergency area'
means a geographic area for which--
''(i) the Secretary has made a determination under section
319 that a public health emergency exists; or
''(ii) a presidential declaration of major disaster has
been issued under section 401 of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act.''.
(b) Effective Date.--With respect to paragraph (6) of section
224(g) of the Public Health Service Act, as added by subsection (a) of
this section:
(1) Except as provided in this subsection, an arrangement
under subparagraph (A)(iii) of such paragraph (6) is deemed to
be in effect for any health professional who, within the
meaning of such paragraph--
(A) is an employee or contractor of a health center
under section 330 of such Act; and
(B) served or is serving as an out-of-area
practitioner in any emergency area declared as a result
of Hurricane Katrina or Hurricane Rita.
(2) Such paragraph (6) is deemed to have taken effect on
August 27, 2005, for purposes of paragraph (1) of this
subsection. Such paragraph (6) otherwise takes effect on the
date of the enactment of this Act.
(3) Paragraph (1) of this subsection applies until the
expiration of the 48-hour period beginning on the date on which
the Secretary of Health and Human Services publishes in the
Federal Register a notice that the applicability of such
paragraph is being terminated.
answer:
Amends the Public Health Service Act to deem certain physicians or other licensed or certified health care practitioners to be employees of the Public Health Service for purposes of any civil action that may arise due to services provided in an emergency area by a contractor or an employee of a qualified health center. Provides that such services must be provided under an arrangement with a qualified health center or with a federal agency with responsibility for providing health services in the emergency area.

question:
SECTION 1. SHORT TITLE.

This Act may be cited as the ''Defending Our Great Lakes Act of
2015''.

SEC. 2. AQUATIC INVASIVE SPECIES CONTROL ZONE AT BRANDON ROAD LOCK AND
DAM SITE, JOLIET, ILLINOIS.

(a) Immediate Actions.--
(1) In general.--The Secretary of the Army, acting through
the Chief of Engineers, the Secretary of the Interior, acting
through the Director of the United States Fish and Wildlife
Service and the Director of the United States Geological
Survey, the Administrator of the Environmental Protection
Agency, and any other applicable Federal agency shall take
immediate actions to prevent the upstream transfer of aquatic
nuisance species from the Mississippi River basin to the Great
Lakes basin through the Brandon Road Lock and Dam site.
(2) Focus.--Actions under paragraph (1) shall place a
special focus on Asian carp species and other aquatic nuisance
species of concern to the Great Lakes as referenced in the
Great Lakes Mississippi River Interbasin Study of the Army
Corps of Engineers issued pursuant to section 1538 of Public
Law 112-141 (126 Stat. 586).
(b) Construction.--
(1) Required measures.--The Chief of Engineers shall
implement measures to improve the Brandon Road Lock and Dam
site to prevent the upstream transfer of Asian carp and other
swimming aquatic nuisance species through the lock and dam,
including--
(A) constructing an engineered channel in the
approach to the site from the Mississippi River
direction, as outlined in the report issued pursuant to
section 1538 of Public Law 112-141 (126 Stat. 586); and
(B) adding technologies and measures necessary for
aquatic nuisance species control, while protecting the
area's ecosystem to the greatest extent feasible.
(2) Cost estimate and schedule.--Not later than 180 days
after the date of enactment of this Act, the Chief of Engineers
shall submit to Congress a cost estimate for, and schedule for
completion of, measures to be constructed under this
subsection.
(c) Other Measures.--The Director of the United States Fish and
Wildlife Service, in consultation with the Director of the United
States Geological Survey, the Chief of Engineers, the Commandant of the
United States Coast Guard, the Administrator of the Environmental
Protection Agency, and the heads of other relevant agencies, shall
implement all appropriate measures in compliance with applicable State
and Federal law around the Brandon Road Lock and Dam site on the
Illinois River to prevent the upstream transfer of swimming and
floating aquatic nuisance species, with a focus on Asian carp species,
including--
(1) implementing existing Asian carp monitoring and control
strategies at the Brandon Road site, as applicable, including
real-time monitoring for aquatic nuisance species passing
through by using relevant technology;
(2) using the Brandon Road Lock and Dam site to the maximum
extent practicable to test new aquatic nuisance species control
technologies and measures;
(3) implementing control strategies identified through that
testing necessary to fulfill the objectives of this section,
considering those strategies that minimize the negative impact
on the river ecosystem and desirable aquatic native species,
while maintaining efficient navigation; and
(4) developing best management practices to mitigate
aquatic nuisance species transfer by boat and barge operators
on the Illinois River and Chicago Sanitary and Shipping Canal
and working with operators to implement the practices.
(d) Administration.--
(1) Acquisition of real estate.--The Chief of Engineers may
only acquire real estate that is necessary to carry out this
section and shall do so pursuant to the laws (including
regulations) in existence at the time of the acquisition.
(2) Cooperation.--In carrying out this section, the Chief
of Engineers, the Director of the United States Fish and
Wildlife Service, and the Director of the United States
Geological Survey shall coordinate with each other and--
(A) the Governors of Illinois, Indiana, Michigan,
Minnesota, New York, Ohio, Pennsylvania, and Wisconsin;
(B) the Chicago Area Waterway System Advisory
Committee; and
(C) any other applicable State, regional, local,
and international government entity.
(3) Consultation.--In carrying out this section, the Chief
of Engineers, the Director of the United States Fish and
Wildlife Service, and the Director of the United States
Geological Survey shall consult with appropriate entities in
the business, commerce, and environmental communities.

