SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Harriet Tubman National Historical
Parks Act''.

SEC. 2. HARRIET TUBMAN UNDERGROUND RAILROAD NATIONAL HISTORICAL PARK,
              MARYLAND.

    (a) Definitions.--In this section:
            (1) Historical park.--The term ``historical park'' means
        the Harriet Tubman Underground Railroad National Historical
        Park established by subsection (b)(1)(A).
            (2) Map.--The term ``map'' means the map entitled
        ``Authorized Acquisition Area for the Proposed Harriet Tubman
        Underground Railroad National Historical Park'', numbered T20/
        80,001, and dated July 2010.
            (3) Secretary.--The term ``Secretary'' means the Secretary
        of the Interior.
            (4) State.--The term ``State'' means the State of Maryland.
    (b) Harriet Tubman Underground Railroad National Historical Park.--
            (1) Establishment.--
                    (A) In general.--Subject to subparagraph (B), there
                is established the Harriet Tubman Underground Railroad
                National Historical Park in Caroline, Dorchester, and
                Talbot Counties, Maryland, as a unit of the National
                Park System.
                    (B) Determination by secretary.--The historical
                park shall not be established until the date on which
                the Secretary determines that a sufficient quantity of
                land, or interests in land, has been acquired to
                constitute a manageable park unit.
                    (C) Notice.--Not later than 30 days after the date
                on which the Secretary makes a determination under
                subparagraph (B), the Secretary shall publish in the
                Federal Register notice of the establishment of the
                historical park, including an official boundary map for
                the historical park.
                    (D) Availability of map.--The official boundary map
                published under subparagraph (C) shall be on file and
                available for public inspection in appropriate offices
                of the National Park Service.
            (2) Purpose.--The purpose of the historical park is to
        preserve and interpret for the benefit of present and future
        generations the historical, cultural, and natural resources
        associated with the life of Harriet Tubman and the Underground
        Railroad.
            (3) Land acquisition.--
                    (A) In general.--The Secretary may acquire land and
                interests in land within the areas depicted on the map
                as ``Authorized Acquisition Areas'' by purchase from
                willing sellers, donation, or exchange.
                    (B) Boundary adjustment.--On acquisition of land or
                an interest in land under subparagraph (A), the
                boundary of the historical park shall be adjusted to
                reflect the acquisition.
    (c) Administration.--
            (1) In general.--The Secretary shall administer the
        historical park in accordance with this section and the laws
        generally applicable to units of the National Park System,
        including--
                    (A) the National Park System Organic Act (16 U.S.C.
                1 et seq.); and
                    (B) the Act of August 21, 1935 (16 U.S.C. 461 et
                seq.).
            (2) Interagency agreement.--Not later than 1 year after the
        date on which the historical park is established, the Director
        of the National Park Service and the Director of the United
        States Fish and Wildlife Service shall enter into an agreement
        to allow the National Park Service to provide for public
        interpretation of historic resources located within the
        boundary of the Blackwater National Wildlife Refuge that are
        associated with the life of Harriet Tubman, consistent with the
        management requirements of the Refuge.
            (3) Interpretive tours.--The Secretary may provide
        interpretive tours to sites and resources located outside the
        boundary of the historical park in Caroline, Dorchester, and
        Talbot Counties, Maryland, relating to the life of Harriet
        Tubman and the Underground Railroad.
            (4) Cooperative agreements.--
                    (A) In general.--The Secretary may enter into a
                cooperative agreement with the State, political
                subdivisions of the State, colleges and universities,
                non-profit organizations, and individuals--
                            (i) to mark, interpret, and restore
                        nationally significant historic or cultural
                        resources relating to the life of Harriet
                        Tubman or the Underground Railroad within the
                        boundaries of the historical park, if the
                        agreement provides for reasonable public
                        access; or
                            (ii) to conduct research relating to the
                        life of Harriet Tubman and the Underground
                        Railroad.
                    (B) Visitor center.--The Secretary may enter into a
                cooperative agreement with the State to design,
                construct, operate, and maintain a joint visitor center
                on land owned by the State--
                            (i) to provide for National Park Service
                        visitor and interpretive facilities for the
                        historical park; and
                            (ii) to provide to the Secretary, at no
                        additional cost, sufficient office space to
                        administer the historical park.
                    (C) Cost-sharing requirement.--
                            (i) Federal share.--The Federal share of
                        the total cost of any activity carried out
                        under this paragraph shall not exceed 50
                        percent.
                            (ii) Form of non-federal share.--The non-
                        Federal share of the cost of carrying out an
                        activity under this paragraph may be in the
                        form of in-kind contributions or goods or
                        services fairly valued.
    (d) General Management Plan.--
            (1) In general.--Not later than 3 years after the date on
        which funds are made available to carry out this section, the
        Secretary shall prepare a general management plan for the
        historical park in accordance with section 12(b) of the
        National Park Service General Authorities Act (16 U.S.C. 1a-
        7(b)).
            (2) Consultation.--The general management plan shall be
        prepared in consultation with the State (including political
        subdivisions of the State).
            (3) Coordination.--The Secretary shall coordinate the
        preparation and implementation of the management plan with--
                    (A) the Blackwater National Wildlife Refuge;
                    (B) the Harriet Tubman National Historical Park
                established by section 3(b)(1)(A); and
                    (C) the National Underground Railroad Network to
                Freedom.
    (e) Authorization of Appropriations.--There are authorized to be
appropriated such sums as are necessary to carry out this section.

SEC. 3. HARRIET TUBMAN NATIONAL HISTORICAL PARK, AUBURN, NEW YORK.

    (a) Definitions.--In this section:
            (1) Historical park.--The term ``historical park'' means
        the Harriet Tubman National Historical Park established by
        subsection (b)(1)(A).
            (2) Home.--The term ``Home'' means The Harriet Tubman Home,
        Inc., located in Auburn, New York.
            (3) Map.--The term ``map'' means the map entitled ``Harriet
        Tubman National Historical Park'', numbered T18/80,000, and
        dated March 2009.
            (4) Secretary.--The term ``Secretary'' means the Secretary
        of the Interior.
            (5) State.--The term ``State'' means the State of New York.
    (b) Harriet Tubman National Historical Park.--
            (1) Establishment.--
                    (A) In general.--Subject to subparagraph (B), there
                is established the Harriet Tubman National Historical
                Park in Auburn, New York, as a unit of the National
                Park System.
                    (B) Determination by secretary.--The historical
                park shall not be established until the date on which
                the Secretary determines that a sufficient quantity of
                land, or interests in land, has been acquired to
                constitute a manageable park unit.
                    (C) Notice.--Not later than 30 days after the date
                on which the Secretary makes a determination under
                subparagraph (B), the Secretary shall publish in the
                Federal Register notice of the establishment of the
                historical park.
                    (D) Map.--The map shall be on file and available
                for public inspection in appropriate offices of the
                National Park Service.
            (2) Boundary.--The historical park shall include the
        Harriet Tubman Home, the Tubman Home for the Aged, the Thompson
        Memorial AME Zion Church and Rectory, and associated land, as
        identified in the area entitled ``National Historical Park
        Proposed Boundary'' on the map.
            (3) Purpose.--The purpose of the historical park is to
        preserve and interpret for the benefit of present and future
        generations the historical, cultural, and natural resources
        associated with the life of Harriet Tubman.
            (4) Land acquisition.--The Secretary may acquire land and
        interests in land within the areas depicted on the map by
        purchase from a willing seller, donation, or exchange.
    (c) Administration.--
            (1) In general.--The Secretary shall administer the
        historical park in accordance with this section and the laws
        generally applicable to units of the National Park System,
        including--
                    (A) the National Park System Organic Act (16 U.S.C.
                1 et seq.); and
                    (B) the Act of August 21, 1935 (16 U.S.C. 461 et
                seq.).
            (2) Interpretive tours.--The Secretary may provide
        interpretive tours to sites and resources located outside the
        boundary of the historical park in Auburn, New York, relating
        to the life of Harriet Tubman.
            (3) Cooperative agreements.--
                    (A) In general.--The Secretary may enter into a
                cooperative agreement with the owner of any land within
                the historical park to mark, interpret, or restore
                nationally significant historic or cultural resources
                relating to the life of Harriet Tubman, if the
                agreement provides that--
                            (i) the Secretary shall have the right of
                        access to any public portions of the land
                        covered by the agreement to allow for--
                                    (I) access at reasonable times by
                                historical park visitors to the land;
                                and
                                    (II) interpretation of the land for
                                the public; and
                            (ii) no changes or alterations shall be
                        made to the land except by mutual agreement of
                        the Secretary and the owner of the land.
                    (B) Research.--The Secretary may enter into a
                cooperative agreement with the State, political
                subdivisions of the State, institutions of higher
                education, the Home and other nonprofit organizations,
                and individuals to conduct research relating to the
                life of Harriet Tubman.
                    (C) Cost-sharing requirement.--
                            (i) Federal share.--The Federal share of
                        the total cost of any activity carried out
                        under this paragraph shall not exceed 50
                        percent.
                            (ii) Form of non-federal share.--The non-
                        Federal share may be in the form of in-kind
                        contributions or goods or services fairly
                        valued.
                    (D) Attorney general.--
                            (i) In general.--The Secretary shall submit
                        to the Attorney General for review any
                        cooperative agreement under this paragraph
                        involving religious property or property owned
                        by a religious institution.
                            (ii) Finding.--No cooperative agreement
                        subject to review under this subparagraph shall
                        take effect until the date on which the
                        Attorney General issues a finding that the
                        proposed agreement does not violate the
                        Establishment Clause of the first amendment to
                        the Constitution.
    (d) General Management Plan.--
            (1) In general.--Not later than 3 years after the date on
        which funds are made available to carry out this section, the
        Secretary shall prepare a general management plan for the
        historical park in accordance with section 12(b) of the
        National Park Service General Authorities Act (16 U.S.C. 1a-
        7(b)).
            (2) Coordination.--The Secretary shall coordinate the
        preparation and implementation of the management plan with--
                    (A) the Harriet Tubman Underground Railroad
                National Historical Park established by section
                2(b)(1); and
                    (B) the National Underground Railroad Network to
                Freedom.
    (e) Authorization of Appropriations.--There are authorized to be
appropriated such sums as are necessary to carry out this Act, except
that not more than $7,500,000 shall be available to provide financial
assistance under subsection (c)(3).

