To provide funds to support graduate medical education programs in children's hospitals.

TEXT OF AMENDMENTS

______

SA 1556. Mr. INHOFE submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:
On page 19, line 16, strike ``$351,295,000'' and insert
``$301,197,000''.
On page 63, line 2, strike ``$1,188,226,000, of which
$1,025,292,000'' and insert ``$1,238,324,000, of which
$1,073,000,000''.

On page 63, line 7, strike ``$59,610,000'' and insert
``$62,000,000''.

[[Page S11120]]

______

SA 1557. Mr. NELSON of Florida proposed an amendment to amendment SA
1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; as follows:

On page 61, between lines 14 and 15, insert the following:

SEC. __. GAO STUDY AND REPORT ON THE PROPAGATION OF CONCIERGE
CARE.

(a) Study.--
(1) In general.--The Comptroller General of the United
States shall conduct a study on concierge care (as defined in
paragraph (2)) to determine the extent to which such care--
(A) is used by medicare beneficiaries (as defined in
section 1802(b)(5)(A) of the Social Security Act (42 U.S.C.
1395a(b)(5)(A))); and
(B) has impacted upon the access of medicare beneficiaries
(as so defined) to items and services for which reimbursement
is provided under the medicare program under title XVIII of
the Social Security Act (42 U.S.C. 1395 et seq.).
(2) Concierge care.--In this section, the term ``concierge
care'' means an arrangement under which, as a prerequisite
for the provision of a health care item or service to an
individual, a physician, practitioner (as described in
section 1842(b)(18)(C) of the Social Security Act (42 U.S.C.
1395u(b)(18)(C))), or other individual--
(A) charges a membership fee or another incidental fee to
an individual desiring to receive the health care item or
service from such physician, practitioner, or other
individual; or
(B) requires the individual desiring to receive the health
care item or service from such physician, practitioner, or
other individual to purchase an item or service.
(b) Report.--Not later than the date that is 18 months
after the date of enactment of this Act, the Comptroller
General of the United States shall submit to Congress a
report on the study conducted under subsection (a)(1)
together with such recommendations for legislative or
administrative action as the Comptroller General determines
to be appropriate.
______

SA 1558. Mr. KOHL proposed an amendment to amendment SA 1542 proposed
by Mr. Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; as follows:

At the appropriate place insert the following:
Sec. __. In addition to any amounts otherwise appropriated
under this Act under the heading of Administration on Aging,
there are appropriated an additional $1,000,000: Provided,
That in addition to the amounts already made available to
carry out the ombudsman program under chapter 2 of title VII
of the Older Americans Act of 1965 (42 U.S.C. 3058 et seq.),
there are made available an additional $1,000,000.
______

SA 1559. Mrs. MURRAY (for herself, Mr. Kennedy, Mr. Dodd, Mr. Leahy,
Mr. Jeffords, Mr. Bingaman, and Mr. Johnson) proposed an amendment to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; as follows:

In the matter under the heading ``Training and Employment
Services'' under the heading ``Employment and Training
Administration'' in title I, add at the end the following:
Subject to the following sentence, for necessary expenses
of the Workforce Investment Act of 1998, including the
purchase and hire of passenger motor vehicles, the
construction, alteration, and repair of buildings and other
facilities, and the purchase of real property for training
centers as authorized by the Workforce Investment Act of
1998, $801,000,000, of which--
(1) $100,000,000 is available to carry out activities
described in section 132(a)(1) of that Act (relating to adult
employment and training activities);
(2) $159,000,000 is available to carry out activities
described in subparagraphs (A) and (B) of section 132(a)(2)
of that Act (relating to dislocated worker employment and
training activities and other activities for dislocated
workers);
(3) $99,000,000 is available to carry out chapter 4 of
subtitle B of title I of that Act (relating to youth
activities);
(4) $250,000,000 is available to carry out section 169 of
that Act (relating to youth opportunity grants);
(5) $23,000,000 is available to carry out section 167 of
that Act (relating to migrant and seasonal farmworker
programs);
(6) $20,000,000 is available to carry out section 166 of
that Act (relating to Native American programs); and
(7) $150,000,000 is available for the acquisition and
improvement of one-stop center infrastructure, including
acquisition of real estate, payment of rent or utilities,
improvement of technology, and staff development.
The amount $6,895,199,000 in section 305(a)(1) of this Act
shall be deemed to be $7,696,199,000 and the amount
$6,783,301,000 in section 305(a)(2) of this Act shall be
deemed to be $5,982,301,000: Provided, That of the funds
appropriated in this Act for the National Institutes of
Health, $370,000,000 shall not be available for obligation
until September 30, 2004.
______