SEC. 3. ACTIONS RELATED TO THE LONG-TERM PREVENTION OF AQUATIC NUISANCE
SPECIES TRANSFER BETWEEN THE GREAT LAKES BASIN AND
MISSISSIPPI RIVER BASIN.

(a) In General.--The Secretary of the Army, acting through the
Chief of Engineers, the Secretary of the Interior, acting through the
Director of the United States Fish and Wildlife Service and the
Director of the United States Geological Survey, the Administrator of
the Environmental Protection Agency, and any other applicable Federal
entity shall take actions for the long-term prevention of aquatic
nuisance species between the Mississippi River basin and the Great
Lakes basin, including transfer through the Chicago Area Waterway
System.
(b) Construction.--The Chief of Engineers shall coordinate with the
Governor of Illinois, the City of Chicago, the Metropolitan Water
Reclamation District of Greater Chicago, and other relevant entities to
design, engineer, and construct flood mitigation and water quality
measures on the Chicago Area Waterway System related to the prevention
of the transfer of aquatic nuisance species between the Mississippi
River basin and the Great Lakes basin, including transfer through the
Chicago Area Waterway System.
(c) Requirements.--In carrying out subsection (b), the Chief of
Engineers shall--
(1) coordinate with the City of Chicago and the
Metropolitan Water Reclamation District of Greater Chicago to
combine infrastructure to the maximum extent practicable with
the Tunnel and Reservoir Plan of the Metropolitan Water
Reclamation District of Greater Chicago, and other relevant
storm and sewer water infrastructure projects;
(2) ensure flood mitigation in the vicinity of the Chicago
Area Waterway System is improved and strengthen protections
against flooding for residential and commercial neighborhoods;
(3) ensure water quality is protected in the Great Lakes,
the Chicago Waterway System, and the Mississippi River basin
consistent with the Federal Water Pollution Control Act (33
U.S.C. 1251 et seq.);
(4) provide for continued commercial and recreational
watercraft traffic on the Chicago Area Waterway System, and
maintain efficient navigation; and
(5) prioritize efforts to prevent the upstream and
downstream transfer of aquatic nuisance species.
(d) Administration.--
(1) Cooperation.--In carrying out this section, the Chief
of Engineers, the Director of the United States Fish and
Wildlife Service, and the Director of the United States
Geological Survey shall coordinate with each other and--
(A) the Governors of Illinois, Indiana, Michigan,
Minnesota, New York, Ohio, Pennsylvania, and Wisconsin;
(B) the Chicago Area Waterway System Advisory
Committee; and
(C) any other applicable State, regional, local,
and international government entity.
(2) Consultation.--In carrying out this section, the Chief
of Engineers, the Director of the United States Fish and
Wildlife Service, and the Director of the United States
Geological Survey shall consult with appropriate entities in
the business, commerce, and environmental communities.
(3) Delegation.--In carrying out this section, the Chief of
Engineers may delegate parts of the project to non-Federal
entities subject to the availability of funding.
(4) Identification of partners.--In carrying out this
section, the Chief of Engineers shall work to identify non-
Federal cost-share partners when applicable.
(5) Acquisition of real estate.--The Chief of Engineers may
only acquire real estate that is necessary to carry out this
section and shall do so pursuant to the laws (including
regulations) in existence at the time of the acquisition.
(e) Report.--
(1) In general.--Not later than 18 months after the date of
enactment of this Act, and each year thereafter, the Chief of
Engineers shall submit to the Committee on Environment and
Public Works of the Senate and the Committee on Transportation
and Infrastructure of the House of Representatives a report
describing the progress made, and a plan for further actions to
be taken, under this section.
(2) Public availability.--Reports under paragraph (1) shall
be made available to the public through electronic means,
including the Internet.