SEC. 4. OFFSET.

    Section 101(b)(12) of the Water Resources Development Act of 1996
(Public Law 104-303; 110 Stat. 3667) is amended by striking
``$53,852,000'' and inserting ``$29,852,000''.

            Passed the Senate July 9, 2014.

            Attest:

                                                NANCY ERICKSON,

                                                             Secretary.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Healthy School Meals Act of 2010''.

SEC. 2. FINDINGS AND PURPOSE.

     (a) Findings.--Congress finds the following:
            (1) National Health and Nutrition Examination Surveys
        (1976-1980 and 2003-2006) conducted for the Centers for Disease
        Control and Prevention show that obesity prevalence increased
        from 5.0 percent to 12.4 percent in children aged 2 to 5 years,
        from 6.5 percent to 17.0 percent in those aged 6-11 years and
        from 5.0 percent to 17.6 percent in those aged 12 to 19 years.
            (2) A 2007 Department of Agriculture School Nutrition
        Dietary study found that an estimated 70 percent of schools
        serve meals that exceed recommended levels of saturated fat,
        which is linked to heart disease and other obesity-related
        chronic diseases, such as diabetes and some cancers.
            (3) The Centers for Disease Control and Prevention predicts
        one in three children born in the year 2000 will develop
        diabetes in his or her life.
            (4) A Yale University study of overweight and obese
        children found higher than normal blood sugar. Twenty-five
        percent of children age 4 to 10 had impaired glucose tolerance,
        suggesting diabetes may soon occur.
            (5) Healthy school meals are essential for protecting
        children from weight problems and other diet-related
        conditions; meals too high in fat and calories are found to
        contribute to weight and health problems.
            (6) The Department of Agriculture's National Nutrient
        Database lists vegetables, fruits, whole grains, and legumes as
        being extremely low in saturated fat and containing no
        cholesterol.
            (7) The American Medical Association and the American
        Public Health Association have passed resolutions calling for
        plant-based foods including vegetables, fruits, legumes,
        grains, and healthful dairy alternative beverages to be
        included in school meals.
            (8) A rapidly increasing number of families in the United
        States opt for plant-based meals for health, ethical, or
        religious reasons.
            (9) The July 2009 Journal of the American Dietetic
        Association published an official position paper of the
        American Dietetic Association which concluded that plant-based
        diets are nutritionally adequate for everyone, including
        children, and provide health benefits when compared to other
        eating patterns.
            (10) Studies have shown that the bioavailability of calcium
        from soymilk fortified with calcium carbonate is equivalent to
        cow's milk.
            (11) The Department of Agriculture includes fruits,
        vegetables, whole grains, and legumes in its commodities
        program, but these essential ingredients to healthy meals are
        often underutilized or unavailable to many schools.
            (12) Access to healthful plant-based school lunch options
        is essential to improving the health of America's children.
    (b) Purpose.--The purpose of this Act is to improve the health of
America's schoolchildren by raising the nutritional quality of food
through the promotion of plant-based meals and healthful dairy
alternative beverages in schools.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Plant-based alternate protein product.--The term
        ``plant-based alternate protein product'' means an alternate
        protein product that--
                    (A) meets the nutritional requirements described in
                appendix A to part 210 of title 7 of the Code of
                Federal Regulations (as in effect on the date of the
                enactment of this Act); and
                    (B) contains no animal-based foods, products, or
                byproducts.
            (2) Plant-based meat alternate.--The term ``plant-based
        meat alternate'' means a meat alternate that--
                    (A) meets the nutritional requirements described in
                paragraph (k)(1) of part 210.10 of title 7 of the Code
                of Federal Regulations (as in effect on the date of the
                enactment of this Act); and
                    (B) contains no animal-based foods, products, or
                byproducts.
            (3) Plant-based entree.--The term ``plant-based entree''
        means a combination of foods or a single food item offered as a
        main course that--
                    (A) meets the nutritional requirements described in
                part 210.10 of title 7 of the Code of Federal
                Regulations (as in effect on the date of the enactment
                of this Act) as a meat alternate for food-based menu
                planning or protein requirement for nutrient-based menu
                planning for lunches that are reimbursable under the
                Richard B. Russell National School Lunch Act (20 U.S.C.
                1751 et seq.); and
                    (B) contains no animal-based foods, products, or
                byproducts.
            (4) Secretary.--The term ``Secretary'' means the Secretary
        of Agriculture.
            (5) Substitute for fluid milk.--The term ``substitute for
        fluid milk'' means a nondairy fluid milk that is nutritionally
        equivalent to fluid dairy milk and meets the nutritional
        standards established by the Secretary, which shall include
        fortification of calcium, 6 or more grams of protein per 8-
        ounce serving, vitamin A, vitamin D, magnesium, phosphorus,
        potassium, riboflavin, and vitamin B12 to levels found in fluid
        dairy milk.

SEC. 4. HEALTHY SCHOOL MEALS PILOT PROGRAM.

    (a) In General.--Not later than 6 months after the date of the
enactment of this Act, the Secretary shall select school food
authorities to participate in a pilot program that evaluates the use of
plant-based alternate protein products and substitute for fluid milk
products under the school meal programs under the Richard B. Russell
National School Lunch Act (42 U.S.C. 1751 et seq.) and section 4 of the
Child Nutrition Act of 1966 (42 U.S.C. 1773).
    (b) Selection and Program Requirements.--
            (1) Selection requirements.--The Secretary shall select
        school food authorities to participate in the pilot program
        under this section that are nationally representative of school
        food authorities in terms of size, geographic location, and
        socioeconomic levels of students served.
            (2) Program requirements.--In addition to the commodities
        delivered under section 6(b) of the Richard B. Russell National
        School Lunch Act (42 U.S.C. 1755(b)), the Secretary shall
        deliver to the school food authorities selected to participate
        in the pilot program under this section, at no cost to the
        school food authorities, plant-based alternate protein products
        and substitute for fluid milk products for schools under the
        jurisdiction of such school food authorities for the
        preparation of daily meals under--
                    (A) the school lunch program under the Richard B.
                Russell National School Lunch Act (42 U.S.C. 1751 et
                seq.); and
                    (B) the school breakfast program under section 4 of
                the Child Nutrition Act of 1966 (42 U.S.C. 1773).
    (c) Evaluation.--Not later than 24 months after the date of the
enactment of this Act the Secretary shall evaluate the pilot program
conducted under this section to assess--
            (1) which plant-based alternate protein products and
        substitute for fluid milk products are superior with regard
        to--
                    (A) cost-effectiveness;
                    (B) marketability to school food authorities;
                    (C) ease of preparation and use; and
                    (D) acceptance by children participating in the
                school meal programs under the Richard B. Russell
                National School Lunch Act (42 U.S.C. 1751 et seq.) and
                section 4 of the Child Nutrition Act of 1966 (42 U.S.C.
                1773).
            (2) any other factors and outcomes associated with
        increasing the availability of plant-based alternate protein
        products and substitute for fluid milk products in schools, as
        determined by the Secretary.
    (d) Funds.--Not later than October 15, 2011, out of the funds in
the Treasury not otherwise appropriated, the Secretary of Treasury
shall transfer to the Secretary of Agriculture $4,000,000 to carry out
this section. The Secretary of Agriculture shall be entitled to receive
the funds and shall accept the funds, without further appropriation.

SEC. 5. PURCHASE OF PLANT-BASED COMMODITIES.

