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   DVA nurses, like their co-workers, provide not only a vital service for our nation's veterans, but honor veterans with compassion, respect and professional care. I urge you to demonstrate to these dedicated workers that their work is valued and appreciated by becoming an original co-sponsor of the Department of Veterans Affairs Nurse Appreciation Act. If you have any questions about this bill, please contact Mike Hall in Senator DeWine's office at 224-2315 or Dominic DelPozzo in Senator Dodd's office at 224-2823 or Linda Bennett in AFGE's Legislative Department at (202) 639-6413.


   Bobby L. Harnage, Sr.,
National President.



   Washington, DC, June 11, 1999.
U.S. House of Representatives,
Washington, DC.

   DEAR REPRESENTATIVE LATOURETTE: The American Nurses Association (ANA) is pleased to support H.R. 1216, the VA Nurse Appreciation Act of 1999. While the Veterans Health Administration (VHA) has made some effort to address the implementation problems of the VA Nurse Locality Pay System, more significant and immediate action must be taken to ensure that VA registered nurses are appropriately paid for their expert work.

   H.R. 1216 would allow for all Title 38 registered nurses, employed within the VHA, to receive the same pay adjustment provided all federal employees covered by the Federal Employees Pay Comparability Act (FEPCA). This pay adjustment would include both the nationwide component and a locality pay component. Passage of H.R. 1216 provides for this adjustment without requiring that VA registered nurses be placed on the General Schedule levels of one to fifteen.

   ANA strongly supports the provision that provides additional authority, starting in 2002, to the Secretary of the Veterans Administration to adjust the rates of basic pay. This provision is necessary to ensure that the VA can continue to adequately recruit and retain registered nurses. The VA's inability to recruit and retain registered nurses was one of the primary reasons for passage of the original VA nurse locality pay bill. In the near future, nursing will again be facing a tightening labor market and the VA must be able to compete.

   ANA applauds your efforts to address this significant problem and we stand ready to assist in anyway possible.


   Marjorie Vanderbilt,
Director, Federal Government Relations.

    Mr. DODD. Mr. President, I rise today to join my colleague, Senator DEWINE, in introducing the Nurse Appreciation Act of 1999. It will alter the Department of Veterans Affairs' regulations regarding compensation rates for nurses. Unfortunately, the current regulations have led to hardship for many of our nation's VA nurses.

   For example, from 1996 through 1999, nurses at 16 VA hospitals have seen their pay slashed by up to eight percent. Also, during those same years, nurses at 80 VA hospitals have not received a single raise. Meanwhile, other federal employees at all VA hospitals received the annual General Schedule increases of 2.4 percent to 3.6 percent. This nation cannot continue a policy of turning a blind eye to those who care for its sick and wounded veterans.

   The Nurse Appreciation Act of 1999 will correct this injustice which seems to be an unintended consequence of the Nurses Pay Act of 1990. That law was written when VA hospitals faced a shortage of qualified nurses, and it gave hospital directors wide discretion in setting pay rates for nurses in their hospitals. The law partially served its purpose because it allowed directors to increase nurses' pay rates if they were having difficulty recruiting and retaining qualified nurses. Those who wrote the law, however, could not have anticipated that the VA would take advantage of the fact that the law did not mandate any minimum annual increase each year. They could not have anticipated that the law would be used to freeze or even reduce nurses' pay rates.

   Over the past several years, a few factors emerged to create the inequity in VA nurses' compensation. First, the nurse shortage of a decade ago has subsided. Second, VA hospital directors and network directors have been granted more responsibility for their budgets. In other words, if hospital directors can save money by not providing an annual increase to nurses, then the directors can use that money for other purposes. Finally, to make matters worse, the funding that goes to these hospitals has been, in many cases, steady or decreasing over the past few years. I know, for example, that the two VA hospitals in Connecticut have not received a real funding increase in about three years. So the hospitals in Newington, West Haven, and in many other cities throughout the country must tighten their belts each year to absorb costs due to inflation.

   The pressure to save money has caused many hospital directors to forgo providing even the slightest annual increase to nurses. Yet, hospital budget pressures have absolutely no bearing on whether other federal employees--including other veterans hospital employees--receive their annual salary increases. Those increases are prescribed by the federal government. This legislation just says that nurses should be treated the same as the others. It says that nurses should not bear a disproportionate share of the burden caused by stagnant budgets at our VA hospitals.

   Apparently the VA believes that, in the absence of a nurse shortage, annual increases for nurses are unnecessary. But I do not subscribe to that reasoning. We should not wait for a crisis before we take action. If we get to the point where some VA hospitals are unable to retain well-qualified nurses as a result of unbearably inadequate pay, we will have waited far too long and will have badly degraded services at our VA hospitals.

