Daniel Inouye

Mr. INOUYE

Mr. INOUYE. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. INOUYE. 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 the Clinical Social Workers' Recognition Act of 1997 to correct an outstanding problem in the Federal Employees Compensation Act. This bill will also provide clinical social workers the recognition they deserve as independent providers of quality mental health care services. Clinical social workers are authorized to independently diagnose and treat mental illnesses through public and private health insurance plans across the Nation. However, title V, United States Code, does not permit the use of mental health evaluations conducted by clinical social workers for use as evidence in determining workers' compensation claims brought about by Federal employees. The bill I am introducing corrects this problem. All 50 States, the District of Columbia, Puerto Rico, and the Virgin Islands legally regulate social workers through licensure or certification. Thirty-one States and the District of Columbia have enacted laws that mandate reimbursement for clinical social workers by insurance plans that offer mental health care coverage. All Federal insurance programs that authorize the provision of mental health care services, including Medicare, the Federal Employee Health Benefits Program [FEHBP], and the Civilian Health and Medical Program of the Uniformed Services [CHAMPUS] recognize the ability of clinical social workers to provide mental health services. It is a sad irony that Federal employees may select a clinical social worker through their health plans to provide mental health services but may not go to this professional for a workers' compensation evaluation. Studies show that as much as 65 percent of all mental health services are provided by clinical social workers and clinical social workers are often the only providers of mental health service in rural areas of the country. The failure to recognize the validity of evaluations provided by clinical social workers unnecessarily limits the choice of Federal employees in selecting a provider to conduct the mental health evaluation and may well impose an undue burden for Federal employees in certain areas where clinical social workers are the only available providers for mental health care. This legislation will correct such an inequity. 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 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 totally 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 attached 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, today I am introducing legislation that would provide a federal charter for the National Academies of Practice. This organization represents outstanding practitioners 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 have 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, today I am introducing 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, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. INOUYE. Mr. President, I feel that it is very important 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 that we are today. As this population becomes older, they are unfortunately finding that they need 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 that I am recommending today would ensure the highest possible quality of care for these dedicated citizens and their families, who gave so much for us. 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 provide for a federal income tax credit for those families who purchase a child restraint system for their automobiles. Accidents and injuries continue to cause almost half of the deaths of children between the ages of one and four, more than half of the deaths of children between five and fifteen, and continue to be the leading cause of death among children and young adults. It is my understanding that although the Department of Transportation has made injury prevention among children a top priority, a significant number of parents either do not have adequate child restraint systems or do not have them properly installed. It is imperative that we create this opportunity to provide America's parents with a financially accessible alternative to the insufficient level of child safety measures currently available for use in automobiles. Mr. President, I ask unanimous consent that the text of this bill be printed in the Congressional Record.

Mr. INOUYE. 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 chapter 74 of title 38, United States Code, to revise certain provisions relating to the appointment of clinical and counseling 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 their country in the Armed Forces. It is certainly fitting that this should be done. Recently a quite distressing situation regarding the care of our veterans has come to my attention. In particular, the recruitment 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 from which a significant portion of our veterans suffer. For example, 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 (over 11 percent and 18 percent 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 of pay as well as by the low number of clinical and counseling 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 VA internship. Recruitment, when successful, takes up to six months or more. Retention of psychologists in the VA system poses an even more significant problem. I have been informed that almost 40 percent of VHA psychologists had five years or less of post-doctoral experience. Without doubt, our veterans would benefit from a higher percentage of senior staff who are more experienced in working with veterans and their particular concerns. My bill provides incentives for psychologists to continue their work with the VHA and seek additional education and training. Several factors are associated with the difficulties in retention of VHA psychologists including low salaries and lack of career advancement opportunities. It seems that psychologists are apt to leave the VA system after five years because they have almost reached peak levels for salary and professional development in the VHA. 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 disorders and mental health problems are deserving of better psychological care from more experienced professionals than they are currently receiving. A hybrid title 38 appointment authority for psychologists would help ameliorate the recruitment and retention problems in several ways. The length of time it takes to recruit psychologists could be abbreviated by eliminating the requirement for applicants to be rated by the Office of Personnel Management. This would also facilitate the recruitment of applicants who are not recent VA 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 of behavioral science experts will be greatly alleviated with the implementation of a hybrid title 38 system for VA psychologists, primarily through offering financial incentives for psychologists to pursue professional development with the VHA. Achievements that would merit salary increases under title 38 should 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 diplomate status, and becoming a Fellow of the American Psychological Association. 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 that I have addressed. Ultimately, an across-the-board salary increase might be necessary. However, the conversion of psychologists to a hybrid title 38, as proposed by this amendment, would provide relief for these difficulties and enhance the quality of care for our Nations' veterans and their families. Mr. President, I ask unanimous consent that the text of this bill be printed in the Congressional Record.