    (a) Purchase of Plant-Based Commodities.--Not later than 24 months
after the date of the enactment of this Act, in addition to the
commodities delivered under section 6(b) of the Richard B. Russell
National School Lunch Act (42 U.S.C. 1755(b)), the Secretary shall
deliver plant-based alternate protein products and substitute for fluid
milk products that are determined to be superior according to the
findings of the evaluation conducted under section 4(c) for use in--
            (1) the school lunch program under the Richard B. Russell
        National School Lunch Act (42 U.S.C. 1751 et seq.); and
            (2) the school breakfast program under section 4 of the
        Child Nutrition Act of 1966 (42 U.S.C. 1773).
    (b) Training.--The Secretary shall provide training materials to
schools and school food authorities on the nutritional benefits and
preparation of plant-based meat alternates and alternate protein
product commodities for schoolchildren.

SEC. 6. COMMODITY ASSISTANCE FOR PLANT-BASED OPTIONS.

    (a) Rules.--Not later than 24 months after the date of the
enactment of this Act, the Secretary shall promulgate rules that--
            (1) based on the most recent Dietary Guidelines published
        under section 301 of the National Nutrition Monitoring and
        Related Research Act of 1990 (7 U.S.C. 5341), reflect specific
        recommendations, expressed in serving recommendations, for
        increased consumption of plant-based foods, including plant-
        based meat alternates and plant-based entrees, in school
        nutrition programs under the Richard B. Russell National School
        Lunch Act (42 U.S.C. 1751 et seq.) and the Child Nutrition Act
        of 1966 (42 U.S.C. 1771 et seq.); and
            (2) provide for the distribution--
                    (A) to any school food authority in which at least
                two-thirds of the students served by the authority are
                offered a plant-based entree as a menu item on each
                daily school lunch menu, supplemental commodity
                assistance or cash in lieu thereof under section 14 of
                the Richard B. Russell National School Lunch Act 42
                U.S.C. 1762a) that--
                            (i) is not less than 25 percent of the
                        total commodity assistance or cash in lieu
                        thereof provided to the school food authority
                        during the preceding school year; and
                            (ii) shall be used by the authority to
                        purchase entirely plant-based commodity food
                        products or substitute for fluid milk products;
                    (B) to each State educational agency in which a
                school food authority receives supplemental commodity
                assistance or cash in lieu thereof pursuant to
                paragraph (1), not more than 5 percent of such
                assistance or cash; and
                    (C) of increased levels of supplemental commodity
                assistance or cash in lieu thereof to school food
                authorities pursuant to paragraph (1) as school food
                authorities increase the number of students who are
                offered a plant-based entree as a menu item on each
                daily school lunch menu.
    (b) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section.

SEC. 7. SUBSTITUTE FOR FLUID MILK.

    (a) Amendments.--Section 9(a)(2) of the Richard B. Russell National
School Lunch Act (42 U.S.C. 1958(a)(2)(A)) is amended to read as
follows:
            ``(2) Fluid milk.--
                    ``(A) In general.--Lunches served by schools
                participating in the school lunch program under this
                Act--
                            ``(i) shall offer students fluid milk in a
                        variety of fat contents; and
                            ``(ii) may offer students flavored and
                        unflavored fluid milk, lactose-free fluid milk,
                        and a nondairy substitute for fluid milk.
                    ``(B) Substitutes.--
                            ``(i) Standards for substitution.--A school
                        shall substitute for the fluid milk provided
                        under subparagraph (A)(i), a nondairy beverage
                        that is nutritionally equivalent to fluid milk
                        and meets nutritional standards established by
                        the Secretary (which shall, among other
                        requirements to be determined by the Secretary,
                        include fortification of calcium, vitamin A,
                        vitamin D, magnesium, phosphorus, potassium,
                        riboflavin, and vitamin B12 to levels found in
                        fluid dairy milk, and not less than 6 grams of
                        protein per 8-ounce serving) for students who
                        cannot consume fluid milk because of a
                        disability or medical or other special dietary
                        need.
                            ``(ii) Excess expenses borne by school food
                        authority.--Expenses incurred in providing
                        substitutions under this subparagraph that are
                        in excess of expenses covered by reimbursements
                        under this chapter shall be paid by the school
                        food authority.''.
    (b) Effective Date.--The amendment made by subsection (a) shall
take effect not later than 24 months after the date of the enactment of
this Act.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Helicopter Medical Services Patient
Safety, Protection, and Coordination Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The Federal Aviation Administration is responsible for
        regulating civil aviation in the United States.
            (2) Each State is responsible for the regulation of public
        health planning and protection, patient safety and protection,
        emergency medical services, the quality and coordination of
        medical care, and the practice of medicine within its
        jurisdiction.
            (3) Helicopter medical services are an essential component
        of the health care delivery and emergency medical services
        system in each State and are integral to each State's
        management of public health planning and protection, patient
        safety and protection, emergency medical services, the quality
        and coordination of medical care, and the practice of medicine
        within the State's jurisdiction.
            (4) Existing or future regulation of helicopter medical
        services by the several States is in the public interest.
            (5) Helicopter medical services represent a unique and
        discrete area of air transportation because those services
        present issues involving the adequacy and availability of
        medical services to patients.
            (6) Court rulings and statutory interpretations issued by
        the Secretary of Transportation have imposed limitations on,
        impeded, or prevented, the ability of States to effectively
        regulate helicopter medical services in a manner similar to the
        regulation of other health care services by the States.
            (7) Those rulings and interpretations have concluded that
        certain State actions related to public health planning and
        protection, patient safety and protection, emergency medical
        services, the quality and coordination of medical care, and the
        practice of medicine, and related aspects of helicopter medical
        services, are preempted by Federal law, either pursuant to the
        preemption provisions of the Airline Deregulation Act of 1978
        (Public Law 95-504; 92 Stat. 1705) or through the application
        of the ``field occupation'' preemption doctrine.
            (8) The Airline Deregulation Act of 1978 did not
        contemplate helicopter medical services, and the use of the Act
        to strike down intrastate health-related regulations overseeing
        the provision of helicopter medical services that would
        otherwise be permissible with respect to any other segment of
        the health care industry is not in the public interest.
            (9) At the same time, it is also important to ensure that
        the Federal Aviation Administration's plenary and exclusive
        jurisdiction over matters of aviation safety is not infringed
        by any State. Accordingly, any State health-related regulation
        of helicopter medical services must be harmonized and shall not
        be inconsistent with Federal regulation of aviation safety
        because the safe operation of the helicopter medical services
        flight is of paramount importance.
            (10) Accordingly, there is a need for clarification of
        existing Federal law so that States may regulate helicopter
        medical services with respect to public health planning and
        protection, patient safety and protection, emergency medical
        services, the quality and coordination of medical care, and the
        practice of medicine without infringing on the Federal
        government's plenary power to regulate aviation safety.

SEC. 3. CLARIFICATION OF STATE AUTHORITY OVER HELICOPTER MEDICAL
              SERVICES.

