Daniel Inouye

Mr. INOUYE

Mr. INOUYE. Mr. President, today, I rise to introduce legislation which amends Public Law 97-359, the Amerasian Immigration Act, to include American children from the Philippines and Japan as eligible applicants. This legislation also expands the eligibility period for the Philippines to November 24, 1992, the date of the last United States military base closure and the date of enactment of the proposed legislation for Japan. Under the Amerasian Immigration Act (Public Law 97-359) children born in Korea, Laos, Kampuchea, Thailand, and Vietnam after December 31, 1950, and before October 22, 1982, who were fathered by United States citizens, are allowed to immigrate to the United States. The initial legislation introduced in the 97th Congress included Amerasians born in the Philippines and Japan with no time limits on their births. The final version enacted by the Congress included only those areas where the U.S. had engaged in active military combat from the Korean War onward. Consequently, Amerasians from the Philippines and Japan were excluded from eligibility. Although the Philippines and Japan were not considered war zones from 1950 to 1982, the extent and nature of U.S. military involvement in both countries are not dissimilar to U.S. military involvement in other Asian countries during the Korean and Viet- nam conflicts. The role of the Philippines and Japan as vital supply and stationing bases brought tens of thousands of U.S. military personnel to these countries. As a result, interracial relations in both countries were common, leading to a significant number of Amerasian children being fathered by U.S. citizens. There are now more than 50,000 Amerasian children in the Philippines. According to the Embassy of Japan, there are 6,000 Amerasian children in Japan born between 1987 and 1992. Public Law 97-359 was enacted in the hope of redressing the situation of Amerasian children in Korea, Laos, Kampuchea, Thailand, and Vietnam who, due to their illegitimate or mixed ethnic make-up, their lack of a father or stable mother figure, or impoverished state, have little hope of escaping their plight. It became the ethical and social obligation of the United States to care for these children. The stigmatization and ostracism felt by Amerasian children in those countries covered by the Amerasian Immigration Act also is felt by Amerasian children in the Philippines and Japan. These children of American citizens deserve the same viable opportunities of employment, education and family life that are afforded their counterparts from Korea, Laos, Kampuchea, Thailand, and Vietnam. Mr. President, I ask unanimous consent that the text of my bill be printed in the Record.

Mr. INOUYE

Mr. INOUYE. Mr. President, today, I rise to introduce legislation which amends Public Law 97-359, the Amerasian Immigration Act, to include American children from the Philippines and Japan as eligible applicants. This legislation also expands the eligibility period for the Philippines to November 24, 1992, the date of the last United States military base closure and the date of enactment of the proposed legislation for Japan. Under the Amerasian Immigration Act (Public Law 97-359) children born in Korea, Laos, Kampuchea, Thailand, and Vietnam after December 31, 1950, and before October 22, 1982, who were fathered by United States citizens, are allowed to immigrate to the United States. The initial legislation introduced in the 97th Congress included Amerasians born in the Philippines and Japan with no time limits on their births. The final version enacted by the Congress included only those areas where the U.S. had engaged in active military combat from the Korean War onward. Consequently, Amerasians from the Philippines and Japan were excluded from eligibility. Although the Philippines and Japan were not considered war zones from 1950 to 1982, the extent and nature of U.S. military involvement in both countries are not dissimilar to U.S. military involvement in other Asian countries during the Korean and Viet- nam conflicts. The role of the Philippines and Japan as vital supply and stationing bases brought tens of thousands of U.S. military personnel to these countries. As a result, interracial relations in both countries were common, leading to a significant number of Amerasian children being fathered by U.S. citizens. There are now more than 50,000 Amerasian children in the Philippines. According to the Embassy of Japan, there are 6,000 Amerasian children in Japan born between 1987 and 1992. Public Law 97-359 was enacted in the hope of redressing the situation of Amerasian children in Korea, Laos, Kampuchea, Thailand, and Vietnam who, due to their illegitimate or mixed ethnic make-up, their lack of a father or stable mother figure, or impoverished state, have little hope of escaping their plight. It became the ethical and social obligation of the United States to care for these children. The stigmatization and ostracism felt by Amerasian children in those countries covered by the Amerasian Immigration Act also is felt by Amerasian children in the Philippines and Japan. These children of American citizens deserve the same viable opportunities of employment, education and family life that are afforded their counterparts from Korea, Laos, Kampuchea, Thailand, and Vietnam. Mr. President, I ask unanimous consent that the text of my bill be printed in the Record.