SA 1560. Mr. DeWINE (for himself and Mrs. Murray) submitted an
amendment intended to be proposed to amendment SA 1542 proposed by Mr.
Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. __. (a) In General.--To provide funding for poison
control centers under the Poison Control Enhancement and
Awareness Act (42 U.S.C. 14801 et seq.), there are
appropriated a total of $27,600,000, including amounts
otherwise made available in this Act for such centers.
(b) Offset.--Amounts appropriated under title III under the
heading ``Program Administration'' for building alterations
and related expenses for relocation shall be reduced by
$5,300,000.
______

SA 1561. Mr. DeWINE (for himself and Mrs. Clinton) submitted an
amendment intended to be proposed to amendment SA 1542 proposed by Mr.
Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. __. (a) In General.--To carry out programs to support
graduate medical education programs in children's hospitals
under section 340E of the Public Health Service Act (42
U.S.C. 256e et seq.), there are appropriated a total of
$305,000,000, including amounts otherwise made available in
this Act for such programs.
(b) Offset.--Amounts appropriated under title III under the
heading ``Program Administration'' shall be reduced by
$15,000,000.
______

SA 1562. Mr. DODD (for himself, Mr. DeWine, Mr. Kennedy, Mrs.
Lincoln, and Ms. Landrieu) submitted an amendment intended to be
proposed to amendment SA 1542 proposed by Mr. Specter to the bill H.R.
2660, making appropriations for the Departments of Labor, Health and
Human Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; which was ordered to
lie on the table; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. __. In addition to any amounts otherwise appropriated
under this Act for the support of the improved newborn and
child screening for heritable disorders program authorized
under section 1109 of the Public Health Service Act (42
U.S.C. 300b-8), there are appropriated an additional
$10,000,000 to carry out such program: Provided, That of the
funds appropriated under this Act for the National Institutes
of Health, $19,000,000 shall not be available for obligation
until September 30, 2004: Provided further, That the amount
$6,895,199,000 in section 305(a)(1) of this Act shall be
deemed to be $6,905,199,000: Provided further, That the
amount $6,783,301,000 in section 305(a)(2) of this Act shall
be deemed to be $6,773,301,000.
______

SA 1563. Mr. BINGAMAN (for himself, Mr. Reid, and Mrs. Murray)
submitted an amendment intended to be proposed to amendment SA 1542
proposed by Mr. Specter to the bill H.R. 2660, making appropriations
for the Departments of Labor, Health and Human Services, and Education,
and related agencies for the fiscal year ending September 30, 2004, and
for other purposes; which was ordered to lie on the table; as follows:

At the end of title III, insert the following:
Sec. 306. (a) In addition to any amounts otherwise
appropriated under this Act, there are appropriated, out of
any money in the Treasury not otherwise appropriated, an
additional $20,000,000 to carry out part H of title I of the
Elementary and Secondary Education Act of 1965 (school
dropout prevention).
(b) Of the funds appropriated in this Act for the National
Institutes of Health, $4,000,000 shall not be available for
obligation until September 30, 2004.
(c) The amount $6,895,199,000 in section 305(a)(1) of this
Act shall be deemed to be $6,915,199,000 and the amount
$6,783,301,000 in section 305(a)(2) of this Act shall be
deemed to be $6,763,301,000.
______

SA 1564. Mr. COLEMAN (for himself and Ms. Collins) submitted an
amendment intended to be proposed to

[[Page S11121]]

amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

On page 70, line 12, strike ``$14,174,115,000'' and insert
``$14,712,115,000''.
______