   Furthermore, this nation has benefitted from a robust economy over the last several years. That economy has given a boost to nearly every segment of society. Clearly, though, despite the immense value of their work, many VA nurses have been left behind. Valuable work on behalf of this nation deserves, at a minimum, adequate compensation. This bill will provide that compensation and enable us to do right by our VA hospital nurses.

   By Mrs. BOXER (for herself, Mrs. MURRAY, Mr. KENNEDY, Mr. LAUTENBERG, and Mr. SCHUMER):

   S. 1400. A bill to protect women's reproductive health and constitutional right to choice, and for other purposes; to the Committee on Health, Education, Labor, and Pensions.


   Mrs. BOXER. Mr. President, when I entered the United States Senate in 1993, women's rights were strong and secure. That year alone, we passed the Violence Against Women Act, the Family and Medical Leave Act, and the Freedom of Access to Clinic Entrances Act. We lifted the gag rule, which freed up doctors to tell their patients that abortion is a legal option.

   Things are quite different now. Since 1994, the tide has turned against women's rights, as there have been nearly 100 votes to restrict choice, and pro-choice forces have lost most of these votes.

   Congress recently blocked women in the military and military dependents from using their own funds to obtain an abortion at military facilities. The House of Representatives voted to make it a crime for any adult to help a teenager travel to another state to avoid her home state's restrictive parental consent laws, and the Senate voted to prohibit women who work for the federal government from accessing health plans that offer abortion services.

   At the same time, violence against clinics and health care workers is increasing. Last year, the Feminist Majority reported that nearly one out of four clinics faced severe anti-abortion violence including death threats, stalking, bomb threats, bombings, arson threats, arson, blockades, invasions, and chemical attacks.

   In my own state of California, there have been 29 recorded incidents of violence against clinics since 1984. The firebombing of a women's health care clinic on July 2 in Sacramento serves as a grim reminder that this violence continues.

   While there are many in the community and in Congress who have helped fight off assaults on women's health rights, playing defense is not enough. We need a positive agenda for women's health, choice and family planning if we hope to move the pendulum back the other way.

   The Family Planning and Choice Protection Act of 1999 sets out such an agenda. This comprehensive bill is pro-choice, pro-family planning, and pro-

[Page: S8881]  GPO's PDF
women's health. It will improve family planning programs and services; strengthen women's right to choose; expand access to contraceptive cover age; prot ect patients and employees at reproductive health care facilities; and give law enforcement the resources needed to protect women's legal rights.

   Mr. President, I urge my colleagues to support this legislation and to stand up for the women in their respective states who deserve to have their rights and health protected. I ask unanimous consent that the bill be printed in the RECORD.

   There being no objection, the bill was ordered to be printed in the RECORD, as follows:

S. 1400

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


    (a) SHORT TITLE.--This Act may be cited as the ``Family Planning and Choice Protection Act of 1999''.

    (b) TABLE OF CONTENTS.--The table of contents of this Act is as follows:

   Sec..1..Short title; table of contents.



   Subtitle A--Family Planning

   Sec..101..Family planning amendments.

   Sec..102..Freedom of full disclosure.

   Subtitle B--Prescription Equity and Contraceptive Cover age

&n bsp;  Sec..111..Short title.


   Sec..113..Amendments to the Employee Retirement Income Security Act of 1974.

   Sec..114..Amendments to the Public Health Service Act relating to the group market.

   Sec..115..Amendment to the Public Health Service Act relating to the individual market.

   Sec..116..FEHBP coverage.

&n bsp;  Subtitle C--Emergency Contraceptives

   Sec..121..Emergency contraceptive educa tion.


   Sec..201..Medicaid funding for abortion services.

   Sec..202..Clinic violence.

   Sec..203..Approval of RU-486.

   Sec..204..Freedom of choice.

   Sec..205..Fairness in insurance.

   Sec..206..Reproductive rights of women in the military.

   Sec..207..Repeal of certain State Child Health Insurance Program limitations.

   Sec..208..Funding for certain services for women in prison.

   Sec..209..Funding for certain services for women in the District of Columbia.

   Sec..210..Funding for certain services for women under the FEHBP.


    Congress makes the following findings:

    (1) Reproductive rights are central to the ability of women to exercise full enjoyment of rights secured to women by Federal and State law.

    (2) Abortion has been a legal and constitutionally protected medical procedure throughout the United States since 1973 and has become part of mainstream medical practice as is evidenced by the positions of medical institutions including the American Medical Association, the American College of Obstetricians and Gynecologists, the American Medical Women's Association, the American Nurses Association, and the American Public Health Association.