Mr. INOUYE

Mr. INOUYE. Mr. President, the legislation I am introducing today would centralize the authority to administer our nation's cargo preference laws in the Department of Transportation. Cargo preference statutes assure U.S.-flag ships a minimum share of cargoes produced by U.S. government programs. They play an important role in ensuring our nation's economic security and the existence of a U.S.-flag merchant fleet to assist in national security during times of national emergencies. This tremendous benefit is achieved at a minimal cost. Under present law, cargo reservation is the only direct support a majority of the U.S. merchant fleet receives. I would also like to point out that a cargo preference policy is not unique. Other nations also provide their merchant fleet preference in carrying cargoes their governments generate. The Maritime Administration, which is part of the Department of Transportation, has been tasked with the difficult duty of monitoring the administration of and compliance with U.S. cargo preference laws and regulations by federal agencies with regard to programs generating ocean-born cargoes. Major programs monitored include humanitarian aid shipments provided by the U.S. Department of Agriculture and the U.S. Agency for International Development, commodities financed by the Export-Import Bank, foreign military sales, and Department of Defense cargo shipped by commercial ocean carriers. These are cargoes generated exclusively by our government. In the past, compliance by federal agencies with the requirements of the cargo reservation laws has been chaotic, uneven and varied from agency to agency. In 1962, President John F. Kennedy, in issuing a directive to all executive branch departments and agencies, recognized the importance of our cargo preference policy in fostering a modern, privately owned, merchant marine capable of serving as a naval and military auxiliary in time of war or national emergency. At the time, President Kennedy stated that, ``the achievement of this national policy is even more essential now because of the worldwide economic and defense burdens facing the United States.'' Never has this sentiment been more true than now. Mr. President, this legislation will merely make certain that federal agencies adhere to existing cargo preference laws, and give the Maritime Administration authority to respond to violations with the proper penalties or sanctions. I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE

Mr. INOUYE. Mr. President, the legislation I am introducing today would centralize the authority to administer our nation's cargo preference laws in the Department of Transportation. Cargo preference statutes assure U.S.-flag ships a minimum share of cargoes produced by U.S. government programs. They play an important role in ensuring our nation's economic security and the existence of a U.S.-flag merchant fleet to assist in national security during times of national emergencies. This tremendous benefit is achieved at a minimal cost. Under present law, cargo reservation is the only direct support a majority of the U.S. merchant fleet receives. I would also like to point out that a cargo preference policy is not unique. Other nations also provide their merchant fleet preference in carrying cargoes their governments generate. The Maritime Administration, which is part of the Department of Transportation, has been tasked with the difficult duty of monitoring the administration of and compliance with U.S. cargo preference laws and regulations by federal agencies with regard to programs generating ocean-born cargoes. Major programs monitored include humanitarian aid shipments provided by the U.S. Department of Agriculture and the U.S. Agency for International Development, commodities financed by the Export-Import Bank, foreign military sales, and Department of Defense cargo shipped by commercial ocean carriers. These are cargoes generated exclusively by our government. In the past, compliance by federal agencies with the requirements of the cargo reservation laws has been chaotic, uneven and varied from agency to agency. In 1962, President John F. Kennedy, in issuing a directive to all executive branch departments and agencies, recognized the importance of our cargo preference policy in fostering a modern, privately owned, merchant marine capable of serving as a naval and military auxiliary in time of war or national emergency. At the time, President Kennedy stated that, ``the achievement of this national policy is even more essential now because of the worldwide economic and defense burdens facing the United States.'' Never has this sentiment been more true than now. Mr. President, this legislation will merely make certain that federal agencies adhere to existing cargo preference laws, and give the Maritime Administration authority to respond to violations with the proper penalties or sanctions. I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE

Mr. INOUYE. Mr. President, all too often we find that our Nation's civilians who have been captured by a hostile government do not receive the recognition they deserve. The bill I introduce today would correct this inequity and establish a prisoner of war medal for civilian employees of the Federal Government. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. INOUYE. Mr. President, I am introducing legislation today to amend Title VII of the Public Health Service Act to establish a psychology post-doctoral program. Psychologists have made a unique contribution in serving the nation's medically underserved populations. Expertise in behavioral science is useful in addressing many of our most distressing concerns such as violence, addiction, mental illness, adolescent and child behavioral disorders, and family disruption. Establishment of a psychology post- doctoral program could be most effective in finding solutions to these pressing societal issues. Similar programs supporting additional, specialized training in traditionally underserved settings or with underserved populations have been demonstrated to be successful in providing services to those same underserved during the years following the training experience. For example, mental health professional who have participated in these specialized federally funded programs have tended not only to meet their pay back obligations, but have continued to work in the public sector or with the underserved populations with whom they have been trained to work. While the doctorate in psychology provides broad based knowledge and mastery in a wide variety of clinical skills, the specialized post- doctoral fellowship programs develop particular diagnostic and treatment skills required to effectively respond to these underserved populations. For example, what looks like severe depression in an elderly person might actually be withdrawal related to hearing loss, or what appears to be poor academic motivation in a child recently relocated from Southeast Asia might be reflective of a cultural value of reserve rather than a disinterest in academic learning. Each of these situations requires very different interventions, of course, and specialized assessment skills. Domestic violence is not just a problem for the criminal justice system, it is a significant public health problem. A single aspect of this issue, domestic violence against women, results in almost 100,000 days of hospitalization, 30,000 emergency room visits and 40,000 visits to physicians each year. Rates of child and spouse abuse in rural areas are particularly high as are the rates of alcohol abuse and depression in adolescents. A post-doctoral fellowship program in psychology of the rural populations could be of special benefit in addressing the problems. Given the changing demographics of the nation--the increasing life span and numbers of the elderly, the rising percentage of minority populations within the country, as well as an increased recognition of the long-term sequelae of violence and abuse--and given the demonstrated success and effectiveness of these kinds of specialized training programs, it is incumbent upon us to encourage participation in post-doctoral fellowships that respond to the needs of the nation's underserved. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, today I am introducing legislation to amend Title XVIII of the Social Security Act to correct discrepancies in the reimbursement of clinical social workers covered through Medicare, Part B. The three proposed changes contained in this legislation clarify the current payment process for clinical social workers and establish a reimbursement methodology for the profession that is similar to other health care professionals reimbursed through the Medicare program. First, this legislation sets payment for clinical social worker services according to a fee schedule established by the Secretary. Second, it explicitly states that services and supplies furnished by a clinical social worker are a covered Medicare expense, just as these services are covered for other mental health professionals in Medicare. Third, the bill allows clinical social workers to be reimbursed for services provided to a client who is hospitalized. Clinical social workers are valued members of our health care provider team. They are legally regulated in every state of the nation and are recognized as independent providers of mental health care throughout the health care system. I believe it is time to correct the disparate reimbursement treatment of this profession under Medicare. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, I rise to introduce legislation today to modify Title VII of the U.S. Public Health Service Act in order to provide students enrolled in graduate psychology programs with the opportunity to participate in various health professions loan programs Providing students enrolled in graduate psychology programs with eligibility for financial assistance in the form of loans, loan guarantees, and scholarships will facilitate a much needed infusion of behavioral science expertise into our public health community of providers. There is a growing recognition of the valuable contribution that is being made by our nation's psychologists toward solving some of our nation's most distressing problems. The participation of students from all backgrounds and clinical disciplines is vital to the success of health care training. The Title VII programs play a significant role in providing financial support for the recruitment of minorities, women and individuals from economically disadvantaged backgrounds. Minority therapists have an advantage in the provision of critical services to minority populations because often they can communicate with clients in their own language and cultural framework. Minority therapists are more likely to work in community settings, where ethnic minority and economically disadvantaged individuals are most likely to seek care. It is critical that continued support be provided for the training of individuals who provide health care services to underserved communities. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, on behalf of our nation's clinical social workers, I am introducing legislation to amend the Public Health Service Act. This legislation would (1) establish a new social work training program; (2) ensure that social work students are eligible for support under the Health Careers Opportunity Program; (3) provide social work schools with eligibility for support under the Minority Centers of Excellence programs; (4) permit schools offering degrees in social work to obtain grants for training projects in geriatrics; and (5) ensure that social work is recognized as a profession under the Public Health Maintenance Organization (HMO) Act. Despite the impressive range of services social workers provide to people of this nation, particularly our elderly, disadvantaged and minority populations, few federal programs exist to provide opportunities for social work training in health and mental health care. This legislation builds on the health professional legislation enacted by the 102d Congress enabling schools of social work to apply for Acquired Immune Deficiency Syndrome (AIDS) training funding and resources to establish collaborative relationships with rural health care providers and schools of osteopathic medicine. This bill would provide funding for traineeships and fellowships for individuals who plan to specialize in, practice, or teach social work, or for operating approved social work training programs; it would help disadvantaged students earn graduate degrees in social work with a concentration in health or mental health; it would provide new resources and opportunities in social work training for minorities; and it would encourage schools of social work to expand program in geriatrics. Finally, the recognition of social work as a profession merely codifies current social work practice and reflects modifications made by the Medicare HMO legislation. I believe it is important to ensure that the special expertise and skill social workers possess continue to be available to the citizens of this nation. This legislation, by providing financial assistance to schools of social work and social work students, recognizes the long history and critical importance of the services provided by social work professionals. In addition, since social workers have provided quality mental health services to our citizens for a long time and continue to be at the forefront of establishing innovative programs to service our disadvantaged populations, I believe it is time to provide them with the recognition they clearly earned and deserve. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, today I rise to introduce legislation to authorize the autonomous functioning of clinical psychologists and clinical social workers within the Medicare comprehensive outpatient rehabilitation facility program. In my judgment, it is truly unfortunate that Medicare requires clinical supervision of the services provided by certain health professionals and does not allow these health professionals to function to the full extent of their state practice licenses. It is especially appropriate that those who need the services of outpatient rehabilitation facilities have access to a wide range of social and behavioral science expertise. Clinical psychologists and clinical social workers are recognized as independent providers of mental health care services through the Federal Employee Health Benefits Program, the Civilian Health and Medical Program of the Uniformed Services, the Medicare (Part B) Program, and numerous private insurance plans. Mr. President, I ask unanimous consent that the text of this bill be printed in the Congressional Record.