SA 1565. Mrs. CLINTON submitted an amendment intended to be proposed
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660,
making appropriations for the Departments of Labor, Health and Human
Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; as follows:

On page 36, line 16, strike the period at the end and
insert ``: Provided further, That the amount $6,252,256,000
under the heading `Health Resources and Services' shall be
deemed to be $6,272,256,000 of which the additional
$20,000,000 shall be available for carrying out sections 765
and 767 of the Public Health Service Act: Provided further,
That the amount $4,588,671,000 under the heading `Disease
Control, Research, and Training' shall be deemed to be
$4,631,871,000: Provided further, That the amount
$1,726,846,000 under the heading `Public Health and Social
Services Emergency Fund' shall be deemed to be
$1,756,846,000: Provided further, That the amount
$1,116,156,000 under the heading `Public Health and Social
Services Emergency Fund' shall be deemed to be $1,146,156,000
Provided further, That the amount $6,895,199,000 in section
305(a)(1) of this Act shall be deemed to be $6,988,399,000:
Provided further, That the amount $6,783,301,000 in section
305(a)(2) of this Act shall be deemed to be $6,690,101,000:
Provided further, That of the funds appropriated in this Act
for the National Institutes of Health, $93,200,000 shall not
be available for obligation until September 30, 2004.
______

SA 1566. Mr. KENNEDY (for himself, Ms. Collins, Mr. Dodd, Mr. Reed,
Mr. Bingaman, Mrs. Murray, Mr. Kerry, Mr. Lieberman, Mr. Edwards, Mr.
Pryor, Mr. Corzine, Ms. Stabenow, Mr. Akaka, Mr. Lautenberg, Mr.
Schumer, Mr. Jeffords, and Mr. Harkin) proposed an amendment to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; as follows:

On the appropriate page and line, insert before the period
the following: ``: Provided further, That of the funds
appropriate in this Act for the National Institutes of
Health, $1,470,000,000 shall not be available for obligation
until September 30, 1994''.
On page 76, between lines 4 and 5, insert the following:
Sec. __. (a) Increase in Funding.--In addition to any
amounts otherwise appropriated under this Act for Federal
Pell Grants under subpart 1 of part A of title IV of the
Higher Education Act of 1965, there are appropriated an
additional $1,688,000,000 for such grants. In addition to any
amounts otherwise appropriated under this Act for Federal
Supplemental Education Opportunity Grants under subpart 3 of
part A of title IV of the Higher Education Act of 1965, there
are appropriated an additional $115,000,000 for such grants.
In addition to any amounts otherwise appropriated under this
Act for Federal Work-Study Programs under part C of title IV
of the Higher Education Act of 1965, there are appropriated
an additional $157,000,000 for such programs. In addition to
any amounts otherwise appropriated under this Act for the
Leveraging Educational Assistance Partnership Program under
subpart 4 of part A of title IV of the Higher Education Act
of 1965, there are appropriated an additional $33,445,000 for
such program. In addition to any amounts otherwise
appropriated under this Act for Federal Trio programs under
chapter 1 of subpart 2 of part A of title IV of the Higher
Education Act of 1965, there are appropriated an additional
$160,000,000 for such programs. In addition to any amounts
otherwise appropriated under this Act for Gear Up programs
under chapter 2 of subpart 2 of part A of title IV of the
Higher Education Act of 1965, there are appropriated an
additional $57,000,000 for such programs. In addition to any
amounts otherwise appropriated under this Act for loan
cancellations under the Federal Perkins Loans program under
part E of title IV of the Higher Education Act of 1965, there
are appropriated an additional $33,000,000 for such loan
cancellations. In addition to any amounts otherwise
appropriated under this Act for the Graduate Assistance in
Areas of National Need program under subpart 2 of part A of
title VII of the Higher Education Act of 1965, there are
appropriated an additional $13,200,000 for such program. In
addition to any amounts otherwise appropriated under this Act
for the Thurgood Marshall Legal Educational Opportunity
Program under subpart 3 of part A of title VII of the Higher
Education Act of 1965, there are appropriated an additional
$7,000,000 for such program. The amount $4,050 under the
heading `Student Financial Assistance' in this title shall be
deemed to be $4,500. The amount $9,935,000 under the heading
`Higher Education' in this title shall be deemed to be
$15,000,000.
(b) Budgetary Authority.--The amount $6,895,199,000 in
section 305(a)(1) of this Act shall be deemed to be
$9,151,909,000. The amount $6,783,301,000 in section
305(a)(2) of this Act shall be deemed to be $4,526,591,000.
______