    (a) In General.--Chapter 401 of title 49, United States Code, is
amended by adding at the end the following:
``Sec. 40130. Clarification of State authority over helicopter medical
              services
    ``(a) Clarification of State Authority.--Nothing in this subtitle
shall prohibit a State from--
            ``(1) requiring medical licenses for the provision of
        helicopter medical services between locations within the State;
        or
            ``(2) prescribing regulations relating to the provision of
        such services if such regulations are prescribed pursuant to
        subsection (c), (d), or (e).
    ``(b) Applicability of Federal Aviation Safety Authority.--No State
health-related regulation established pursuant to this section shall
supersede or be inconsistent with any Federal operating requirement
with respect to aviation safety.
    ``(c) State Authority Over Medical Services.--A State may prescribe
regulations relating to the provision of helicopter medical services
with respect to the following:
            ``(1) The medical qualifications and medical training of
        helicopter medical personnel, except that a State may not
        impose any requirement with respect to a pilot.
            ``(2) The obligation of providers of helicopter medical
        services to comply with the health planning, patient safety,
        and medical service requirements of the State, including--
                    ``(A) coordination of the interrelationship,
                interaction, and agreements among providers of
                helicopter medical services, providers of other
                emergency medical services, providers of other medical
                transport services, referring entities, and medical
                institutions that receive patients transported by
                providers of helicopter medical services with respect
                to the transport of patients;
                    ``(B) demonstration of adequate capacity to provide
                helicopter medical services;
                    ``(C) demonstration of the need for new or expanded
                helicopter medical services;
                    ``(D) determinations with respect to the number and
                base location of helicopters used in the provision of
                helicopter medical services within the State or region
                of the State or the regulation of competition for
                specific markets within the State;
                    ``(E) affiliation with health care institutions;
                    ``(F) sanitation and infection control protocols;
                    ``(G) medical records requirements;
                    ``(H) quality of medical care requirements,
                including participation in patient safety and medical
                quality control efforts, such as peer review processes,
                utilization review, and error reporting systems; and
                    ``(I) the proffer of gifts of monetary value (other
                than training or educational programs) to referring
                entities (or personnel employed by such entities)
                within the State.
    ``(d) State Authority Over Medical Services Subject to
Harmonization Requirement.--A State may prescribe regulations relating
to the provision of helicopter medical services with respect to the
following, if such regulations are harmonized with, and do not infringe
upon, any applicable Federal operating requirements:
            ``(1) The establishment of appropriate medical criteria for
        determining the appropriate medical institution to receive a
        patient being transported from the scene at which the patient's
        injury or accident, or other event resulting in the need for
        medical services for the patient, occurred.
            ``(2) The specification of service requirements with
        respect to geographic areas within the State or during
        specified hours and days.
            ``(3) The coordination of flight requests for emergency
        helicopter medical services.
            ``(4) The compliance with accreditation requirements
        regarding medical services, except where such requirements
        infringe upon relevant Federal operating requirements.
            ``(5) The provision of emergency helicopter medical
        services to all persons for whom such services are medically
        necessary and appropriate.
    ``(e) State Authority Over Medical Services Subject to Consistency
Requirement.--
            ``(1) In general.--Subject to paragraph (2), a State may
        prescribe regulations relating to the provision of helicopter
        medical services with respect to the following, if such
        regulations are consistent with, and do not infringe upon, any
        applicable Federal operating requirements:
                    ``(A) The necessary medical equipment and supplies
                to be carried on board or affixed to the helicopter.
                    ``(B) The physical attributes of the helicopter--
                            ``(i) necessary for the provision of
                        quality medical care, including--
                                    ``(I) permanently installed climate
                                control systems capable of meeting
                                specified temperature settings;
                                    ``(II) a configuration that allows
                                adequate access to the patient, medical
                                equipment, and medical supplies by the
                                helicopter medical personnel;
                                    ``(III) use of materials in the
                                helicopter that are appropriate for
                                proper patient care;
                                    ``(IV) sufficient electrical supply
                                to support medical equipment without
                                compromising helicopter power; and
                                    ``(V) the ability of the helicopter
                                to transport a patient a certain
                                distance without refueling within the
                                State; and
                            ``(ii) necessary--
                                    ``(I) for the protection of
                                helicopter personnel, ground medical
                                personnel, and emergency response
                                personnel; and
                                    ``(II) to ensure that the
                                helicopter has no structural or
                                functional defects that may adversely
                                affect such personnel, such as by
                                requiring tailroter illumination for
                                loading patients at night or external
                                search lights.
                    ``(C) Communication capabilities enabling--
                            ``(i) the helicopter medical personnel to
                        communicate with emergency medical services and
                        public safety personnel and personnel at
                        medical institutions that receive patients
                        transported by providers of helicopter medical
                        services; and
                            ``(ii) the flightcrew to communicate with
                        the helicopter medical personnel, to the extent
                        that the communications do not interfere with
                        the safe operation of the flight.
            ``(2) Limitations.--
                    ``(A) Providers licensed in multiple states.--If a
                provider of helicopter medical services is licensed to
                provide such services in more than one State and the
                regulations established pursuant to this subsection by
                the States in which the provider is licensed are
                inconsistent, the provider shall comply with the most
                stringent of such regulations.
                    ``(B) Nondelegation requirement.--A State may not
                delegate authority provided under this subsection to a
                political subdivision of the State.
    ``(f) Interstate Agreements.--In regulating the provision of
helicopter medical services pursuant to this section, a State shall, if
necessary, establish regulations or negotiate mutual aid agreements
with adjacent States or providers of helicopter medical services in
adjacent States to ensure access to helicopter medical services across
State borders.
    ``(g) Definitions.--In this section:
            ``(1) Helicopter medical services.--The term `helicopter
        medical services' means the helicopter transport of a patient,
        in both emergency and nonemergency situations, as well as the
        medical services provided to such patient in the course of
        transport by such helicopter.
            ``(2) Federal operating requirements.--The term `Federal
        operating requirements' means requirements under part A of
        subtitle VII of title 49, United States Code, and Federal
        aviation regulations set forth in title 14, Code of Federal
        Regulations.
            ``(3) Referring entities.--The term `referring entity'
        means any entity that dispatches or provides a referral for a
        provider of helicopter medical services, such as a medical
        institution, an agency providing emergency medical services, or
        a first responder.''.
    (b) Conforming Amendment.--The table of sections at the beginning
of chapter 401 of title 49, United States Code, is amended by adding at
the end the following:

``40130. Clarification of State authority over intrastate helicopter
                            medical services.''.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Helping Responsible Homeowners
Act''.

SEC. 2. AFFORDABLE REFINANCING OF MORTGAGES OWNED OR GUARANTEED BY
              FANNIE MAE AND FREDDIE MAC.

    (a) Definitions.--As used in this Act, the following definitions
shall apply:
            (1) Director.--The term ``Director'' means the Director of
        the Federal Housing Finance Agency.
            (2) Enterprise.--The term ``enterprise'' means the Federal
        National Mortgage Association and the Federal Home Loan
        Mortgage Corporation.
            (3) Qualified mortgage.--The term ``qualified mortgage''
        means a mortgage that--
                    (A) is an existing first mortgage that was made for
                purchase of, or refinancing another first mortgage on,
                a one- to four-family dwelling, including a condominium
                or a share in a cooperative ownership housing
                association, that is occupied by the mortgagor as the
                principal residence of the mortgagor;
                    (B) is owned or guaranteed by the Federal National
                Mortgage Association or the Federal Home Loan Mortgage
                Corporation; and
                    (C) the mortgagor is current on payments due under
                the mortgage.
            (4) Refinancing mortgage.--The term ``refinancing
        mortgage'' means a mortgage that meets the following
        requirements:
                    (A) Refinancing of qualified mortgage.--The
                principal loan amount repayment of which is secured by
                the mortgage shall be used to satisfy all indebtedness
                under an existing qualified mortgage and any closing
                costs from the refinancing of the mortgage that the
                mortgagor chooses to include in the refinanced
                mortgage.
                    (B) Single-family housing.--The property that is
                subject to the mortgage shall be the same property that
                is subject to the qualified mortgage being refinanced.
                    (C) Interest rate.--The mortgage shall bear a fair
                rate of interest, which shall not exceed 40 basis
                points above the required net yield for a 60-day
                commitment to purchase a prime conventional conforming
                fixed rate mortgage as published by the Federal
                National Mortgage Association or the Federal Home Loan
                Mortgage Corporation at the time the interest rate is
                locked in.
                    (D) Loan to value.--The mortgage shall not be
                limited by the loan-to-value ratio.
                    (E) Waiver of prepayment penalties.--All penalties
                for prepayment or refinancing of the qualified mortgage
                that is refinanced by the mortgage, and all fees and
                penalties related to the default or delinquency on such
                mortgage, shall have been waived or forgiven.
                    (F) Term to maturity.--The mortgage shall have a
                term to maturity of not more than 40 years from the
                date of the beginning of the amortization of the
                mortgage.
    (b) Authority.--The Federal National Mortgage Association and the
Federal Home Loan Mortgage Corporation shall each carry out a program
under this section to provide for the refinancing of qualified
mortgages on single-family housing owned by such enterprise through a
refinancing mortgage, and for the purchase of and securitization of
such refinancing mortgages, in accordance with this section and
policies and procedures that the Director of the Federal Housing
Finance Agency shall establish. Such program shall require the Federal
National Mortgage Association and the Federal Home Loan Mortgage
Corporation to purchase or guarantee the refinancing mortgage used to
refinance a qualified mortgage upon the request of the mortgagee.
    (c) Prohibition on Loan Level Price Adjustments and Post Settlement
Delivery Fees.--In carrying out the program established under this
section, the Federal National Mortgage Association and the Federal Home
Loan Mortgage Corporation shall not charge the mortgagee any up-front
fee beyond the standard guarantee fee for the refinancing of the
qualified mortgage through the refinancing mortgage.
    (d) Resubordination of Second Liens.--For any servicer or creditor
holding a second lien on a qualified mortgage who refuses to
resubordinate that lien, thereby preventing the refinancing of the
qualified mortgage, new mortgages originated by that servicer or
creditor shall be ineligible for purchase or guarantee by the Federal
National Mortgage Association or the Federal Home Loan Mortgage
Corporation.
    (e) Termination.--The requirement for an enterprise to refinance
qualified mortgages under this section shall not apply to any request
for refinancing made after the expiration of the 1-year period
beginning on the date of the enactment of this Act. Notwithstanding the
prior sentence, the Director, at his or her discretion, may extend the
program established under this section, and the requirements of such
program shall apply during any such extension, in 1-year increments.
    (f) Regulations.--The Director shall issue any regulations or
guidance necessary to carry out the program established under this
section.

SEC. 3. NOTICE OF THE REFINANCING PROGRAM.

    The Federal National Mortgage Association and the Federal Home Loan
Mortgage Corporation shall require each servicer of a mortgage owned or
guaranteed by each such enterprise to inform each borrower of such
mortgage of the refinancing program authorized and established under
section 2.

SEC. 4. REPORT.