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. My bill would correct this inequity and provide 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, today I am introducing 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 programs such as this currently require clinical supervision of the services provided by certain health professionals and do not allow each of the various health professions to truly function to the extent of their state practice acts. In my judgment, 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, today, I am introducing The Physical Therapy and Occupational Therapy Education Act of 1997. This legislation will assist in educating physical therapy and occupational therapy practitioners 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 projected that the demand for services provided by physical therapy practitioners will increase dramatically over the next decade. According to the Bureau, between 1994 and 2005 the increase in demand will create a need for 81,000 additional physical therapists, an 80 percent increase over 1994 figures. Demand for physical therapist assistants is expected to grow at an even faster rate, experiencing an 83 percent increase over the same time period. The Bureau also predicts increasing demand for practitioners in the field of occupational therapy. Between 1994 and 2005 the increase in demand will create a need for 39,000 occupational therapists, a 72 percent increase over 1994 figures. Demand for occupational therapist assistants is projected to experience an 82 percent increase over the same time period. Several factors contribute to the present need for Federal support in this area. The rapid aging of our nation's population, the demands of the AIDS crisis, increasing emphasis on health promotion and disease prevention, and the growth of home health care have out paced 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 the past would have proven fatal. America's inability to educate an adequate number of physical therapists and occupational 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 the physical therapy and occupational therapy fields as having among the highest number of H-1B visa holders in the U.S., second only to computer specialists. According to the Immigration and Naturalization Service (INS), we know that 1,389 H-1B visa holders sought employment as physical therapists in 1994. This number represents 5.9 percent of the 23,500 arrivals for which the INS can verify their known occupation. An additional 82,399 holders of H-1B visas were reported to have entered the U.S. in 1994 for which the INS does not have occupation data. If we assume that the same percentage of H-1B visa holders are seeking employment in physical therapy as in the known-occupation pool, we can calculate that an additional 4,861 foreign-educated physical therapists were also seeking employment (5.9 percent of 82,399 aliens). Thus, the total number of foreign-educated physical therapists seeking employment in the U.S. during 1994 was approximately 6,250. In comparison, U.S. programs of physical therapy graduated a total of 5,846 physical therapists from 141 institutions nationwide in the same year. While the INS does not categorize occupational therapy as a separate profession when tracking H-1B visa entrants, the National Board for Certification in Occupational Therapy documents that the percentage of newly certified occupational therapists who are foreign graduates has risen from 3 percent in 1985 to more than 20 percent in 1995. The legislation I introduce today would provide necessary assistance to physical therapy and occupational therapy programs throughout the country to meet the health care demands of the 21st century. In awarding grants, preference would be given to those applicants that seek to educate and train practitioners at clinical sites in either rural or urban medically underserved communities. In addition to a shortage of practitioners, the present shortage of physical therapy and occupational therapy faculty impedes the expansion of established programs. The critical shortage of doctoral-prepared physical therapists and occupational therapists has resulted in an almost nonexistent pool of potential faculty. Presently, there exist 117 faculty vacancies among the 131 accredited, professional-level physical therapy programs in the U.S. Similarly, during the '93-'94 academic year there existed 51 faculty vacancies among the 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 those grant applicants seeking to develop and expand post-professional programs for the advanced training of physical therapists and occupational therapists. The investment we make through passage of The Physical Therapy and Occupational Therapy Education Act of 1997 will help reduce America's dependence on foreign labor and help create high-skilled, high-wage employment opportunities for American citizens. I look forward to working with my colleagues in the Congress to enact this important legislation. Mr. President, I ask unanimous consent that the text of this bill be printed in the Congressional 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 that are contained in this legislation are necessary to clarify the current payment process for clinical social workers and to establish a reimbursement methodology for the profession that is similar to other health care professionals reimbursed through the Medicare program. First, this legislation would set payment for clinical social worker services according to a fee schedule established by the Secretary. Currently, the methodology for reimbursing clinical social workers' services is set at a percentage of the fee for another nonphysician provider group, creating a greater differential in charges than that which exists in the marketplace. I am aware of no other provision in the Medicare statute where one nonphysician's reimbursement rate is tied to that of another nonphysician provider. This is a precedent that clinical social workers understandably wish to change. I also wish to see that clinical social workers' services are valued on their own merit. Second, this legislation makes it clear that services and supplies furnished incident to a clinical social worker's services are a covered Medicare expense, just as these services are currently covered for other mental health professionals in Medicare. Third, the bill would allow a clinical social worker 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 our nation and are recognized as independent providers of mental health care throughout the health care system. Clinical social worker services were made available to Medicare beneficiaries through the Omnibus Budget Reconciliation Act of 1989. I believe that it is time now to correct the reimbursement problems that this profession has experienced through Medicare. Mr. President, I ask unanimous consent that the text of this bill be printed in the Record.