Mr. INOUYE. Mr. President, I rise today to introduce the Nursing School Clinics Act of 1999. This measure builds on our concerted efforts to provide access to quality health care for all Americans by offering grants and incentives for nursing schools to establish primary care clinics in underserved areas where additional medical services are most needed. In addition, this measure provides the opportunity for nursing schools to enhance the scope of student training and education by providing firsthand clinical experience in primary care facilities. Nursing school administered primary care clinics are university or nonprofit entity primary care centers developed primarily in collaboration with university schools of nursing and the communities they serve. These centers are staffed by faculty and staff who are nurse practitioners and public health nurses. Students supplement patient care while receiving preceptorships provided by college of nursing faculty and primary care physicians, often associated with academic institutions, who serve as collaborators with nurse practitioners. To date, the comprehensive models of care provided by nursing clinics have yielded excellent results including significantly fewer emergency room visits, fewer hospital inpatient days, and less use of specialists, as compared to conventional primary health care. The LaSalle Neighborhood Nursing Center, for example, reported that in 1997, fewer than 0.02 percent of the primary care clients reported hospitalization for asthma; fewer than 4 percent of expectant mothers who enrolled delivered low birth rate infants; and 90 percent of infants and young children were immunized on time. In addition, there was a 50 percent reduction in emergency room visits and a 97 percent overall patient satisfaction rate. The 1997 Balanced Budget Act (P.L. 105-33) included a provision that, for the first time ever, authorized direct Medicare reimbursement of all nurse practitioners and clinical nurse specialists, regardless of the setting in which services are performed. This provision built upon previous legislation that allowed direct reimbursement to individual nurse practitioners for individual services provided in rural health clinics throughout America. Medicaid is gradually being reformed to incorporate their services more effectively. This bill reinforces the principle of combining health care delivery in underserved areas with the education of advanced practice nurses. To accomplish these objectives, Title XIX of the Social Security Act would be amended to designate that the services provided in these nursing school clinics are reimbursable under Medicaid. The combination of grants and the provision of Medicaid reimbursement furnishes the incentives and operational resources to establish the clinics. In order to meet the increasing challenges of bringing cost-effective and quality health care to all Americans, we must consider and debate various proposals, both large and small. Most importantly, we must approach the issue of health care with creativity and determination, ensuring that all reasonable avenues are pursued. Nurses have always been an integral part of health care delivery. The Nursing School Clinics Act of 1999 recognizes the central role they can perform as care givers to the medically underserved. Mr. President, I ask unanimous consent that the text of this bill be printed in the Congressional Record.

Mr. INOUYE. Mr. President, I rise today to introduce the Rural Preventive Health Care Training Act of 1999, a bill that responds to the dire need of our rural communities for quality health care and disease prevention programs. Almost one fourth of Americans live in rural areas and frequently lack access to adequate physical and mental health care. As many as 21 million of the 34 million people living in underserved rural areas are without access to a primary care provider. In areas where providers exist, there are numerous limits to access, such as geography, distance, lack of transportation, and lack of knowledge about available resources. Due to the divesity of rural populations, language and cultural obstacles are often a factor in the access to medical care. Compound these problems with limited financial resources and many Americans living in rural communities go without vital health care, especially preventive care. Children fail to receive immunizations and routine checkups. Preventable illnesses and injuries occur needlessly and lead to expensive hospitalizations. Early symptoms of emotional problems and substance abuse go undetected and often develop into full blown disorders. An Institute of Medicine (IOM) report entitled, ``Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research'' highlights the benefits of preventive care for all health problems. Training of health care providers in prevention is crucial in order to meet the demand for care in underserved areas. Currently, rural health care providers face a lack of preventive care training opportunities. Interdisciplinary preventive training of rural health care providers must be encouraged. Through interdisciplinary training rural health care providers can build a strong foundation from the behavioral, biological and psychological sciences to form the most effective preventive care possible. Interdisciplinary team prevention training will also facilitate both health and mental health clinics sharing single service sites and routine consultation between groups. Emphasizing the mental health disciplines and their servcies as part of the health care team will contribute to the overall health of rural communities. The Rural Preventive Health Care Training Act of 1999 would implement the risk-reduction model described in the IOM study. This model is based on the identification of risk factors and targets specific interventions for those risk factors. The human suffering caused by poor health is immeasurable, and places a huge financial burden on communities, families and individuals. By implementing preventive measures to reduce this suffering, the potential psychological and financial savings are onormous. Mr. President, I ask unanimous consent that the text of this bill be printed in the Congressional Record.

Mr. INOUYE. Mr. President, I rise today to introduce legislation to amend the Public Health Service Act for the establishment of a National Center for Social Work Research. Social workers provide a multitude of health care delivery services throughout America to our children, families, the elderly, and persons suffering from various forms of abuse and neglect. The purpose of this center is to support and disseminate information with respect to basic and clinical social work research, training, and other programs in patient care, with emphasis on service to underserved and rural populations. Social work research has grown in size and scope since the 1980's. In 1998, the National Institutes of Mental Health led the way with $17 million in funding for 61 social work research grants. Dr. Pat Ewalt, Dean of the Department of Social Work at the University of Hawaii, is one of the foremost leaders in the field of social work research and has worked diligently to gain recognition of the many important contributions of social work to mental and behavioral health care delivery. While the Federal Government provides funding for various social work research activities through the National Institutes of Health and other Federal agencies, there presently is no coordination or direction of these critical activities and no overall assessment of needs and opportunities for empirical knowledge development. The establishment of a Center for Social Work Research would result in improved behavioral and mental health care outcomes for our nation's children, families, and elderly, and others. In order to meet the increasing challenges of bringing cost- effective, research-based, quality health care to all Americans, we must recognize the important contributions of social work researchers to health care delivery and the central role that the Center for Social Work can provide in facilitating this process. Mr. President, I ask unanimous consent that the text of this bill be printed on the Record.