    The Director shall, as part of the monthly Foreclosure Prevention &
Refinance Report published by the Director, include information on the
progress of the refinancing program authorized and established under
section 2.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Hereditary Hemorrhagic
Telangiectasia Diagnosis and Treatment Act of 2011''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Hereditary hemorrhagic telangiectasia (``HHT'') is a
        largely undiagnosed or misdiagnosed vascular genetic bleeding
        disorder that causes abnormalities of the blood vessels. A
        person with HHT has the tendency to form blood vessels that
        lack the capillaries between an artery and vein. HHT can cause
        spontaneous hemorrhage or stroke when brain or lung
        arteriovenous malformations, which are tangled blood vessels,
        rupture unexpectedly in all age groups. In addition to
        hemorrhagic stroke, embolic stroke, and brain abscess occur in
        approximately 30 percent of individuals with HHT caused by
        artery-vein malformations in the lung (due to lack of
        capillaries between the arterial and venous systems which
        prevent or normally filter out clots and bacteria), causing
        disability and sudden premature death.
            (2) One in 5,000 American children and adults suffer from
        HHT.
            (3) Studies have found an increase in morbidity and
        mortality rate for individuals who suffer from HHT.
            (4) Due to the widespread lack of knowledge, accurate
        diagnosis, and appropriate intervention, 90 percent of HHT-
        affected families are at risk for preventable life-threatening
        and disabling medical incidents such as stroke.
            (5) Early detection, screening, and treatment can prevent
        premature deaths, spontaneous hemorrhage, hemorrhagic stroke,
        embolic stroke, brain abscess, and other long-term health care
        complications resulting from HHT.
            (6) HHT is an important health condition with serious
        health consequences which are amenable to early identification
        and diagnosis with suitable tests, and acceptable and available
        treatments in established treatment centers.
            (7) Timely identification and management of HHT cases is an
        important public health objective because it will save lives,
        prevent disability, and reduce direct and indirect health care
        costs expenditures.
            (8) Without a new program for early detection, screening,
        and treatment, 14,000 children and adults who suffer from HHT
        in the population today will suffer premature death and
        disability.

SEC. 3. PURPOSE.

    The purpose of this Act is to create a federally led and financed
initiative for early diagnosis and appropriate treatment of hereditary
hemorrhagic telangiectasia that will result in the reduction of the
suffering of families, prevent premature death and disability, and
lower health care costs through proven treatment interventions.

SEC. 4. NATIONAL INSTITUTES OF HEALTH.

    Part B of title IV of the Public Health Service Act (42 U.S.C. 284
et seq.) is amended by adding at the end the following:

``SEC. 409K. HEREDITARY HEMORRHAGIC TELANGIECTASIA.

    ``(a) HHT Initiative.--
            ``(1) Establishment.--The Secretary shall establish and
        implement an HHT initiative to assist in coordinating
        activities to improve early detection, screening, and treatment
        of people who suffer from HHT. Such initiative shall focus on--
                    ``(A) advancing research on the causes, diagnosis,
                and treatment of HHT, including through the conduct or
                support of such research; and
                    ``(B) increasing physician and public awareness of
                HHT.
            ``(2) Consultation.--In carrying out this subsection, the
        Secretary shall consult with the Director of the National
        Institutes of Health and the Director of the Centers for
        Disease Control and Prevention.
    ``(b) HHT Coordinating Committee.--
            ``(1) Establishment.--Not later than 60 days after the date
        of the enactment of this section, the Secretary, in
        consultation with the Director of the National Institutes of
        Health, shall establish a committee to be known as the HHT
        Coordinating Committee.
            ``(2) Membership.--
                    ``(A) In general.--The members of the Committee
                shall be appointed by the Secretary, in consultation
                with the Director of the National Institutes of Health,
                and shall consist of 12 individuals who are experts in
                HHT or arteriovenous malformation (AVM) as follows:
                            ``(i) Four representatives of HHT Treatment
                        Centers of Excellence designated under section
                        317U(c)(1).
                            ``(ii) Four experts in vascular, molecular,
                        or basic science.
                            ``(iii) Four representatives of the
                        National Institutes of Health.
                    ``(B) Chair.--The Secretary shall designate the
                Chair of the Committee from among its members.
                    ``(C) Interim members.--In place of the 4 members
                otherwise required to be appointed under paragraph
                (2)(A)(i), the Secretary may appoint 4 experts in
                vascular, molecular, or basic science to serve as
                members of the Committee during the period preceding
                designation and establishment of HHT Treatment Centers
                of Excellence under section 317U.
                    ``(D) Publication of names.--Not later than 30 days
                after the establishment of the Committee, the Secretary
                shall publish the names of the Chair and members of the
                Committee on the Website of the Department of Health
                and Human Services.
                    ``(E) Terms.--The members of the Committee shall
                each be appointed for a 3-year term and, at the end of
                each such term, may be reappointed.
                    ``(F) Vacancies.--A vacancy on the Committee shall
                be filled by the Secretary in the same manner in which
                the original appointment was made.
            ``(3) Responsibilities.--The Committee shall develop and
        coordinate implementation of a plan to advance research and
        understanding of HHT by--
                    ``(A) conducting or supporting basic,
                translational, and clinical research on HHT across the
                relevant national research institutes, national
                centers, and offices of the National Institutes of
                Health, including the National Heart, Lung, and Blood
                Institute; the National Institute of Neurological
                Disorders and Stroke; the National Institutes of
                Diabetes and Digestive and Kidney Diseases; the Eunice
                Kennedy Shriver National Institute of Child Health and
                Human Development; the National Cancer Institute; and
                the Office of Rare Diseases; and
                    ``(B) conducting evaluations and making
                recommendations to the Secretary, the Director of the
                National Institutes of Health, and the Director of the
                National Cancer Institute regarding the prioritization
                and award of National Institutes of Health research
                grants relating to HHT, including with respect to
                grants for--
                            ``(i) expand understanding of HHT through
                        basic, translational, and clinical research on
                        the cause, diagnosis, prevention, control, and
                        treatment of HHT;
                            ``(ii) training programs on HHT for
                        scientists and health professionals; and
                            ``(iii) HHT genetic testing research to
                        improve the accuracy of genetic testing.
    ``(c) Definitions.--In this section:
            ``(1) The term `Committee' means the HHT Coordinating
        Committee established under subsection (b).
            ``(2) The term `HHT' means hereditary hemorrhagic
        telangiectasia.''.

SEC. 5. CENTERS FOR DISEASE CONTROL AND PREVENTION.

    Part B of title III of the Public Health Service Act is amended by
inserting after section 317T (42 U.S.C. 247b-22) the following:

``SEC. 317U. HEREDITARY HEMORRHAGIC TELANGIECTASIA.