    (3) The availability of abortion services is diminishing throughout the United States, as evidenced by--

    (A) the fact that 86 percent of counties in the United States have no abortion provider; and

    (B) the fact that, between 1992 and 1996, the number of abortion providers decreased by 14 percent.

    (4)(A) The Department of Health and Human Services and the Institute of Medicine of the National Academy of Sciences have contributed to the development of a report entitled ``Healthy People 2000'', which urges that the rate of unintended pregnancy in the United States be reduced by nearly 50 percent by the year 2000.

    (B) Nearly 50 percent, or approximately 3,050,000, of all pregnancies in the United States each year are unintended, resulting in 1,370,000 abortions in the United States each year.

    (C) The provision of family planning services, including emergency contraception, is a cost-effective way of reducing the number of unintended pregnancies and abortions in the United States.




Subtitle A--Family Planning


    Section 1001(d) of the Public Health Service Act (42 U.S.C. 300(d)) is amended to read as follows:

    ``(d) For the purpose of making grants and entering into contracts under this section, there are authorized to be appropriated $500,000,000 for each of fiscal years 2000 through 2004.''.


    Title XI of the Civil Rights Act of 1964 (42 U.S.C. 2000h et seq.) is amended by adding at the end the following:


    ``(a) DEFINITION.--As used in this section, the term `governmental authority' means any authority of the United States.

    ``(b) GENERAL AUTHORITY.--Notwithstanding any other provision of law, no governmental authority shall, in or through any program or activity that is administered or assisted by such authority and that provides health care services or information, limit the right of any person to provide, or the right of any person to receive, nonfraudulent information about the availability of reproductive health care services, including family planning, prenatal care, adoption, and abortion services.''.


Subtitle B--Prescription Equity and Contraceptive Cover age er>


    This subtitle may be cited as the ``Equity in Prescription Insurance and Contraceptive Cover age Act o f 1999''.

   SEC. 112. FINDINGS.

    Congress finds that--

    (1) each year, 3,000,000 pregnancies, or one half of all pregnancies, in this country are unintended;

    (2) contraceptive servi ces are part of basic health care, allowing families to both adequately space desired pregnancies and avoid unintended pregnancy;

    (3) studies show that contraceptives are cost effective: for every $1 of public funds invested in family planning, $4 to $14 of public funds is saved in pregnancy and health care-related costs;

    (4) by reducing rates of unintended pregnancy, contraceptives help reduce the need for abortion;

    (5) unintended pregnancies lead to higher rates of infant mortality, low-birth weight, and maternal morbidity, and threaten the economic viability of families;

    (6) the National Commission to Prevent Infant Mortality determined that ``infant mortality could be reduced by 10 percent if all women not desiring pregnancy used contraception'';

    (7) most women in the United States, including three-quarters of women of childbearing age, rely on some form of private insurance (through their own employer, a family member's employer, or the individual market) to defray their medical expenses;

    (8) the vast majority of private insurers cover prescription drugs, but many exclude coverage for p rescription contraceptives;

    (9) private insurance provides extremely limited coverage of co ntraceptives: half of traditional indemnity plans and preferred provider organizations, 20 percent of point-of-service networks, and 7 percent of health maintenance organizations cover no contraceptive metho ds other than sterilization;

    (10) women of reproductive age spend 68 percent more than men on out-of-pocket health care costs, with contraceptives and reproductive health care services accounting for much of the difference;

    (11) the lack of contraceptive cover age in he alth insurance places many effective forms of contraceptives beyond the financial reach of many women, leading to unintended pregnancies;

    (12) the Institute of Medicine Committee on Unintended Pregnancy recommended that ``financial barriers to contraception be reduced by increasing the proportion of all health insurance policies that cover contraceptive servi ces and supplies'';

    (13) in 1998, Congress agreed to provide contraceptive cover age to th e 2,000,000 women of reproductive age who are participating in the Federal Employees Health Benefits Program, the largest employer-sponsored health insurance plan in the world; and

    (14) eight in 10 privately insured adults support contraceptive cover age.


    (a) IN GENERAL.--Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following new section:


    ``(a) REQUIREMENTS FOR COVERAGE.- -A group health plan, and a health insurance issuer providing health insurance coverage in co nnection with a group health plan, may not--

    ``(1) exclude or restrict benefits for prescription contraceptive drugs or devices approved by the Food and Drug Administration, or generic equivalents approved as substitutable by the Food and Drug Administration, if such plan provides benefits for other outpatient prescription drugs or devices; or

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