SEC. 4. SENSE OF CONGRESS.

It is the sense of Congress that there is an ongoing need to
further examine and protect the tributaries and waterways located in
other affected areas and States in the Great Lakes region, including at
a minimum, the St. Croix River, the Minnesota River, the Wisconsin
River, and the Ohio River, against the transfer of aquatic nuisance
species.
answer:
Defending Our Great Lakes Act of 2015 This bill requires federal agencies to take immediate actions to prevent the upstream transfer of aquatic nuisance species from the Mississippi River basin to the Great Lakes basin through the Brandon Road Lock and Dam site. The actions must place a special focus on Asian carp species and other aquatic nuisance species of concern to the Great Lakes referred to in the Great Lakes Mississippi River Interbasin Study conducted by the U.S. Army Corps of Engineers. The Army Corps must implement measures to improve the site to prevent the upstream transfer of Asian carp and other aquatic nuisance species swimming through the lock and dam, including by constructing an engineered channel in the approach to the site from the Mississippi River direction. The U.S. Fish and Wildlife Service must implement all appropriate measures around the site on the Illinois River to prevent the upstream transfer of swimming and floating aquatic nuisance species, with a focus on Asian carp species. Federal entities must take actions for the long-term prevention of the transfer of aquatic nuisance species between the Mississippi River and Great Lakes basins, including through the Chicago Area Waterway System. The Army Corps must design, engineer, and construct flood mitigation and water quality measures on the Chicago Area Waterway System related to preventing such transfer.

question:
SECTION 1. AUTOMATIC INCREASE IN THE FEDERAL MEDICAL ASSISTANCE
PERCENTAGE DURING PERIODS OF NATIONAL ECONOMIC DOWNTURN.