    ``(a) In General.--With respect to hereditary hemorrhagic
telangiectasia (in this section referred to as `HHT'), the Director of
the Centers for Disease Control and Prevention (in this section
referred to as the `Director') shall carry out the following
activities:
            ``(1) The conduct of population screening described in
        subsection (c).
            ``(2) The identification and conduct of investigations to
        further develop and support guidelines for diagnosis of, and
        intervention for, HHT, including cost-benefit studies.
            ``(3) The development of a standardized survey and
        screening tool on family history.
            ``(4) The establishment, in collaboration with a voluntary
        health organization representing HHT families, of an HHT
        resource center within the Centers for Disease Control and
        Prevention to provide comprehensive education on, and
        disseminate information about, HHT to health professionals,
        patients, industry, and the public.
            ``(5) The conduct or support of public awareness programs
        in collaboration with medical, genetic, and professional
        organizations to improve the education of health professionals
        about HHT.
    ``(b) Collaborative Approaches.--The Director shall carry out this
section through collaborative approaches within the National Center on
Birth Defects and Developmental Disabilities and the Division for Heart
Disease and Stroke Prevention of the Centers for Disease Control and
Prevention.
    ``(c) Population Screening.--In carrying out population screening
under subsection (a)(1), the Director shall--
            ``(1) designate and provide funding for a sufficient number
        of HHT Treatment Centers of Excellence to improve patient
        access to information, treatment, and care by HHT experts;
            ``(2) conduct surveillance through a regional population
        study, supplemented by sentinel health care provider or center
        surveillance, and administrative database analyses as useful to
        accurately identify--
                    ``(A) the prevalence of HHT; and
                    ``(B) the prevalence of hemorrhagic and embolic
                stroke and brain abscess, resulting from HHT;
            ``(3) include HHT screening questions in the Behavioral
        Risk Factor Surveillance System survey conducted by the Centers
        for Disease Control and Prevention in order to screen a broader
        population and more accurately determine the prevalence of HHT;
            ``(4) disseminate data collected under paragraph (2)(B) to
        the Paul Coverdell National Acute Stroke Registry, to be
        utilized for analyses of natural history of hemorrhagic and
        embolic stroke in HHT, and to develop screening and artery-vein
        malformation treatment guidelines specific to prevention of
        complications from HHT;
            ``(5) develop and implement programs, targeted for
        physicians and health care professional groups likely to be
        accessed by families with HHT, to increase HHT diagnosis and
        treatment rates through the--
                    ``(A) establishment of a partnership with HHT
                Treatment Centers of Excellence designated under
                paragraph (1) through the creation of an international
                database of patients assessed at such HHT Treatment
                Centers of Excellence (including with respect to
                phenotype information, genotype information,
                transfusion dependence, and radiological findings);
                    ``(B) integration of such database with the
                universal data collection system used by the Centers
                for monitoring hemophilia with the blood disorders and
                the Paul Coverdell National Acute Stroke Registry; and
                    ``(C) inclusion of other medical providers who
                treat HHT patients; and
            ``(6) use existing administrative databases on non-HHT
        Treatment Center of Excellence patients to learn about the
        natural history of HHT, the efficacy of various treatment
        modalities, and to better inform and develop screening and
        treatment guidelines associated with improvement in health care
        outcomes, and research priorities relevant to HHT.
    ``(d) Eligibility for Designation as HHT Treatment Center of
Excellence.--In carrying out subsection (c)(1), the Director may
designate as an HHT Treatment Center of Excellence only academic health
centers demonstrating each of the following:
            ``(1) The academic health center possesses a team of
        medical experts capable of providing comprehensive evaluation,
        treatment, and education to individuals with known or suspected
        HHT and their health care providers.
            ``(2) The academic health center has sufficient personnel
        with knowledge about HHT, or formal collaboration with
        partnering organizations for personnel or resources, to be able
        to--
                    ``(A) respond in a coordinated, multidisciplinary
                way to patient inquiries; and
                    ``(B) coordinate evaluation, treatment, and
                education of patients and their families in a timely
                manner.
            ``(3) The academic health center has the following
        personnel, facilities, and patient volume:
                    ``(A) A medical director with--
                            ``(i) specialized knowledge of the main
                        organ manifestations of HHT; and
                            ``(ii) the ability to coordinate the
                        multidisciplinary diagnosis and treatment of
                        patients referred to the center.
                    ``(B) Administrative staff with--
                            ``(i) sufficient knowledge to respond to
                        patient inquiries and coordinate patient care
                        in a timely fashion; and
                            ``(ii) adequate financial support to allow
                        the staff to commit at least 25 to 50 percent
                        of their time on the job to HHT.
                    ``(C) An otolaryngologist with experience and
                expertise in the treatment of recurrent epistaxis in
                HHT patients.
                    ``(D) An interventional radiologist with experience
                and expertise in the treatment of pulmonary
                arteriovenous malformations (AVM).
                    ``(E) A genetic counselor or geneticist with the
                expertise to provide HHT-specific genetic counseling to
                patients and families.
                    ``(F) On-site facilities to screen for all major
                organ manifestations of HHT.
                    ``(G) A patient volume of at least 25 new HHT
                patients per year.
                    ``(H) Established mechanisms to coordinate
                surveillance and outreach with HHT patient advocacy
                organizations.''.

SEC. 6. ADDITIONAL HEALTH AND HUMAN SERVICES ACTIVITIES.

    With respect to hereditary hemorrhagic telangiectasia (in this sec
referred to as ``HHT''), the Secretary of Health and Human Services,
acting through the Administrator of the Centers for Medicare & Medicaid
Services, shall award grants on a competitive basis--
            (1) for an analysis by grantees of the Medicare Provider
        Analysis and Review (MEDPAR) file to develop preliminary
        estimates on the total costs to the Medicare program under
        title XVIII of the Social Security Act for items, services, and
        treatments for HHT furnished to individuals with HHT who are
        entitled to benefits under part A of title XVIII of the Social
        Security Act or enrolled under part B of such title; and
            (2) to make recommendations regarding an enhanced data
        collection protocol to permit a more precise determination of
        the total costs described in paragraph (1).

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--To carry out section 409K of the Public Health
Service Act as added by section 4 of this Act, section 317U of the
Public Health Service Act as added by section 5 of this Act, and
section 6 of this Act, there is authorized to be appropriated
$5,000,000 for each of fiscal years 2012 through 2016.
    (b) Resource Center.--Of the amount authorized to be appropriated
under subsection (a) for each of fiscal years 2012 through 2016,
$1,000,000 shall be for carrying out section 317U(a)(4) of the Public
Health Service Act, as added by section 5 of this Act.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Highway Trust Fund Integrity Act of
1997''.

SEC. 2. FINDINGS.

    Congress finds that--
            (1)(A) the Budget Enforcement Act of 1990 split the Federal
        budgeting process into two budget categories, one for receipts
        and mandatory spending and the other for discretionary
        spending; and
            (B) each budget category has its own rules, procedures, and
        incentives;
            (2) the taxes deposited into the Highway Trust Fund are in
        the mandatory category, but most spending from the Highway
        Trust Fund is in the discretionary category;
            (3) since the Highway Trust Fund is split between the two
        budget categories, the link between Highway Trust Fund taxes
        and transportation spending is severed; and
            (4) to reestablish the link between the taxes and spending
        of the Highway Trust Fund, all the components of the Highway
        Trust Fund should be part of the same budget category and
        subject to the same budget rules and procedures.

SEC. 3. DEFINITION.

    (a) Balanced Budget and Emergency Deficit Control Act of 1985.--
Section 250(c) of the Balanced Budget and Emergency Deficit Control Act
of 1985 (2 U.S.C. 900(c)) is amended by adding at the end the
following:
            ``(22) Revenue constrained fund.--The term `revenue
        constrained fund'--
                    ``(A) means the budget authority, outlays, and
                receipts of the--
                            ``(i) the Highway Account of the Highway
                        Trust Fund as established by section 9503 of
                        the Internal Revenue Code of 1986;
                    ``(B) shall not be--
                            ``(i) considered to be part of any category
                        (as defined in section 250(c)(4) of the
                        Balanced Budget and Emergency Deficit Control
                        Act of 1985 (2 U.S.C. 900(c)(4))) of
                        discretionary appropriations; or
                            ``(ii) subject to sequestration under
                        section 251(a) of the Act (2 U.S.C. 901(a));
                        and
                    ``(C) shall not be--
                            ``(i) considered to be part of direct
                        spending (as defined in section 250(c)(8) of
                        the Balanced Budget and Emergency Deficit
                        Control Act of 1985 (2 U.S.C. 900(c)(8))); or
                            ``(ii) subject to sequestration under
                        section 252(b) of the Act (2 U.S.C. 902(b)).''.
    (b) Congressional Budget Act of 1974.--Section 3 of the
Congressional Budget Act of 1974 (2 U.S.C. 622) is amended by adding at
the end thereof the following:
            ``(11) Revenue constrained fund.--The term `revenue
        constrained fund' has the meaning given that term in section
        250(c) of the Balanced Budget and Emergency Deficit Control Act
        of 1985 (2 U.S.C. 900(c)).''.

SEC. 4. BUDGETARY TREATMENT.

    (a) In General.--Part A of title IV of the Congressional Budget Act
of 1974 (2 U.S.C. 651 et seq.) is amended by adding at the end the
following:

                      ``revenue constrained funds

    ``Sec. 408. It shall not be in order in either the House of
Representatives or the Senate to consider any bill, joint resolution,
amendment, motion, conference report, or other measure if the effect of
the measure would have the effect of increasing any specific new budget
authority for a fiscal year for a revenue constrained fund above the
amount made available by section 251B(b)(2) of the Balanced Budget and
Emergency Deficit Control Act of 1985.''.
    (b) Point of Order.--Subsections (c) and (d) of section 904 of the
Congressional Budget Act of 1974 are each amended by inserting after
``306,'' the following: ``408,''.
    (c) Amendment to Table of Contents.--The table of contents for the
Congressional Budget Impoundment Control Act of 1974 is amended by
adding at the end of title IV the following:

``Sec. 408. Revenue constrained funds.''.

SEC. 5. SEQUESTER.

    (a) In General.--Part C of the Balanced Budget and Emergency
Deficit Control Act of 1985 (2 U.S.C. 900 et seq.) is amended by
inserting after section 251A the following:

``SEC. 251B. SEQUESTRATION WITH RESPECT TO REVENUE CONSTRAINED FUNDS.