Mr. INOUYE. Mr. President, today I am introducing a private relief bill on behalf of Donald C. Pence of Sanford, North Carolina, for compensation for the failure of the Department of Veterans Affairs to pay dependency and indemnity compensation to Kathryn E. Box, the now deceased mother of Donald C. Pence. It is rare that a federal agency admits a mistake. In this case, the Department of Veterans Affairs has admitted that a mistake was made and explored ways to permit payment under the law, including equitable relief, but has found no provision to release the remaining benefits that were unpaid to Mrs. Box at the time of her death. My bill would correct this injustice and I urge my colleagues to support this measure. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. INOUYE. Mr. President, today I am introducing legislation that would provide a federal charter for the National Academies of Practice. This organization represents outstanding medical professionals who have made significant contributions to the practice of applied psychology, medicine, dentistry, nursing, optometry, podiatry, social work, and veterinary medicine. When fully established, each of the nine academies will possess 100 distinguished practitioners selected by their peers. This umbrella organization will be able to provide the Congress of the United States and the executive branch with considerable health policy expertise, especially from the perspective of those individuals who are in the forefront of actually providing health care. As we continue to grapple with the many complex issues surrounding the delivery of health care services, it is clearly in our best interest to ensure that the Congress has systematic access to the recommendations of an interdisciplinary body of health care practitioners. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, I introduce legislation today to amend Chapter 74 of Title 38, United States Code, to revise certain provisions relating to the appointment of clinical and professional psychologists in the Veterans Health Administration (VHA). The VHA has a long history of maintaining a staff of the very best health care professionals to provide care to those men and women who have served our country in the Armed Forces. Recently, a quite distressing situation regarding the care of our veterans has come to my attention. In particular, the recruiting and retention of psychologists in the VHA of the Department of Veterans Affairs has become a significant problem. The Congress has recognized the important contribution of the behavioral sciences in the treatment of several conditions afflicting a significant portion of our veterans. Programs related to homelessness, substance abuse, and post traumatic stress disorder (PTSD) have received funding from the Congress in recent years. Certainly, psychologists, as behavioral science experts, are essential to the successful implementation of these programs. However, the high vacancy and turnover rates for psychologists in the VHA (more than 5% and 8% respectively as reported in one recent survey) might seriously jeopardize these programs and will negatively impact overall patient care in the VHA. Recruitment of psychologists by the VHA is hindered by a number of factors including a pay scale not commensurate with private sector rates and the low number of clinical and professional psychologists appearing on the register of the Office of Personnel Management (OPM). Most new hires have no post-doctoral experience and are hired immediately after a VHA internship. Recruitment, when successful, takes up to six months or more. Retention of psychologists in the VHA system poses an even more significant problem. I have been informed that almost 40% of VHA psychologists have five years or less of post-doctoral experience. Psychologists leave the VHA system after five years because they have almost reached peak levels for salary and professional advancement. Furthermore, under the present system psychologists cannot be recognized nor appropriately compensated for excellence or for taking on additional responsibilities such as running treatment programs. In effect, the current system for hiring psychologists in the VHA supports mediocrity, not excellence and mastery. Our veterans with behavioral and mental health disorders are deserving of better psychological care from more experienced professionals than they are currently receiving. Currently, psychologists are the only doctoral level health care providers in the VHA who are not included in Title 38. This is without question a significant factor in the recruitment and retention difficulties which I have addressed. Title 38 appointment authority for psychologists would help ameliorate the recruitment and retention problems. The length of time to recruit psychologists could be abbreviated by eliminating the requirement for applicants to be rated by the Office of Personnel Management. This would also encourage the recruitment of applicants who are not recent VHA interns by reducing the amount of time between identifying a desirable applicant and being able to offer that applicant a position. It is expected that problems in retention will be greatly alleviated with the implementation of a Title 38 system that offers financial incentives for psychologists to pursue professional development. Achievements that would merit salary increases include such activities as assuming supervisory responsibilities for clinical programs, implementing innovative clinical treatments that improve the effectiveness and/or efficiency of patient care, making significant contributions to the science of psychology, earning the ABPP displomate state, and becoming a Fellow of the American Psychological Association. The conversion of psychologists to Title 38, as proposed by this amendment, would provide relief for the retention and recruitment issues and enhance the quality of care for our Nation' veterans and their families. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, today I introduce an amendment that would change the existing law regarding the designated position and grade for the Chief Nurses of the United States Army, the United States Navy, and the United States Air Force. Currently, the Chief Nurses of the three branches of the military are one-star general officer grades; this law would change the current grade to Major General in the Army and Air Force and Rear Admiral (upper half) in the Navy. Our military Chief Nurses have an awesome responsibility--their scope of duties include peacetime and wartime health care doctrine, standards and policy for all nursing personnel within their respective branches. They are responsible for 80,000 Army, 5,200 Navy, and 20,000 Air Force officer and enlisted nursing personnel in the active, reserve and guard components of the military. This level of responsibility certainly supports the need to change the grade for the Chief Nurses which would ensure that they have an appropriate voice in Defense Health Program executive management. Organizations are best served when the leadership is composed of a mix of specialties--of equal rank--who bring their unique talents to the policy setting and decision-making process. I believe it is time to ensure that military health care organizations utilize the expertise and unique contributions of the military Chief Nurses. Mr. President, I request unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, today I introduce legislation to amend Title 18 of the United States Code to allow our nation's clinical social workers to provide their mental health expertise to the federal judiciary. I feel that the time has come to allow our nation's judicial system to have access to a wide range of behavioral science and mental health expertise. I am confident that the enactment of this legislation would be very much in our nation's best interest. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, today I rise to introduce a bill which is of great importance to a group of patriotic Americans. This legislation is designed to extend space-available travel privileges on military aircraft to those who have been completely disabled in the service of our country. Currently, retired members of the Armed Forces are permitted to travel on a space-available basis on non-scheduled military flights within the continental United States and on scheduled overseas flights operated by the Military Airlift Command. My bill would provide the same benefits for 100 percent service-connected disabled veterans. Surely, we owe these heroic men and women, who have given so much to our country, a debt of gratitude. Of course, we can never repay them for the sacrifice they have made on behalf of our nation, but we can surely try to make their lives more pleasant and fulfilling. One way in which we can help is to extend military travel privileges to these distinguished American veterans. I have received numerous letters from all over the country attesting to the importance attesting to this issue by veterans. Therefore, I ask that my colleagues show their concern and join me in saying ``thank you'' by supporting this legislation. Mr. President, I ask unanimous consent that the text of my bill be printed in the Record.