(a) National Economic Downturn Assistance FMAP.--
(1) In general.--Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended--
(A) in subsection (b), in the first sentence--
(i) by striking ''and (4)'' and inserting
''(4)''; and
(ii) by inserting ''and (5) with respect to
each fiscal year quarter other than the first
quarter of a national economic downturn
assistance period described in subsection
(y)(1), the Federal medical assistance
percentage for any State described in
subsection (y)(2) shall be equal to the
national economic downturn assistance FMAP
determined for the State for the quarter under
subsection (y)(3)'' before the period; and
(B) by adding at the end the following:
''(y) National Economic Downturn Assistance FMAP.--For purposes of
clause (5) of the first sentence of subsection (b):
''(1) National economic downturn assistance period.--A
national economic downturn assistance period described in this
paragraph--
''(A) begins with the first fiscal year quarter for
which the Secretary determines that for at least 23
States, the rolling average unemployment rate for that
quarter has increased by at least 10 percent over the
corresponding quarter for the most recent preceding 12-
month period for which data are available (in this
subsection referred to as the 'trigger quarter'); and
''(B) ends with the first succeeding fiscal year
quarter for which the Secretary determines that less
than 23 States have a rolling average unemployment rate
for that quarter with an increase of at least 10
percent over the corresponding quarter for the most
recent preceding 12-month period for which data are
available.
''(2) Eligible state.--A State described in this paragraph
is a State for which the Secretary determines that the rolling
average unemployment rate for the State for any quarter
occurring during a national economic downturn assistance period
described in paragraph (1) has increased over the corresponding
quarter for the most recent preceding 12-month period for which
data are available.
''(3) Determination of national economic downturn
assistance fmap.--
''(A) In general.--The national economic downturn
assistance FMAP for a fiscal year quarter determined
with respect to a State under this paragraph is equal
to the Federal medical assistance percentage for the
State for that quarter increased by the number of
percentage points determined by--
''(i) dividing--
''(I) the Medicaid additional
unemployed increased cost amount
determined under subparagraph (B) for
the quarter; by
''(II) the State's total Medicaid
quarterly spending amount determined
under subparagraph (C) for the quarter;
and
''(ii) multiplying the quotient determined
under clause (i) by 100.
''(B) Medicaid additional unemployed increased cost
amount.--For purposes of subparagraph (A)(i)(I), the
Medicaid additional unemployed increased cost amount
determined under this subparagraph with respect to a
State and a quarter is the product of the following:
''(i) State increase in rolling average
number of unemployed individuals from the base
quarter of unemployment.--
''(I) In general.--The amount
determined by subtracting the rolling
average number of unemployed
individuals in the State for the base
unemployment quarter for the State
determined under subclause (II) from
the rolling average number of
unemployed individuals in the State for
the quarter.
''(II) Base unemployment quarter
defined.--
''(aa) In general.--For
purposes of subclause (I),
except as provided in item
(bb), the base quarter for a
State is the quarter with the
lowest rolling average number
of unemployed individuals in
the State in the 12-month
period preceding the trigger
quarter for a national economic
downturn assistance period
described in paragraph (1).
''(bb) Exception.--If the
rolling average number of
unemployed individuals in a
State for a quarter occurring
during a national economic
downturn assistance period
described in paragraph (1) is
less than the rolling average
number of unemployed
individuals in the State for
the base quarter determined
under item (aa), that quarter
shall be treated as the base
quarter for the State for such
national economic downturn
assistance period.
''(ii) National average amount of
additional federal medicaid spending per
additional unemployed individual.--In the case
of--
''(I) a calendar quarter occurring
in fiscal year 2012, $350; and
''(II) a calendar quarter occurring
in any succeeding fiscal year, the
amount applicable under this clause for
calendar quarters occurring during the
preceding fiscal year, increased by the
annual percentage increase in the
medical care component of the consumer
price index for all urban consumers
(U.S. city average), as rounded up in
an appropriate manner.
''(iii) State nondisabled, nonelderly
adults and children medicaid spending index.--
''(I) In general.--With respect to
a State, the quotient (not to exceed
1.00) of--
''(aa) the State
expenditure per person in
poverty amount determined under
subclause (II); divided by--
''(bb) the National
expenditure per person in
poverty amount determined under
subclause (III).
''(II) State expenditure per person
in poverty amount.--For purposes of
subclause (I)(aa), the State
expenditure per person in poverty
amount is the quotient of--
''(aa) the total amount of
annual expenditures by the
State for providing medical
assistance under the State plan
to nondisabled, nonelderly
adults and children; divided by
''(bb) the total number of
nonelderly adults and children
in poverty who reside in the
State, as determined under
paragraph (4)(A).
''(III) National expenditure per
person in poverty amount.--For purposes
of subclause (I)(bb), the National
expenditure per person in poverty
amount is the quotient of--
''(aa) the sum of the total
amounts determined under
subclause (II)(aa) for all
States; divided by
''(bb) the sum of the total
amounts determined under
subclause (II)(bb) for all
States.
''(C) State's total medicaid quarterly spending
amount.--For purposes of subparagraph (A)(i)(II), the
State's total Medicaid quarterly spending amount
determined under this subparagraph with respect to a
State and a quarter is the amount equal to--
''(i) the total amount of expenditures by
the State for providing medical assistance