Mr. INOUYE. Mr. President, I rise today to introduce the Nursing School Clinics Act of 1997, a bill that has two main purposes. First, it builds on our concerted efforts to provide access to quality health care for all Americans by furnishing grants and incentives for nursing schools to establish primary care clinics in areas where additional medical services are most needed. Second, it provides the opportunity for nursing schools to enhance the scope of their students' training and education by giving them firsthand clinical experience in primary care facilities. Any good manager knows that when major problems are at hand and resources are tight, the most important act is the one that makes full use of all available resources. The American health care system is particularly deficient in this regard. We all know only too well that many individuals in the Nation have no or inadequate access to health care services, especially if they live in many of our rural towns and villages or inhabit our Indian communities. Many good people are trying to deliver services that are so vitally needed, but we need to do more. We must make full use of all health care practitioners, especially those who have been long waiting to give the nation the full measure of their professional abilities. Nursing is one of the noblest professions, with an enduring history of offering effective and sensitive care to those in need. Yet it is only in the last few years that we have begun to recognize the role that nurses can play as independent providers of care. Only recently, in 1990, Medicare was changed to authorize direct reimbursements to nurse practitioners. Medicaid is gradually being reformed to incorporate their services more effectively. The Nursing School Clinics Act continues the progress toward fully incorporating nurses in the delivery of health care services. Under the act, nursing schools will be able to establish clinics, supervised and staffed by nurse practitioners and nurse practitioner students, that provide primary care targeted to medically underserved rural and native American populations. In the process of giving direct ambulatory care to their patients, these clinics will also furnish the forums in which both public and private schools of nursing can design and implement clinical training programs for their students. Simultaneous school-based education and clinical training have been a traditional part of physician development, but nurses have enjoyed fewer opportunities to combine classroom instruction with the practical experience of treating patients. This bill reinforces the principle for nurses of joining schooling with the actual practice of health care. To accomplish these objectives, title XIX of the Social Security Act is 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 start the clinics and to keep them going. To meet the increasing challenges of bringing cost-effective and quality health care to all Americans, we are going to have to think about and debate a variety of proposals, both large and small. Most important, however, 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 1997 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 Record.