SA 1567. Mr. CONRAD (for himself, Mr. Roberts, and Mr. Crapo)
submitted an amendment intended to be proposed to amendment SA 1542
proposed by Mr. Specter to the bill H.R. 2660, making appropriations
for the Departments of Labor, Health and Human Services, and Education,
and related agencies for the fiscal year ending September 30, 2004, and
for other purposes; which was ordered to lie on the table; as follows:

On page 27, line 2, insert before the period the following:
``: Provided further, That $5,000,000 shall be made available
to carry out the rural emergency medical service training and
equipment assistance program under section 330J of the Public
Health Service Act (42 U.S.C. 254c-15)''.
______

SA 1568. Mr. DASCHLE (for himself, Ms. Collins, Mr. Conrad, Mr.
Dorgan, Mr. Dodd, Mr. Baucus, Mr. Pryor, Mr. Bingaman, Mrs. Lincoln,
Mr. Johnson, Mr. Kerry, and Mr. Nelson of Nebraska) proposed an
amendment to amendment SA 1542 proposed by Mr. Specter to the bill H.R.
2660, making appropriations for the Departments of Labor, Health and
Human Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; as follows:

On page 76, between lines 10 and 11, insert the following:
Sec.__. In addition to any amounts otherwise appropriated
under this Act to carry out part B of title VI of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
7341 et seq.), there are appropriated an additional
$132,347,000 to carry out such part: Provided, That of the
funds appropriated in this Act for the National Institutes of
Health, $25,000,000 shall not be available for obligation
until September 30, 2004: Provided further, That the amount
$6,895,199,000 in section 305(a)(1) of this Act shall be
deemed to be $7,027,546,000: Provided further, That the
amount $6,783,301,000 in section 305(a)(2) of this Act shall
be deemed to be $6,650,954,000.
______

SA 1569. Mrs. BOXER submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

At the appropriate place, insert the following:
Sec.   . Not later than May 1, 2004, the Secretary of
Health and Human Services shall submit to the appropriate
committees of Congress a report concerning the manner in
which the Department of Health and Human Services expends
Federal funds for research, patient care, and other
activities relating to Hansen's Disease. The report shall
include--
(1) the amounts provided for each research project;
(2) the amounts provided to each of the 12 treatment
centers for each of research, patient care, and other
activities;
(3) the per patient expenditure of patient care funds at
each of the 12 treatment centers; and
(4) the mortality rates at each of the 12 treatment
centers.
______

SA 1570. Mr. DeWINE submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. __. In addition to any amounts otherwise appropriated
under this Act to carry out mother-to-child HIV transmission
prevention activities, there are appropriated an additional
$60,000,000 to carry out such activities.
______

SA 1571. Mr. DeWINE submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

On page 61, between lines 14 and 15, insert the following:

[[Page S11122]]

Sec. __. In addition to any amounts otherwise appropriated
under this Act to carry out mother-to-child HIV transmission
prevention activities, there are appropriated an additional
$60,000,000 to carry out such activities. Amounts
appropriated under this section shall be designated as
emergency spending pursuant to section 502(c) of House
Concurrent Resolution 95 (108th Congress).
______

SA 1572. Mr. DODD (for himself, Mr. Hagel, Mr. Jeffords, Ms. Collins,
Mrs. Murray, Mr. Dorgan, Mr. Bingaman, Mr. Kerry, Ms. Mikulski, Mr.
Pryor, Mr. Coleman, and Ms. Stabenow) proposed an amendment to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; as follows:

On page 76, between lines 10 and 11, insert the following:
Sec.__. In addition to any amounts otherwise appropriated
under this Act for grants to States under part B of the
Individuals with Disabilities Education Act (20 U.S.C. 1411
et seq.), there are appropriated an additional $1,200,000,000
for such grants: Provided, That of the funds appropriated in
this Act for the National Institutes of Health, $84,000,000
shall not be available for obligation until September 30,
2004: Provided further, That the amount $6,895,199,000 in
section 305(a)(1) of this Act shall be deemed to be
$8,095,199,000: Provided further, That the amount
$6,783,301,000 in section 305(a)(2) of this Act shall be
deemed to be $5,583,301,000.
______

SA 1573. Ms. MIKULSKI submitted an amendment intended to be proposed
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660,
making appropriations for the Departments of Labor, Health and Human
Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; which was ordered to
lie on the table; as follows:

On page 61, between lines 14 and 15, insert the following:

SEC. __. STUDIES CONCERNING MAMMOGRAPHY STANDARDS.

(a) Study by GAO.--
(1) In general.--The Comptroller General of the United
States shall conduct a study of the program established under
the Mammography Quality Standards Act of 1992 (section 354 of
the Public Health Service Act (42 U.S.C. 263b)) (referred to
in this section as the ``MQSA'') to--
(A) evaluate the demonstration program regarding frequency
of inspections authorized under section 354(g) of the Public
Health Service Act (42 U.S.C. 263b(g)), including the effect
of the program on compliance with the MQSA;
(B) evaluate the factors that contributed to the closing of
the approximately 700 mammography facilities nationwide since
2001, whether those closings were due to consolidation or
were a true reduction in mammography availability, explore
the relationship between certified units and facility
capacity, and evaluate capacity issues, and determine the
effect these and other closings have had on the accessibility
of mammography services, including for underserved
populations, since the April 2002 General Accounting Office
report on access to mammography; and
(C) evaluate the role of States in acting as accreditation
bodies or certification bodies, or both, in addition to
inspection agents under the MQSA, and in acting as
accreditation bodies for facilities in other States and
determine whether and how these roles affect the system of
checks and balances within the MQSA.
(2) Report.--Not later than 16 months after the date of
enactment of this Act, the Comptroller General of the United
States shall submit to the Committee on Health, Education,
Labor, and Pensions and the Committee on Appropriations of
the Senate and the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representatives a
report on the study described in paragraph (1).
(b) Study by the Institute of Medicine.--
(1) In general.--Not later than 30 days after the date of
enactment of this Act, the Secretary of Health and Human
Services shall enter into an agreement with the Institute of
Medicine of the National Academy of Sciences for the conduct
of a study and the making of recommendations regarding the
following:
(A) Ways to improve physicians' interpretations of
mammograms, including approaches that could be taken under
the MQSA without negatively impacting access to quality
mammography.
(B) What changes could be made in the MQSA to improve
mammography quality, including additional regulatory
requirements that would improve quality, as well as the
reduction or modification of regulatory requirements that do
not contribute to quality mammography, or are no longer
necessary to ensure quality mammography. Such reduction or
modification of regulatory requirements and improvements in
the efficiency of the program are important to help eliminate
disincentives to enter or remain in the field of mammography.
(C) Ways, including incentives, to ensure that sufficient
numbers of adequately trained personnel at all levels are
recruited and retained to provide quality mammography
services.
(D)(i) How data currently collected under the MQSA could be
used to improve the quality, interpretation of, and access to
mammography.
(ii) Identification of new data points that could be
collected to aid in the monitoring and assessment of
mammography quality and access.
(E) Other approaches that would improve the quality of and
access to mammography services, including approaches to
improving provisions under the MQSA.
(F) Steps that should be taken to help make available safe
and effective new screening and diagnostic devices and tests
for breast cancer.
(2) Report.--Not later than 15 months after the date on
which the agreement is entered into under paragraph (1), the
Institute of Medicine shall complete the study described
under such subsection and submit a report to the Secretary of
Health and Human Services, the Committee on Health,
Education, Labor, and Pensions and the Committee on
Appropriations of the Senate, and the Committee on Energy and
Commerce and the Committee on Appropriations of the House of
Representatives.
(3) Funding.--Of the amounts appropriated under this title
to the Office of the Secretary of Health and Human Services
for general departmental management, $500,000 shall be made
available to carry out the study under this subsection.
______