Mr. INOUYE. Mr. President, I rise today to introduce legislation that would direct the Secretary of the Army to determine whether certain nationals of the Philippine Islands performed military service on behalf of the United States during World War II. Mr. President, our Filipino veterans fought side by side and sacrificed their lives on behalf of the United States. This legislation would confirm the validity of their claims and further allow qualified individuals the opportunity to apply for military and veterans benefits to which, I believe, they are entitled. As this population becomes older, it is important for our nation to extend its firm commitment to the Filipino veterans and their families who participated in making us the great nation we are today. I ask unanimous consent that the text of my bill be printed in the Record.

Mr. INOUYE. Mr. President, in our effort to accommodate many Americans by making the last Monday in May, Memorial Day, we have lost sight of the significance of this day to our nation. Instead of using Memorial Day as a time to honor and reflect on the sacrifices made by Americans in combat, many Americans use the day as a celebration of the beginning of summer. My bill would restore Memorial Day to May 30 and authorize our flag to fly at half mast on that day. In addition, this legislation would authorize the President to issue a proclamation designating Memorial Day and Veterans Day as days for prayer and ceremonies honoring American veterans. This legislation would help restore the recognition our veterans deserve for the sacrifices they have made on behalf of our nation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. INOUYE. Mr. President, I rise today to introduce a measure which passed in the Senate toward the close of the 105th session of the Congress to amend the Native American Housing Assistance and Self- Determination Act to provide Federal housing assistance to address the serious unmet housing needs of Native Hawaiians. Mr. President, the primary objective of this measure is to enable Native Hawaiians who are eligible to reside on the Hawaiian Home Lands to have access to federal housing assistance that is currently provided to other eligible low-income American families based upon documented need. In 1920, with the enactment of Hawaiian Homes Commission Act, the United States set aside approximately 200,000 acres of public land that had been ceded to the United States in what was then the Territory of Hawaii to establish a permanent homeland for the native people of Hawaii, based upon findings of the Congress that Native Hawaiians were a landless people and a ``dying'' people. The Secretary of the Interior, Franklin Lane, likened the relationship between the United States and Native Hawaiians to the guardian-ward relationship that then existed between the United States and American Indians. As a condition of its admission into the Union of States in 1959, the United States transferred title to the 200,000 acres of land to the State of Hawaii with the requirement that the lands be held ``in public trust'' for ``the betterment of the conditions of Native Hawaiians, as defined in the Hawaiian Homes Commission Act of 1920''. The Hawaii Admissions Act also required that the Hawaii State Constitution provide for the assumption by the new State of a trust responsibility for the lands. The lands are now administered by a State agency, the Department of Hawaiian Home Lands. However, similar to the responsibility with which the Secretary of the Interior is charged in the administration of Indian lands, the United States retained and continues to retain the exclusive authority to enforce the trust and to institute legal action against the State of Hawaii for any breach of the trust, as well as the exclusive right to consent to any actions affecting the lands which comprise the corpus of the trust and any amendments to the Hawaiian Homes Commission Act enacted by the legislature of the State of Hawaii affecting the rights of the beneficiaries under the Act. Within the last several years, three recent studies have documented the housing conditions that confront Native Hawaiians who either reside on the Hawaiian home lands or who are eligible to reside on the home lands. In 1992, the National Commission on American Indian, Alaska Native, and Native Hawaiian Housing issued its final report to the Congress, ``Building the Future: A Blueprint for Change''. The Commission's Study compared housing data for Native Hawaiians with housing information for other citizens in the State of Hawaii. The Commission found that Native Hawaiians, like American Indians and Alaska Natives, lacked access to conventional financing because of the trust status of the Hawaiian home lands, and that Native Hawaiians had the worst housing conditions in the State of Hawaii and the highest percentage of homelessness, representing over 30 percent of the State's homeless population. The Commission concluded that the unique circumstances of Native Hawaiians require the enactment of new legislation to alleviate and address the severe housing needs of Native Hawaiians, and recommended that the Congress extend to Native Hawaiians the same federal housing assistance programs that are provided to American Indians and Alaska Natives under the Low-Income Rental, Mutual Help, Loan Guarantee Program and Community Development Block Grant programs. Subsequently, the Community Development Block Grant program authority was amended to address the housing needs of Native Hawaiians. In 1995, the U.S. Department of Housing and Urban Development (HUD) issued a report entitled, ``Housing Problems and Needs of Native Hawaiians''. The HUD report was particularly helpful because it compared the data on Native Hawaiian housing conditions with housing conditions nationally