[Congressional Record Volume 161, Number 31 (Tuesday, February 24, 2015)]
[Senate]
[Pages S1076-S1078]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. CARDIN (for himself and Ms. Collins):
  S. 539. A bill to amend title XVIII of the Social Security Act to 
repeal the Medicare outpatient rehabilitation therapy caps; to the 
Committee on Finance.
  Mr. CARDIN. Mr. President, I rise in support of the Medicare Access 
to Rehabilitation Services Act, which I am introducing today with my 
colleague Senator Collins. This important bill repeals the monetary 
caps that limit Medicare beneficiaries' access to medically necessary 
outpatient physical therapy, occupational therapy, and speech-language 
pathology services.
  Limits on outpatient rehabilitation therapy services under Medicare 
were first imposed in 1997 as part of the Balanced Budget Act. The 
decision to impose limits on these services was not based on data, 
quality-of-care concerns, or clinical judgment--its sole purpose was to 
limit spending in order to balance the federal budget. Since 1997, 
Congress has acted over 12 times to prevent the implementation of the 
therapy caps through moratoriums and an exceptions process. While these 
short-term actions have provided necessary relief to our seniors, a 
long-term solution is essential to bring permanent relief and much-
needed stability for both patients and providers.
  We need a full repeal of the existing caps on physical therapy, 
occupational therapy, and speech-language pathology services. These 
annual financial caps limit services often needed after a stroke, 
traumatic brain injury, or spinal cord injury, or to effectively manage 
conditions such as Parkinson's disease, multiple sclerosis, and 
arthritis. Arbitrary caps on these vital Medicare outpatient therapy 
services are simply unacceptable. They also discriminate against the 
oldest and sickest Medicare beneficiaries, who typically require the 
most intensive therapy, and disadvantage Medicare beneficiaries who 
live in regions with higher health care costs.
  In a 2009 report issued by the Medicare Payment Advisory Committee, 
MEDPAC, it was estimated that the

[[Page S1077]]

therapy cap, if enforced without an exceptions process, could 
negatively impact 931,000 Medicare beneficiaries. Arbitrarily capping 
outpatient rehabilitation therapy services would likely cause some 
beneficiaries to delay necessary care, force others to assume higher 
out-of pocket costs, and disrupt the continuum of care for many seniors 
and individuals with disabilities.
  I urge my colleagues to join me and Senator Collins in supporting the 
Medicare Access to Rehabilitation Services Act to ensure that our 
seniors have access to the outpatient rehabilitation therapy services 
that they need.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 539

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicare Access to 
     Rehabilitation Services Act of 2015''.

     SEC. 2. OUTPATIENT THERAPY CAP REPEAL.

       Section 1833 of the Social Security Act (42 U.S.C. 1395(l)) 
     is amended by striking subsection (g).
                                 ______
                                 