SA 1574. Ms. CANTWELL submitted an amendment intended to be proposed
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660,
making appropriations for the Departments of Labor, Health and Human
Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; which was ordered to
lie on the table; as follows:

In the matter under the heading ``Training and Employment
Services'' under the heading ``Employment and Training
Administration'' in title I, add at the end the following:
For necessary expenses of the Workforce Investment Act of
1998, including the purchase and hire of passenger motor
vehicles, the construction, alteration, and repair of
buildings and other facilities, and the purchase of real
property for training centers as authorized by the Workforce
Investment Act of 1998, $50,000,000 to carry out activities
described in section 132(a)(2)(B) of that Act (relating to
dislocated worker employment and training activities and
other activities for dislocated workers). There shall be
transferred from the account relating to the Department of
Labor's Working Capital Fund, $5,000,000 to the account
relating to carrying out activities described in section
132(a)(2)(B) of the Workforce Investment Act of 1998
(relating to dislocated worker employment and training
activities and other activities for dislocated workers).
There shall be transferred from the account relating to the
Department of Labor's management cross cut activities,
$5,000,000 to the account relating to carrying out activities
described in section 132(a)(2)(B) of the Workforce Investment
Act of 1998 (relating to dislocated worker employment and
training activities and other activities for dislocated
workers).
On page 2, line 23, strike ``$276,608,000 shall be for
activities'' and insert ``$226,608,000 shall be used with
priority given to carry out the amendments made by section
203 of the Trade Adjustment Assistance Reform Act of 2002 and
shall be for activities''.
______

SA 1575. Mr. HARKIN (for himself, Mrs. Clinton, Mr. Corzine, Mr.
Kerry, Mr. Bingaman, Mrs. Murray, and Ms. Stabenow) proposed an
amendment to amendment SA 1542 proposed by Mr. Specter to the bill H.R.
2660, making appropriations for the Departments of Labor, Health and
Human Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; as follows:

On page 76, between lines 10 and 11, insert the following:
Sec.__. (a) Additional Funds.--
(1) In general.--In addition to any amounts otherwise
appropriated under this Act for the Fund for the Improvement
of Education under part D of title V of the Elementary and
Secondary Education Act of 1965 (20 U.S.C. 7241 et seq.),
there are appropriated an additional $1,000,000,000 for such
fund that shall be used by the Secretary of Education to
award formula grants to State educational agencies to enable
such State educational agencies--
(A) to expand existing structures to alleviate overcrowding
in public schools;
(B) to make renovations or modifications to existing
structures necessary to support alignment of curriculum with
State standards in mathematics, reading or language arts, or
science in public schools served by such agencies;
(C) to make emergency repairs or renovations necessary to
ensure the safety of students and staff and to bring public
schools into compliance with fire and safety codes;
(D) to make modifications necessary to render public
schools in compliance with the

[[Page S11123]]

Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et
seq.) and section 504 of the Rehabilitation Act of 1973 (29
U.S.C. 794);
(E) to abate or remove asbestos, lead, mold, and other
environmental factors in public schools that are associated
with poor cognitive outcomes in children; and
(F) to renovate, repair, and acquire needs related to
infrastructure of charter schools.
(2) Amount of grants.--The Secretary shall allocate amounts
available for grants under this subsection to States in
proportion to the funds received by the States, respectively,
for the previous fiscal year under part A of title I of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
6311 et seq).
(b) Offset.--Of the funds appropriated in this Act for the
National Institutes of Health, $352,000,000 shall not be
available for obligation until September 30, 2004: Provided,
That the amount $6,895,199,000 in section 305(a)(1) of this
Act shall be deemed to be $7,895,199,000, and the amount
$6,783,301,000 in section 305(a)(2) of this Act shall be
deemed to be $5,783,301,000.
______