Mr. INOUYE. Mr. President, today I am introducing legislation to enable those former prisoners of war who have been separated honorably from their respective services and who have been rated to have a 30 percent service-connected disability to have the use of both the military commissary and post exchange privileges. While I realize that it is impossible to adequately compensate one who has endured long periods of incarceration at the hands of our Nation's enemies, I do feel that this gesture is both meaningful and important to those concerned. It also serves as a reminder that our Nation has not forgotten their sacrifices. 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 the Rural Preventive Health Care Training Act of 1997, a bill that responds to the dire situation our rural communities face in obtaining quality health care and disease prevention programs. Almost one fourth of Americans live in rural areas and thus frequently lack access to adequate physical and mental health care. For example, approximately 1,700 rural communities in virtually every state of the union suffer critical shortages of health care providers. 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 and distance, lack of transportation, and lack of knowledge about available resources. Additionally, due to the diversity of rural populations, ranging from native Americans to migrant farm workers, language and cultural obstacles are often a factor. Compound these problems with slim financial resources and many of America's 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 from their two-year study entitled, ``Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research'' highlights the benefits of preventive care for all health problems. Rural health care providers face a lack of training opportunities. Training in prevention is crucial in order to meet the demand for care in underserved areas. Beyond the scope of simple prevention training, interdisciplinary preventive training in rural health is important because of a growing array of evidence that links mental disorders to physical ailments. For example, it has been estimated that from fifty to seventy percent of visits to physicians for medical symptoms are due in part or whole to psychosocial problems. By encouraging interdisciplinary training, rural communities can integrate the behavioral, biological, and psychological sciences to form the most effective preventive care possible. The problems with quality, access, and understanding of health care in rural areas all suggest that promoting interdisciplinary training of psychologists, nurses, and social workers is essential. The need becomes clearer when considering that many of the behavior-related problems afflicting rural communities are amenable to proven risk reduction strategies that are best provided by trained mental health care professionals. Interdisciplinary team prevention training will facilitate both health and mental health clinics sharing single service sites and routine consultation between groups. Social workers, psychologists, clinical psychiatric nurse specialists, and paraprofessionals play an important role in extending rural mental health services to those in need. Linkage of these services can provide better utilization of existing mental health care personnel, increase awareness and understanding of mental health services, and contribute to the overall health of rural communities. The Rural Preventive Health Care Training Act of 1997, targeted specifically toward rural communities, would implement the risk- reduction model described in the IOM study. This model is based on the identification of risk factors for a certain disorder and the implementation of specific preventive strategies to target groups with those risk factors. The IOM Committee aptly demonstrates that methods of risk reduction have proven highly successful in many health-related areas, such as cardiovascular disease, smoking reduction, and the numerous childhood diseases and conditions that are preventable by early prenatal care for pregnant women. The cost of human suffering caused by poor health is immeasurable, but the huge financial burden placed on communities, families, and individuals is evident. By implementing preventive measures, the potential for savings in psychological and financial realms is enormous. This savings is the goal of the Rural Preventive Health Care Training Act of 1997. 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 an amendment that would change 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 level general officer grades; this law would change the current grade to Major General in the United States Army and Air Force and Rear Admiral (upper half) in the United States Navy. Our military Chief Nurses have an awesome responsibility--a degree of responsibility that is absolutely deserving of this change in grade. You might be surprised at how big their scope of duties actually is. For example, the Chiefs are responsible for both peacetime and wartime health care doctrine, standards and policy for all nursing personnel within their respective branches. In fact, the Chief Nurses are responsible for more than 80,000 Army, 5,200 Navy, and 26,000 Air Force nursing personnel. This includes officer and enlisted nursing specialties 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 insure that they have a seat at the corporate table of policy and decision making. There has been much discussion about the so-called glass ceilings that unfairly impact the ability of women to achieve the same status as their male counterparts. While I do not want to make this a gender- discrimination issue, the reality is that military nurses hit two glass ceilings: one as a nurse in a physician-dominated health care system and one as a woman in a male-dominated military system. The simple fact is that organizations are best served when the leadership is composed of a mix of specialty and gender groups--of equal rank--who bring their unique talents to the corporate table. For military nurses, the two- star level of general officer Chief Nurse will insure that nurses indeed get to the corporate executive table. I strongly believe that it is very important, and past time, that we recognize the extensive scope and level of responsibility the military Chief Nurses have and make sure that future military health care organizations will continue to benefit from their expertise and unique contributions. Mr. President, I request unanimous consent that the text of this bill be printed in the Congressional 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 will: First, establish a new social work training program; second, ensure that social work students are eligible for support under the Health Careers Opportunity Program and that social work schools are eligible for support under the Minority Centers for Excellence programs; Third, permit schools offering degrees in social work to obtain grants for training projects in geriatrics; and fourth, 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 the 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 professions education legislation enacted by the 102d Congress enabling schools of social work to apply for AIDS training funding and resources to establish collaborative relationships with rural health care providers and schools of medicine or osteopathic medicine. This bill provides 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 assists disadvantaged students to earn graduate degrees in social work with concentrations in health or mental health; it provides new resources and opportunities in social work training for minorities; and it encourages schools of social work to expand programs in geriatrics. Finally, the recognition of social work as a profession merely codifies current social work practice and reflects the modifications made by the Medicare HMO legislation. I believe it is important to ensure that the special expertise and skills 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 serve our disadvantaged populations, I believe that it is time to provide them with the proper recognition of their profession that they have clearly earned and deserve. Mr. President, I ask unanimous consent that the text of this bill be printed in the Congression Record.