      By Ms. COLLINS (for herself and Ms. Heitkamp):
  S. 540. A bill to amend the Richard B. Russell National School Lunch 
Act to require the Secretary of Agriculture to make loan guarantees and 
grants to finance certain improvements to school lunch facilities, to 
train school food service personnel, and for other purposes; to the 
Committee on Agriculture, Nutrition, and Forestry.
  Ms. COLLINS. Mr. President, I am pleased today to join my friend and 
colleague from North Dakota, Senator Heitkamp, in introducing the 
School Food Modernization Act to assist schools in providing healthier 
meals to students throughout the country.
  School meals play a vital role in the lives of our young people. More 
than 30 million children participate in the National School Lunch 
Program every school day. In Maine, 40 percent of children qualify for 
free or reduced-price meals based on household income.
  The food served at schools to these children affects their health and 
well-being. Many children consume up to half their daily caloric intake 
at school. In fact, children often get their most nutritious meal of 
the day at school instead of at home. At the same time, too many of our 
children are at risk of serious disease. One-third of the children in 
this country are overweight or obese, which increases their risk for 
heart disease, high blood pressure, Type 2 Diabetes and other chronic 
diseases. These conditions may have a lifelong effect on their health 
as they grow to adulthood.
  In response to concerns about the health of our children, our schools 
have stepped up to the plate. Nationwide, schools are working 
diligently to meet the new U.S. Department of Agriculture standards and 
serve healthier meals. For example, in the New Sweden Consolidated 
School in Aroostook County, ME, food service manager Melanie Lagasse 
prepares meals from scratch instead of opening cans or pushing a 
defrost button. The school's 64 students, ranging from preschool to 
eighth grade, have grown to relish the chicken stew, baked fish, and 
meatloaf that she makes fresh.
  Many schools, however, lack the right tools for preparing meals rich 
in fresh ingredients and must rely on workarounds that are expensive, 
inefficient, and unsustainable. Schools built decades ago lack the 
tools and the infrastructure necessary beyond reheating and holding 
food for meal service.
  To serve healthier meals to their students, 99 percent of Maine 
school districts need at least one piece of equipment and almost half, 
48 percent, of districts need kitchen infrastructure upgrades. The 
median equipment need per school is $45,000.
  Even more costly would be making the required changes to 
infrastructure. Forty-eight percent of Maine schools need some kind of 
infrastructure change to serve healthy meals. For example, 41 percent 
of schools need more physical space, 22 percent need more electrical 
capacity, 21 percent need more plumbing capacity, and 19 percent need 
more ventilation.
  Add the equipment costs together with the infrastructure costs and it 
is estimated that overall, $58.8 million would be needed just in Maine 
to serve healthy meals to all of our students. That far exceeds the 
$111,000 in grants that the USDA awarded Maine during the last two 
fiscal years for new equipment.
  Our bill authorizes loan guarantee assistance and grants for school 
equipment and infrastructure improvements, thereby helping food service 
personnel meet nutrition standards. First, it would establish a loan 
guarantee assistance program within USDA to help schools acquire new 
equipment to prepare and serve healthier, more nutritious meals to 
students. School administrators and other eligible borrowers could 
obtain Federal guarantees for 80 percent of the loan value needed to 
construct, remodel, or expand their kitchens, dining, or food storage 
infrastructure.
  Second, the bill would provide targeted grant assistance to give 
school administrators and food service directors the seed funding 
needed to upgrade kitchen infrastructure or to purchase high-quality, 
durable kitchen equipment such as commercial ovens, steamers, and 
stoves.
  Finally, to aid school food service personnel in meeting the 
nutrition guidelines, the legislation would strengthen training and 
provide technical assistance by authorizing USDA to provide support on 
a competitive basis to highly qualified third-party trainers to develop 
and administer training and technical assistance, including online 
programs.
  We need to start our school children off on the right food every day. 
If they are going to be able to learn and compete, they need to be 
healthy and their minds and bodies fully nourished. This bill will help 
us achieve that goal.
                                 ______
                                 
      By Mrs. FEINSTEIN (for herself, Mr. Whitehouse, Mr. Schumer, Mr. 
        Durbin, Mr. Blumenthal, Mrs. Boxer, Mr. Reed, Mr. Menendez, 
        Mrs. Gillibrand, Mr. Murphy, Ms. Warren, and Mr. Markey):
  S. 551. A bill to increase public safety by permitting the Attorney 
General to deny the transfer of firearms or the issuance of firearms 
and explosives licenses to known or suspected dangerous terrorists; to 
the Committee on the Judiciary.
  Mrs. FEINSTEIN. Mr. President, I rise today to address what I believe 
is a national security and public safety weakness.
  The United States currently has a system in place to keep known or 
suspected terrorists off of airplanes. But even though they can't fly, 
these very same terrorists can walk into any gun store anywhere in the 
country and purchase a firearm.
  If a terrorist is too dangerous to board an airplane, that same 
individual is too dangerous to possess a gun.
  That's why we are introducing the Denying Firearms and Explosives to 
Dangerous Terrorists Act, a bill to fix this glaring loophole in our 
background check system.
  This is not a hypothetical issue.
  Individuals with links to terrorism regularly purchase guns in the 
United States.
  According to data just received from the Government Accountability 
Office, between February 2004 and December 2014, there were at least 
2,233 cases in which a known or suspected terrorist--individuals who at 
the time were on federal terrorist watch lists--tried to buy a firearm 
or obtain a firearm or explosives license or permit.
  In 91 percent of these cases, a total of 2,043 separate occasions, 
those known or suspected terrorists successfully passed a background 
check.
  The Kouachi brothers, the terrorists who killed 12 people at Charlie 
Hebdo in Paris, are reportedly on the U.S. no fly list.
  However, if they had made it to the United States, the fact that they 
were on terrorist watch lists would have done nothing to prevent them 
from legally buying firearms or explosives.
  One of the alleged Boston Marathon bombers, Tamerlan Tsarnaev, was 
reportedly placed on two terrorist watch lists in 2011.
  He later killed three and injured 170 with homemade explosives and 
killed a police officer with a handgun.