SA 1576. Mr. EDWARDS submitted an amendment intended to be proposed
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660,
making appropriations for the Departments of Labor, Health and Human
Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; which was ordered to
lie on the table; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. __. In addition to any amounts otherwise appropriated
in this Act for programs and activities under the Health Care
Safety Net Amendments (Public Law 107-251) and the amendments
made by such Act, and for other telehealth programs under
section 330 of the Public Health Service Act (42 U.S.C. 254b
et seq), there are appropriated an additional $10,000,000 for
such programs and activities, including $2,500,000 for a
minimum of 10 telehealth resource centers which provide
assistance with respect to technical, legal and regulatory,
service delivery or other related barriers to the deployment
of telehealth technologies, $5,000,000 for network grants,
and $2,500,000 for grants to State professional licensing
boards to carry out programs under which such licensing
boards of various States cooperate to develop and implement
State policies that will reduce statutory and regulatory
barriers to telemedicine: Provided, That $30,000,000 of the
amount appropriated under this Act for the National
Institutes of Health shall not be available for obligation
until September 30, 2004: Provided further, That the amount
$6,895,199,000 in section 305(a)(1) of this Act shall be
deemed to be $6,905,199,000: Provided further, That the
amount $6,783,301,000 in section 305(a)(2) of this Act shall
be deemed to be $6,773,301,000.
______

SA 1577. Mrs. FEINSTEIN submitted an amendment intended to be
proposed to amendment SA 1542 proposed by Mr. Specter to the bill H.R.
2660, making appropriations for the Departments of Labor, Health and
Human Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; which was ordered to
lie on the table; as follows:

On page 76, between lines 10 and 11, insert the following:
Sec. __. In addition to any amounts otherwise appropriated
under this Act for the Federal Trio programs under chapter 1
of subpart 2 of part A of title IV of the Higher Education
Act of 1965 (20 U.S.C. 1070a-11 et seq.), there are
appropriated not more than $16,000,000 that shall be used by
the Secretary of Education to award grants to Upward Bound,
Upbound Math/Science, and McNair grant applicants that
submitted applications for grants under chapter 1 of subpart
2 of part A of title IV of the Higher Education Act of 1965
(20 U.S.C. 1070a-11 et seq.) for fiscal year 2003 that were
eligible to receive grants but did not receive grants because
the applications were received after the closing date or
exceeded the 100 page limit. If the amount appropriated under
this section is insufficient to pay the full amounts that all
applicants are eligible to receive under this section, the
Secretary shall ratably reduce such amounts: Provided, That
of the funds appropriated in this Act for the National
Institutes of Health, $1,500,000,000 shall not be available
for obligation until September 30, 2004: Provided further,
That the amount $6,895,199,000 in section 305(a)(1) of this
Act shall be deemed to be $6,911,199,000: Provided further,
That the amount $6,783,301,000 in section 305(a)(2) of this
Act shall be deemed to be $6,767,301,000.
______

SA 1578. Mr. DeWINE (for himself, Mr. Alexander, Ms. Stabenow, Mr.
Grassley, and Mr. Voinovich) proposed an amendment to amendment SA 1542
proposed by Mr. Specter to the bill H.R. 2660, making appropriations
for the Departments of Labor, Health and Human Services, and Education,
and related agencies for the fiscal year ending September 30, 2004, and
for other purposes; as follows:

On page 74, line 1, strike ``$409,863,000, of which
$13,644,000'' and insert ``$406,863,000, of which
$10,644,000''.
On page 76, between lines 11 and 12, insert the following:
Sec. __. For necessary expenses for the Underground
Railroad Education and Cultural Program, there are
appropriated $3,000,000.
______

SA 1579. Mrs. FEINSTEIN submitted an amendment intended to be
proposed to SA 1542 proposed by Mr. Specter to the bill H.R. 2660,
making appropriations for the Departments of Labor, Health and Human
Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; which was ordered to
lie on the table; as follows:

At the end of title II, insert the following:
Sec. __. (a) State Election.--
(1) In general.--In lieu of the Federal medical assistance
percentage otherwise determined for the State under section
1905(b) of the Social Security Act (42 U.S.C. 1396d(b))
(without regard to the application of section 401 of the Jobs
and Growth Tax Relief Reconciliation Act of 2003 (42 U.S.C.
1396d note)), a State may elect to have the alternative
Federal medical assistance percentage determined under
subsection (b) apply to the State for purposes of
expenditures under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.) for fiscal years beginning on or after
the date of such an election, but only with respect to
expenditures under title XIX of such Act that exceed the
total amount of expenditures incurred under that title with
respect to the State for fiscal year 2003.
(2) Irreversible election.--A State election under
paragraph (1) shall be irreversible.
(3) Limitation.--A State may not make an election under
paragraph (1) before October 1, 2003.
(b) Alternative Federal Medical Assistance Percentage.--
(1) In general.--Subject to paragraph (4), the alternative
Federal medical assistance percentage determined under this
subsection is, with respect to a State and a fiscal year, 100
percent reduced by the product of 0.40 and the ratio of--
(A) the State's economic resources per person in poverty,
as defined in paragraph (2); to
(B) the economic resources per person in poverty for all
States, as defined in paragraph (3).
(2) State's economic resources per person in poverty.--For
purposes of paragraph (1)(A), except as provided in paragraph
(4)(C)(i), with respect to a State, the State's economic
resources per person in poverty is the ratio of--
(A) the most recent 3-year average of the total taxable
resources of the State, as determined by the Secretary of the
Treasury; to
(B) the most recent 3-year average of the number of
individuals residing in the State whose income is below the
official poverty income threshold (as determined by the
Secretary of Commerce).
(3) Economic resources per person in poverty for all
States.--For purposes of paragraph (1)(B), the economic
resources per person in poverty for all States is the ratio
of--
(A) the sum of the most recent 3-year averages determined
under paragraph (2)(A) for all States; to
(B) the sum of the most recent 3-year averages determined
under paragraph (2)(B) for the 50 States and the District of
Columbia.
(4) Special rules.--
(A) Hold harmless; cap on increases.--Subject to
subparagraph (B), with respect to a State making an election
under this section, the alternative Federal medical
assistance percentage determined for the State for a fiscal
year under this subsection--
(i) shall not be less than the Federal medical assistance
percentage determined for the State under section 1905(b) of
the Social Security Act (42 U.S.C. 1396d(b)) for the fiscal
year; and
(ii) only with respect to each of fiscal years 2004 through
2013, shall not exceed--

(I) the Federal medical assistance percentage determined
for the State under section 1905(b) of the Social Security
Act (42 U.S.C. 1396d(b)) for the preceding fiscal year by
more than 1 percent; and
(II) the alternative Federal medical assistance percentage
determined for the State under this subsection for the
preceding fiscal year by more than 1 percent.

(B) Overall cap.--In no event may the alternative Federal
medical assistance percentage determined for a State for a
fiscal year exceed 83 percent.
(C) Alaska; district of columbia.--
(i) Alaska.--In the case of Alaska, the State's economic
resources per person in poverty is the ratio of--

(I) the most recent 3-year average of the total taxable
resources of the State, as determined by the Secretary of the
Treasury; to
(II) the most recent 3-year average of the number of
individuals residing in the State whose income is below the
official poverty income threshold (as determined by the
Secretary of Commerce), multiplied by 1.05.

(ii) District of columbia.--The alternative Federal medical
assistance percentage for the District of Columbia for any
fiscal year is 70 percent.
(c) Scope of Application.--An election under this section
shall apply only for purposes of title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) and shall not apply
with respect to--

[[Page S11124]]

(1) disproportionate share hospital payments described in
section 1923 of such Act (42 U.S.C. 1396r-4);
(2) payments under title IV or XXI of such Act (42 U.S.C.
601 et seq., 1397aa et seq.); or
(3) any payments under XIX of such Act that are based on
the enhanced FMAP described in section 2105(b) of such Act
(42 U.S.C. 1397ee(b)).
(d) Definition of State.--In this section, the term
``State'' has the meaning given such term for purposes of
title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.).

____________________