    ``(a) Budget Authority Limits.--Amounts available from a revenue
constrained fund shall be reduced by the amount necessary to eliminate
any amount by which budget authority in the budget year from the
revenue constrained fund exceed the amount deposited in the revenue
constrained fund in the previous fiscal year.
    ``(b) Amount Available.--
            ``(1) Initial estimate.--
                    ``(A) In general.--On October 1 of each year OMB
                shall estimate the total amount of revenues deposited
                into each revenue constrained fund during the previous
                fiscal year.
                    ``(B) Initial amount available.--An amount equal to
                40 percent of the total amount of revenues is estimated
                to be deposited in a revenue constrained fund under
                subparagraph (A) shall be available for obligation in
                the budget year on the date of the estimate under
                subparagraph (A).
            ``(2) Final estimate.--
                    ``(A) In general.--On December 15 of each year OMB
                shall determine the total amount of revenues deposited
                into each revenue constrained fund during the previous
                fiscal year.
                    ``(B) Amount available.--An amount equal to the
                total amount of revenues determined to be deposited in
                a revenue constrained fund under subparagraph (A)--
                            ``(i) shall be the total amount available
                        for obligation in the budget year on the date
                        of the determination under subparagraph (A);
                        and
                            ``(ii) shall replace the amount made
                        available under paragraph (1).
    ``(c) Look-Back.--If--
            ``(1) an appropriation for the fiscal year in progress is
        enacted that causes a budgetary excess in a revenue constrained
        fund as described in subsection (a) for that year; or
            ``(2) errors in the determination made pursuant to
        subsection (b)(2) cause a budgetary excess in a revenue
        constrained fund for the fiscal year in progress;
the level set forth in subsection (b)(2) for the next fiscal year shall
be reduced by the amount of that excess.''.
    (b) Amendment to Table of Contents.--The table of contents for the
Balanced Budget and Emergency Deficit Control Act of 1985 is amended by
adding after the item for section 251A the following:

``Sec. 251B. Sequestration with respect to revenue constrained
                            funds.''.

SEC. 5. BUDGETARY IMPACT.

    (a) Findings and Purpose.--
            (1) Findings.--The Congress finds that--
                    (A) the United States has substantial surface
                transportation and infrastructure needs; and
                    (B) this Act will result in additional spending
                from the Highway Account of the Highway Trust Fund to
                help address these substantial needs.
            (2) Purpose.--The purpose of this section is to clarify
        that any budgetary offset necessary because of the additional
        spending provided by this Act should not come from surface
        transportation programs.
    (b) Sequestration.--The budgetary impact of the amendments made by
this Act shall not be considered for purposes of sequestration under
sections 251 or 252 of the Balanced Budget and Emergency Deficit
Control Act of 1985 (2 U.S.C. 901, 902).
    (c) Discretionary Spending Limitations.--OMB shall reduce
discretionary spending limits for budget authority and outlays in
accordance with the Balanced Budget and Emergency Deficit Control Act
of 1985 for each applicable fiscal year set forth in section
601(a)(2)--
            (1) for budget authority, by an amount equal to the total
        amount of discretionary budget authority provided from the
        Highway Account of the Highway Trust Fund in the Department of
        Transportation and Related Agencies Appropriations Act, 1997;
        and
            (2) for outlays, by an amount equal to an estimate of the
        amount of discretionary outlays that would be expended from the
        Highway Account of the Highway Trust Fund assuming that the
        total amount of new budget authority and obligation authority
        from the Highway Account of the Highway Trust Fund equaled the
        amounts of new budget authority and obligation authority
        provided from the Highway Account of the Highway Trust Fund in
        the Department of Transportation and Related Agencies
        Appropriations Act, 1997.

SEC. 6. STUDY TO ENSURE THAT THE HIGHWAY TRUST FUND IS DEFICIT NEUTRAL.

    (a) Findings.--The Congress finds the following:
            (1) It is the policy of the United States Government that
        the Highway Trust Fund should not contribute to or reduce the
        Federal Government's annual budget deficit.
            (2) Under current budgetary scorekeeping conventions used
        by both the Congressional Budget Office and the Office of
        Management and Budget, increases in Highway Trust Fund revenue
        generated by tax increases are partially offset by a reduction
        in other Federal revenues that is equal to 25 percent of the
        increase in Highway Trust Fund revenue.
            (3) This 25 percent offset is a scorekeeping convention
        that applies to all excise taxes, and is not uniquely applied
        to Highway Trust Fund taxes.
            (4) An up-to-date examination of how this offset should be
        applied to Highway Trust Fund taxes is needed.
    (b) Report.--
            (1) In general.--Not later than 24 months after the date of
        enactment of this Act, the Secretary of Treasury, in
        consultation with the Director of the Office of Management and
        Budget, shall submit a report to Congress on ensuring the
        deficit neutrality of the Highway Trust Fund.
            (2) Contents.--In the report, the Secretary shall--
                    (A) determine the extent to which each of the taxes
                deposited into the Highway Trust Fund is a deductible
                expense from other Federal taxes;
                    (B) provide an estimate of the amount of Highway
                Trust Fund taxes that were deducted from Federal income
                taxes or other taxes;
                    (C) provide an estimate of the annual revenue loss
                because Highway Trust Fund taxes are deductible from
                other Federal taxes;
                    (D) determine the appropriate scorekeeping
                convention that should apply to Highway Trust Fund
                taxes, or if needed, separately to each of the taxes
                now deposited into the Highway Trust Fund; and
                    (E) provide the Congress with policy options that
                would ensure that changes to the Highway Trust Fund
                taxes do not contribute to the deficit.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Hire Just One Act of 2013''.

SEC. 2. TREATMENT OF EMPLOYMENT ASSISTANCE VOUCHER PROGRAMS.

    (a) Use of Unemployment Fund for Employment Assistance Voucher
Program.--
            (1) State law.--Section 3304(a)(4) of the Internal Revenue
        Code of 1986 is amended by striking ``and'' at the end of
        subparagraph (F), by inserting ``and'' at the end of
        subparagraph (G), and by adding at the end the following new
        subparagraph:
                    ``(H) during the 120-day period beginning on the
                date of the enactment of the Hire Just One Act of 2013,
                amounts may be withdrawn for the payment of allowances
                under an employment assistance voucher program (as
                defined in section 3306(v));''.
            (2) Permissible expenditures.--Section 3306(f) of such Code
        is amended--
                    (A) by striking ``and'' at the end of paragraph
                (5),
                    (B) by redesignating the paragraph relating to the
                self-employment assistance program as paragraph (6) and
                striking the period at the end of such paragraph and
                inserting ``; and'', and
                    (C) by adding at the end the following new
                paragraph:
            ``(7) during the 120-day period beginning on the date of
        the enactment of the Hire Just One Act of 2013, amounts may be
        withdrawn for the payment of allowances under an employment
        assistance voucher program (as defined in subsection (v)).''.
    (b) Employment Assistance Voucher Program Defined.--Section 3306 of
such Code is amended by adding at the end the following new subsection:
    ``(v) Employment Assistance Voucher Program.--For the purposes of
this chapter--
            ``(1) In general.--The term `employment assistance voucher
        program' means a program under which--
                    ``(A) an eligible individual is issued an
                employment assistance voucher,
                    ``(B) upon employment with an employer described in
                paragraph (5)--
                            ``(i) the eligible individual transfers the
                        employment assistance voucher to the employer,
                            ``(ii) the individual ceases to receive
                        unemployment compensation and is paid wages by
                        the employer, and
                            ``(iii) the employer receives payments upon
                        presenting the voucher to the State, and
                    ``(C) the program meets such other requirements as
                the Secretary of Labor determines to be appropriate.
            ``(2) Rules relating to unemployed individuals.--For
        purposes of paragraph (1)--
                    ``(A) Compensation.--Compensation pursuant to
                paragraph (1)(B)(ii) shall--
                            ``(i) not be less than 200 percent of the
                        unemployment compensation otherwise payable to
                        the individual on the date of the individual's
                        employment under the employment assistance
                        voucher program,
                            ``(ii) not be less than the minimum wage
                        (as specified in section 6 of the Fair Labor
                        Standards Act of 1938),
                            ``(iii) be payable for a period not to
                        exceed the maximum number of remaining weeks of
                        unemployment compensation (including
                        supplemental and emergency) to which the
                        employee would be entitled (but for
                        participating in the employment assistance
                        voucher program), determined as of the date of
                        employment.
                    ``(B) Termination of employment.--If, before the
                end of the period referred to in subparagraph (A)(iii),
                an individual's employment with an employer under the
                employment assistance voucher program is terminated for
                reasons other than cause, the individual is entitled to
                the remaining period of entitlement referred to in
                subparagraph (A)(iii) less the number of weeks of such
                employment.
                    ``(C) Certain requirements not to apply.--State
                requirements relating to availability for work, active
                search for work, and refusal to accept work are not
                applicable to individuals participating in the
                employment assistance voucher program.
            ``(3) Employment assistance voucher.--The term `employment
        assistance voucher' means a voucher--
                    ``(A) obtained by an eligible individual pursuant
                to the State law,
                    ``(B) payable to the employer of the eligible
                individual--
                            ``(i) at a rate determined under State law
                        but not to exceed 90 percent of the amount of
                        unemployment compensation to which the eligible
                        individual is entitled, and
                            ``(ii) on the same schedule as unemployment
                        compensation would be payable to the individual
                        but for employment under the employment
                        assistance voucher program.
            ``(4) Eligible individual.--The term `eligible individual'
        means an individual who--
                    ``(A) is eligible to receive regular unemployment
                compensation under the State law, extended
                unemployment, or emergency unemployment or would be
                eligible to receive such compensation except for the
                requirements described in paragraph (1)(B),
                    ``(B) is identified pursuant to a State worker
                profiling system as an individual likely to exhaust
                regular unemployment compensation,
                    ``(C) immediately prior to employment by the
                eligible employer, was unemployed for not less than 6
                months, and
                    ``(D) is employed by an eligible employer.
            ``(5) Eligible employer.--The term `eligible employer'
        means an employer who agrees to the terms and conditions of
        employment under the unemployment assistance voucher program
        and who is approved by the State agency.
            ``(6) Treatment of participating individuals under federal
        and state law.--Individuals participating in an unemployment
        assistance voucher program shall be treated as unemployed for
        the purposes of Federal and State laws applicable to
        unemployment compensation, except that wages paid to the
        employee under such program shall be subject to Federal and
        State taxation to the same extent and in the same manner as
        wages generally.
            ``(7) Cost limiter.--A State program shall not be treated
        as an employment assistance voucher program for purposes of
        this chapter unless the program does not result in any cost to
        the Unemployment Trust Fund (established by section 904(a) of
        the Social Security Act) in excess of the cost that would be
        incurred by such State and charged to such Fund, or to any
        Federal funds in the system if the State had not participated
        in such program.
            ``(8) Prevention of employment termination to participate
        in program.--A State program shall not be treated as an
        employment assistance voucher program for purposes of this
        chapter unless the State has in effect measures to prevent
        employers from terminating employment for purposes of
        participating in the employment assistance voucher program.
            ``(9) Prevention in terminating employees during program.--
        A State program shall not be treated as an employment
        assistance voucher program for purposes of this chapter unless
        the State has in effect measures to recoup payments made to an
        employer under the program if the employer has terminated from
        employment more employees during the 120-day period referred to
        in section 3304(a)(4)(H) than the employer has hired under the
        program.''.
    (c) Conforming Amendment.--Section 303(a)(5) of the Social Security
Act (42 U.S.C. 503(a)(5)) is amended by striking ``; and'' and
inserting ``: Provided further, That amounts may be withdrawn for the
payment of allowances under an employment assistance voucher program
(as defined in section 3306(v) of the Internal Revenue Code of 1986);
and''.
    (d) State Reports.--Any State operating an employment assistance
voucher program approved by the Secretary of Labor pursuant to section
3304(a)(4)(H) of the Internal Revenue Code of 1986 (as added by this
section) shall report annually to the Secretary on the number of
individuals who participate in the program, the operating costs of the
program, compliance with program requirements, and any other relevant
aspects of program operations requested by the Secretary.
    (e) Report to Congress.--Not later than 1 year after the date of
the enactment of this Act, the Secretary of Labor shall submit a report
to the Congress with respect to the operation of the employment
assistance voucher program. Such report shall be based on the reports
received from the States pursuant to subsection (d) and include such
other information as the Secretary of Labor determines is appropriate.
    (f) Effective Date.--The provisions of this section and the
amendments made by this section shall take effect on the date of the
enactment of this Act.


SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Home Health Care Planning
Improvement Act of 2007''.

SEC. 2. IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES.

    (a) In General.--Section 1814(a)(2) of the Social Security Act (42
U.S.C. 1395f(a)(2)), in the matter preceding subparagraph (A), is
amended--
            (1) by inserting ``(as those terms are defined in section
        1861(aa)(5))'' after ``clinical nurse specialist''; and
            (2) by inserting ``, or in the case of services described
        in subparagraph (C), a physician, or a nurse practitioner or
        clinical nurse specialist who is working in collaboration with
        a physician in accordance with State law, or a certified nurse-
        midwife (as defined in section 1861(gg)) as authorized by State
        law, or a physician assistant (as defined in section
        1861(aa)(5)) under the supervision of a physician'' after
        ``collaboration with a physician''.
    (b) Conforming Amendments.--(1) Section 1814(a) of the Social
Security Act (42 U.S.C. 1395f(a)) is amended--
            (A) in paragraph (2)(C), by inserting ``, a nurse
        practitioner, a clinical nurse specialist, a certified nurse-
        midwife, or a physician assistant (as the case may be)'' after
        ``physician'' each place it appears;
            (B) in the second sentence, by striking ``or clinical nurse
        specialist'' and inserting ``clinical nurse specialist,
        certified nurse-midwife, or physician assistant'';
            (C) in the third sentence--
                    (i) by striking ``physician certification'' and
                inserting ``certification'';
                    (ii) by inserting ``(or on January 1, 2008, in the
                case of regulations to implement the amendments made by
                section 2 of the Home Health Care Planning Improvement
                Act of 2007)'' after ``1981''; and
                    (iii) by striking ``a physician who'' and inserting
                ``a physician, nurse practitioner, clinical nurse
                specialist, certified nurse-midwife, or physician
                assistant who''; and
            (D) in the fourth sentence, by inserting ``, nurse
        practitioner, clinical nurse specialist, certified nurse-
        midwife, or physician assistant'' after ``physician''.
    (2) Section 1835(a) of the Social Security Act (42 U.S.C. 1395n(a))
is amended--
            (A) in paragraph (2)--
                    (i) in the matter preceding subparagraph (A), by
                inserting ``or, in the case of services described in
                subparagraph (A), a physician, or a nurse practitioner
                or clinical nurse specialist (as those terms are
                defined in 1861(aa)(5)) who is working in collaboration
                with a physician in accordance with State law, or a
                certified nurse-midwife (as defined in section
                1861(gg)) as authorized by State law, or a physician
                assistant (as defined in section 1861(aa)(5)) under the
                supervision of a physician'' after ``a physician''; and
                    (ii) in each of clauses (ii) and (iii) of
                subparagraph (A) by inserting ``, a nurse practitioner,
                a clinical nurse specialist, a certified nurse-midwife,
                or a physician assistant (as the case may be)'' after
                ``physician'';
            (B) in the third sentence, by inserting ``, nurse
        practitioner, clinical nurse specialist, certified nurse-
        midwife, or physician assistant (as the case may be)'' after
        physician;
            (C) in the fourth sentence--
                    (i) by striking ``physician certification'' and
                inserting ``certification'';
                    (ii) by inserting ``(or on January 1, 2008, in the
                case of regulations to implement the amendments made by
                section 2 of the Home Health Care Planning Improvement
                Act of 2007)'' after ``1981''; and
                    (iii) by striking ``a physician who'' and inserting
                ``a physician, nurse practitioner, clinical nurse
                specialist, certified nurse-midwife, or physician
                assistant who''; and
            (D) in the fifth sentence, by inserting ``, nurse
        practitioner, clinical nurse specialist, certified nurse-
        midwife, or physician assistant'' after ``physician''.
    (3) Section 1861 of the Social Security Act (42 U.S.C. 1395x) is
amended--
            (A) in subsection (m)--
                    (i) in the matter preceding paragraph (1)--
                            (I) by inserting ``a nurse practitioner or
                        a clinical nurse specialist (as those terms are
                        defined in subsection (aa)(5)), a certified
                        nurse-midwife (as defined in section 1861(gg)),
                        or a physician assistant (as defined in
                        subsection (aa)(5))'' after ``physician'' the
                        first place it appears; and
                            (II) by inserting ``a nurse practitioner, a
                        clinical nurse specialist, a certified nurse-
                        midwife, or a physician assistant'' after
                        ``physician'' the second place it appears; and
                    (ii) in paragraph (3), by inserting ``a nurse
                practitioner, a clinical nurse specialist, a certified
                nurse-midwife, or a physician assistant'' after
                ``physician''; and
            (B) in subsection (o)(2)--
                    (i) by inserting ``, nurse practitioners or
                clinical nurse specialists (as those terms are defined
                in subsection (aa)(5)), certified nurse-midwives (as
                defined in section 1861(gg)), or physician assistants
                (as defined in subsection (aa)(5))'' after
                ``physicians''; and
                    (ii) by inserting ``, nurse practitioner, clinical
                nurse specialist, certified nurse-midwife, physician
                assistant,'' after ``physician''.
    (4) Section 1895 of the Social Security Act (42 U.S.C. 1395fff) is
amended--
            (A) in subsection (c)(1), by inserting ``, the nurse
        practitioner or clinical nurse specialist (as those terms are
        defined in section 1861(aa)(5)), the certified nurse-midwife
        (as defined in section 1861(gg)), or the physician assistant
        (as defined in section 1861(aa)(5)),'' after ``physician''; and
            (B) in subsection (e)--
                    (i) in paragraph (1)(A), by inserting ``, a nurse
                practitioner or clinical nurse specialist (as those
                terms are defined in section 1861(aa)(5)), a certified
                nurse-midwife (as defined in section 1861(gg)), or a
                physician assistant (as defined in section
                1861(aa)(5))'' after ``physician''; and
                    (ii) in paragraph (2)--
                            (I) in the heading, by striking ``Physician
                        certification'' and inserting ``Rule of
                        construction regarding requirement for
                        certification''; and
                            (II) by striking ``physician''.
    (c) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 2008.