Mr. INOUYE. Mr. President, the legislation I am introducing today would centralize the authority in the Secretary of Transportation for administering our cargo preference laws. The background of these laws, the need for them, and the problems with, in my view, necessitate the legislation, are succinctly stated in a Journal of Commerce article dated November 18, 1988. While the printing of this article was several years ago, the background it provides and the light it sheds on our present needs are still pertinent. I ask unanimous consent that the text of the bill and the article be printed in the Record.

Mr. INOUYE. Mr. President, I rise to introduce legislation to restore the business meals and entertainment tax deduction to 80 percent. I am joined by Senators Thomas, Cochran, and Stevens. Restoration of this deduction is essential to the livelihood of the food service, travel and tourism, and entertainment industries throughout the United States. These industries are being economically harmed as a result of this reduction. All are major industries which employ millions of people. many of whom are already feeling the effects of the reduction. The deduction for business meals and entertainment was reduced from 80 to 50 percent under the Omnibus budget Reconciliation Act of 1993, and went into effect on January 1, 1994. Many companies, small and large, have changed their policies and guidelines on travel and entertainment expenses as a result of the tax reduction in the business meals and entertainment expenses deduction. Businesses have also been forced to curtail company reimbursement policies because of the reduction in the business meals and entertainment expenses deduction. In some cases, businesses have eliminated their expense accounts. Consequently, restaurant establishments, which have replied heavily on business lunch and dinner services, are being adversely affected by the reduction in business meals. For example: Jay's Restaurant in Dayton, Ohio, closed its lunch service on July 14, 1994, following a 15 percent decrease in lunch business. This decision was based on 2,000 fewer lunch customers from January through June 1994 as compared to the same period in 1993. The Wall Street Restaurant in Des Moines, Iowa, an upscale restaurant serving American and Continental cuisine, has seen its revenues decline 40 percent since the beginning of 1994. Owner Joey Fasano reduced his staff from 50 to 35 employees. The Boca in Middlesex County, New Jersey, averaged 40 to 60 lunches per day prior to 1994. The restaurant now serves between 5 to 15 lunches per day. Owner Robert Campione reduced his staff from 18 to 14 employees. The 37th Street Hideaway Restaurant in New York City did 150 lunches a day prior to 1994. Owner Van Panopoulos now serves 40 lunches and his dinner business has dropped 30 to 40 percent. Mr. Panopoulos reduced his staff from 20 to 10 employees. Bianco's in Denver, Colorado, closed its lunch service in April 1994 because of the decline in business. Owner Fred White reduced his staff from 26 to 15 employees. Edward's at Kanoloa in Hawaii has seen its revenues decline by 15 percent since 1994. Owner Edward Frady attributes the decline in his business to the reduction in business meals and entertainment expense deduction. I sincerely hope that the business meals reduction to 50 percent does not become a Luxury Tax Two, in which the Congress moves toward restoration only after the damage has been done and huge job losses have occurred. Accordingly, I urge my colleagues to join me in cosponsoring this important legislation. Mr. President, I ask unanimous consent that the bill text 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 undeserved populations. Expertise in behavorial science is useful in addressing many of our most distressing concerns such as violence, addiction, mental illness, children's behavior 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 undeserved settings or with specific undeserved populations have been demonstrated to be successful in providing services to those same undeserved populations during the years following the training experience. That is, mental health professionals who have participated in these specialized federally funded programs have tended not only to meet their payback obligations, but have continued to work in the public sector or with the undeserved 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 provide 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 be a withdrawal related to hearing loss, or what looks like 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 the 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 the psychology of rural populations could be of special benefit in addressing these 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 on the long-term sequel 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 fellowship programs 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 rise to introduce legislation which amends Public Law 97-359, the Amerasian Immigration Act, to include Amerasian 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 concerning their births. The final version as enacted by the Congress included only those areas where the U.S. had engaged in active military combat from the Korea 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 Vietnam 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 over 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 passed 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 is 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. 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. 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. 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.