and with the housing conditions of American Indians and Alaska Natives. The most alarming finding of the HUD report was that Native Hawaiians experience the highest percentage of housing problems in the nation--49 percent--higher than even that of American Indians and Alaska Natives residing on reservations (44 percent) and substantially higher than that of all U.S. households (27 percent). Additionally, the HUD study found that the percentage of overcrowding in the Native Hawaiian population is 36 percent as compared to 3 percent for all other households in the United States. Applying the HUD guidelines, 70.8 percent of Native Hawaiians who either reside or who are eligible to reside on the Hawaiian home lands have incomes which fall below the median family income in the United States, and 50 percent of those Native Hawaiians have incomes below 30 percent of the median family income in the United States. Also in 1995, the Hawaii State Department of Hawaiian Home Lands published a Beneficiary Needs Study as a result of research conducted by an independent research group. This study found that among the Native Hawaiian population, the needs of Native Hawaiians eligible to reside on the Hawaiian home lands are the most severe--with 95 percent of home lands applicants (16,000) in need of housing, and with one-half of those applicant households facing overcrowding and one-third paying more than 30 percent of their income for shelter. Eligibility for an assignment of Hawaiian home lands for purposes of housing, agricultural development or pasture land is a function of federal law--the Hawaiian Homes Commission Act of 1920. There are approximately 60,000 Native Hawaiians who would be eligible to reside on the home lands, but applying for an assignment of a parcel of home lands is voluntary. Because of the lack of resources to develop infrastructure (roads, access to water and sewer and electricity) on the home lands as required by State and county laws before housing can be constructed, hundreds of Native Hawaiians on the waiting list have died before receiving an assignment of home lands. Once an eligible Native Hawaiian reaches the top of the waiting list, he or she must be able to qualify for a private home loan mortgage, because the limited Federal and State funds available to the Department of Hawaiian Home Lands have been used to develop infrastructure rather than the construction of housing. An assignment of home lands property is in the form of a 99-year lease. Unless the heirs of the eligible Native Hawaiian qualify in their own right for an assignment of home lands under the provisions of the Hawaiian Homes Commission Act, upon the death of the eligible Native Hawaiian, the heirs must move off the land. Currently, Native Hawaiians who are eligible to reside on the home lands but who do not qualify for private mortgage loans do not have access to federal housing assistance programs that provide assistance to low-income families. This is due to the fact that for many years, the federal government took the legal position that because the government that represented the Native Hawaiian people had been overthrown in 1893 and thus there was no government-to-government relationship with the United States, extending federal housing program assistance to lands set aside exclusively for Native Hawaiians would be discriminating on the basis of race or ethnicity. The Hawaiian Homes Commission Act not only provides authority for the assignment of home lands property to Native Hawaiians. The Act also authorizes general leases to non-Hawaiians. At the time the Act was passed by the Congress, it was anticipated that revenues derived from general leases would be sufficient to develop the necessary infrastructure and housing on the home lands. However, general lease revenue has not proven sufficient to address infrastructure and housing needs. In recent years, as a result of litigation involving third-party leases of Hawaiian home lands, the United States revisited its legal position and found that the authority contained in the Hawaiian Homes Commission Act for general leases to non-Hawaiians meant that the land was not set aside exclusively for Native Hawaiians. The non-exclusive nature of the land set aside was thus found not to violate Constitutional prohibitions on racial discrimination. The change in the United States' legal position may be further informed by the ruling of the Ninth Circuit Court of Appeals in Rice v. Cayetano, No. 97-16095, 146 F.3d 1075 (9th Cir. 1998) in which the Appeals Court compared the special treatment of Native Hawaiians to the special treatment of Indians that the Supreme Court approved in Morton v. Mancari, 417 U.S. 535 (1974) and cited its reference to Mancari in Alaska Chapter, Associated Gen. Contractors v. Pierce, 694 F.2d 1162 (9th Cir. 1981), in which the Circuit Court expressed its finding that preferential treatment that is grounded in the government's unique obligation toward Indians is a political rather than a racial classification, even though racial criteria may be used in defining eligibility. However, the result of the United States' earlier legal position was that Native Hawaiians who were eligible to reside on the Hawaiian Home Lands and would have otherwise been eligible by virtue of their low- income status to apply for Federal housing assistance were foreclosed from participating in Federal housing assistance programs that were available to all other eligible families in the United States. Mr. President, if enacted into law, the measure which I introduce today will finally provide some relief and support to those who are in the greatest need for a simple roof over their heads and a place to raise their families. Mr. President, I respectfully request that the text of this measure be printed in the Record.