under the State plan to all individuals
enrolled in the plan for the most recent fiscal
year for which data is available; divided by
''(ii) 4.
''(4) Data.--In making the determinations required under
this subsection, the Secretary shall use, in addition to the
most recent available data from the Bureau of Labor Statistics
Local Area Unemployment Statistics for each State referred to
in paragraph (5), the most recently available--
''(A) data from the Bureau of the Census with
respect to the number of nonelderly adults and children
who reside in a State described in paragraph (2) with
family income below the poverty line (as defined in
section 2110(c)(5)) applicable to a family of the size
involved (or, if the Secretary determines it
appropriate, a multiyear average of such data);
''(B) data reported to the Secretary by a State
described in paragraph (2) with respect to expenditures
for medical assistance under the State plan under this
title for nondisabled, nonelderly adults and children;
and
''(C) econometric studies of the responsiveness of
Medicaid enrollments and spending to changes in rolling
average unemployment rates and other factors, including
State spending on certain Medicaid populations.
''(5) Definition of 'rolling average number of unemployed
individuals', 'rolling average unemployment rate'.--In this
subsection, the term--
''(A) 'rolling average number of unemployed
individuals' means, with respect to a calendar quarter
and a State, the average of the 12 most recent months
of seasonally adjusted unemployment data for each
State;
''(B) 'rolling average unemployment rate' means,
with respect to a calendar quarter and a State, the
average of the 12 most recent monthly unemployment
rates for the State; and
''(C) 'monthly unemployment rate' means, with
respect to a State, the quotient of--
''(i) the monthly seasonally adjusted
number of unemployed individuals for the State;
divided by
''(ii) the monthly seasonally adjusted
number of the labor force for the State,
using the most recent data available from the Bureau of Labor
Statistics Local Area Unemployment Statistics for each State.
''(6) Increase in cap on payments to territories.--With
respect to any fiscal year quarter for which the national
economic downturn assistance Federal medical assistance
percentage applies to Puerto Rico, the Virgin Islands, Guam,
the Northern Mariana Islands, or American Samoa, the amounts
otherwise determined for such commonwealth or territory under
subsections (f) and (g) of section 1108 shall be increased by
such percentage of such amounts as the Secretary determines is
equal to twice the average increase in the national economic
downturn assistance FMAP determined for all States described in
paragraph (2) for the quarter.
''(7) Scope of application.--The national economic downturn
assistance FMAP shall only apply for purposes of payments under
section 1903 for a quarter and shall not apply with respect
to--
''(A) disproportionate share hospital payments
described in section 1923;
''(B) payments under title IV or XXI; or
''(C) any payments under this title that are based
on the enhanced FMAP described in section 2105(b).
''(8) Additional requirement for certain states.--In the
case of a State described in paragraph (2) that requires
political subdivisions within the State to contribute toward
the non-Federal share of expenditures required under section
1902(a)(2), the State shall not require that such political
subdivisions pay for any fiscal year quarters occurring during
a national economic downturn assistance period a greater
percentage of the non-Federal share of such expenditures, or a
greater percentage of the non-Federal share of payments under
section 1923, than the respective percentage that would have
been required by the State under State law in effect on the
first day of the fiscal year quarter occurring immediately
prior to the trigger quarter for the period.''.
(2) Effective date; no retroactive application.--The
amendments made by paragraph (1) take effect on January 1,
2012. In no event may a State receive a payment on the basis of
the national economic downturn assistance Federal medical
assistance percentage determined for the State under section
1905(y)(3) of the Social Security Act for amounts expended by
the State prior to January 1, 2012.
(b) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall analyze the previous periods of national economic
downturn, including the most recent such period in effect as of
the date of enactment of this Act, and the past and projected
effects of temporary increases in the Federal medical
assistance percentage under the Medicaid program with respect
to such periods.
(2) Report.--Not later than April 1, 2011, the Comptroller
General of the United States shall submit a report to Congress
on the results of the analysis conducted under paragraph (1).
Such report shall include such recommendations as the
Comptroller General determines appropriate for modifying the
national economic downturn assistance FMAP established under
section 1905(y) of the Social Security Act (as added by
subsection (a)) to improve the effectiveness of the application
of such percentage in addressing the needs of States during
periods of national economic downturn, including
recommendations for--
(A) improvements to the factors that begin and end
the application of such percentage;
(B) how the determination of such percentage could
be adjusted to address State and regional economic
variations during such periods; and
(C) how the determination of such percentage could
be adjusted to be more responsive to actual Medicaid
costs incurred by States during such periods, as well
as to the effects of any other specific economic
indicators that the Comptroller General determines
appropriate.
answer:
Amends title XIX (Medicaid) of the Social Security Act to authorize an automatic increase in the federal medical assistance percentage (FMAP) for any eligible state during periods of national economic downturn.

Directs the Comptroller General to analyze and report to Congress on previous periods of national economic downturn, including the most recent one, and the past and projected effects of temporary increases in the Medicaid FMAP with respect to them.