Mr. INOUYE

Mr. INOUYE. Mr. President, today I rise to introduce the Physical and Occupational Therapy Education Act of 1999. This legislation will increase educational opportunities for physical therapy and occupational therapy practitioners in order to meet the growing demand for the valuable services they provide in our communities. In its most recent report, the Department of Labor's Bureau of Labor Statistics (BLS) projected that the demand for services provided by physical therapists will increase dramatically over the next decade. According to the BLS statistics, the increase in demand for these services will create a need for 81,000 additional therapists, an 80% increase over 1994 figures. The BLS also predicts an increased demand for occupational therapists. According to the BLS, by the year 2005, the increase in demand will create a need for 39,000 additional occupational therapists, a 72% increase over 1994 figures. Several factors contribute to the present need for federal support in this area. The rapid aging of our nations' population, the demands of the AIDs crisis, increasing emphasis on health promotion and disease prevention, and the growth of home health care have exceeded our ability to educate an adequate number of physical therapy and occupational therapy practitioners. In addition, technological advances are allowing injured and disabled individuals to survive conditions that, in past years, would have proven fatal. America's inability to educate an adequate number of physical therapists has led to an increased reliance on foreign-educated, non- immigrant temporary workers (H-1B visa holders). The U.S. Commission on Immigration Reform has identified physical therapy and occupational therapy as having the highest number of H-1B visa holders in the U.S., second only to computer specialists. While the INS does not categorize occupational therapy as a separate profession when tracking H-1B visa entrants, the National Board of Certification in Occupational Therapy documents that the percentage of newly certified occupational therapists who are foreign graduates has risen from 3% in 1985 to more than 20% in 1995. The legislation I introduce today would provide necessary assistance to physical and occupational therapy programs throughout the country. In awarding grants, preference would be given to applicants seeking to educate and train practitioners at clinical sites in medically underserved communities. In addition to the shortage of practitioners, the current shortage of physical therapy and occupational therapy faculty impedes the expansion of established programs. The critical shortage of doctoral-prepared occupational therapists and physical therapists has resulted in an almost nonexistent pool of potential faculty. Presently, there are 117 faculty vacancies among 131 accredited physical therapy programs in the U.S. Similiarily, during the 1995-1996 academic year there were 51 faculty vacancies among 85 accredited professional level occupational therapy programs. The legislation I introduce today would assist in the development of a pool of qualified faculty by giving preference to applicants seeking to develop and expand post professional programs for the advanced training of physical and occupational therapists. The investment we make through passage of the Physical Therapy and Occupational Therapy Education Act of 1999 will help reduce America's dependence on foreign labor and create highly-skilled, high-wage employment opportunities for American citizens. I look forward to working with my colleagues in Congress to enact this important legislation. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE

Mr. INOUYE. Mr. President, I feel that it is imperative that our nation continue its firm commitment to those individuals and their families who have served in the Armed Forces and made us the great nation we are today. As this population ages, there is a need for a wider range of health services, some of which are simply not available under Medicare. These individuals made a commitment to their nation, trusting that when they needed help the nation would honor that commitment. The bill I am introducing today would ensure the highest possible quality of care for these dedicated citizens and their families by authorizing payment under CHAMPUS of certain health care expenses to the extent such expenses are not payable under Medicare. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE

Mr. INOUYE. Mr. President, I feel that it is imperative that our nation continue its firm commitment to those individuals and their families who have served in the Armed Forces and made us the great nation we are today. As this population ages, there is a need for a wider range of health services, some of which are simply not available under Medicare. These individuals made a commitment to their nation, trusting that when they needed help the nation would honor that commitment. The bill I am introducing today would ensure the highest possible quality of care for these dedicated citizens and their families by authorizing payment under CHAMPUS of certain health care expenses to the extent such expenses are not payable under Medicare. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.