[[Page S1078]]

  In 2009, Abdulhakim Mujahid Muhammad opened fire at a military 
recruiting station in Little Rock, Arkansas. He killed one and 
critically injured another.
  According to press reports, Muhammad had been under investigation by 
the FBI for suspected links to terrorism after traveling to Yemen, 
where he was arrested for using a Somali passport. Those actions 
certainly would have placed him on terrorist watch lists, but would not 
have kept him from buying firearms.
  The bill that we are introducing today is very simple.
  It would close this dangerous loophole by giving the Attorney General 
discretion to prevent someone from buying explosives or a gun if that 
individual is a known or suspected terrorist and may use the firearm in 
connection with terrorism.
  It would also give the Attorney General discretion to prevent someone 
from obtaining a license to sell guns or explosives if that individual 
is a known or suspected terrorist and may use the firearm in connection 
with terrorism.
  The Attorney General could use a range of tools to make this 
decision, most notable terrorist watch lists and the no fly list.
  In addition to making the decision at the discretion of the Attorney 
General, the bill includes other safeguards to make sure innocent 
individuals are not denied the ability to buy firearms or explosives.
  The first safeguard is that very high standards already exist for an 
individual to be designated as a known or suspected terrorist.
  The FBI or the National Counterterrorism Center must nominate the 
individual to be included in the Terrorist Screening Database.
  There must be sufficient identifying data about the person to ensure 
they can be accurately matched with the terrorist on the watch list.
  The circumstances must meet the ``reasonable suspicion'' standard. 
This means the facts of the case must be strong enough to reasonably 
determine the person is known or suspected to be engaged in terrorism.
  The second safeguard is that every provision in current law allowing 
individuals to appeal the denial of a firearm or explosive purchase 
will also apply to this bill.
  The office within the FBI that handles the background check system, 
known as the NICS Section, or the National Instant Criminal Background 
Check System Section, must provide the reason for denial upon request.
  Individuals then have the right to correct any inaccurate records in 
the background check system. If a purchase is still denied, individuals 
can take the Justice Department to court to overturn the decision.
  Gun safety safety bills are often labeled as Democratic bills. That 
is not the case here.
  This bill was first proposed by the Justice Department under 
President George W. Bush, who recognized that keeping guns away from 
terrorists is good policy.
  Attorney General Holder has also testified that the Justice 
Department under President Obama continues to support this proposal.
  The bill has also been endorsed by Everytown for Gun Safety. This 
group represents more than 1,000 current and former mayors, both 
Republican and Democrat.
  The legislation has also been endorsed by the Brady Campaign to 
Prevent Gun Violence, the Violence Policy Center, Americans for 
Responsible Solutions, and the Coalition to Stop Gun Violence.
  I would also like to thank the bill's cosponsors: Senators 
Whitehouse, Schumer, Durbin, Blumenthal, Boxer, Reed, Menendez, 
Gillibrand, Murphy, Warren, and Markey. All of you are champions for 
stronger gun safety laws.
  The terrorist attack in Paris should be a wake-up call for everyone.
  This sort of terrorist attack is very possible here in the United 
States, and the ability for known and suspected terrorists to buy guns 
and explosives makes it even more likely.
  Congress should close this loophole in our background check system 
and ensure that known and suspected terrorists can't easily gain access 
to these weapons.
  I urge my colleagues to support this bill.
                                 ______
                                 
      By Mr. RISCH (for himself, Mr. Cardin, Ms. Ayotte, and Mrs. 
        Shaheen):
  S. 552. A bill to amend the Small Business Investment Act of 1958 to 
provide for increased limitations on leverage for multiple licenses 
under common control; to the Committee on Small Business and 
Entrepreneurship.
  Mr. CARDIN. Mr. President, I am pleased join my colleague, Senator 
Risch, in introducing the Small Business Investment Company Capital, 
SBIC, Act of 2015. And I am pleased that Congressman Chabot, Chairman 
of the House Small Business Committee, is introducing the same bill on 
the House side today.
  This bipartisan legislation makes a common-sense change to the Small 
Business Investment Company, SBIC, program run by the Small Business 
Administration, SBA. This change will provide increased support to some 
of the program's most successful participants, SBICs that run multiple 
funds at a time. At no additional cost to the taxpayer, the SBIC Act 
will raise the limit that a ``family of funds'' can borrow with an SBA 
guarantee from $225 million to $350 million
  The SBIC program guarantees loans to qualified investment funds, or 
SBICs. In turn, these SBICs invest in promising small businesses by 
combining the SBA loan with privately raised capital, often at a 2:1 
ratio. It is important to note that while these SBICs are licensed and 
regulated by the SBA, they are privately owned and operated.
  Since its inception, the SBIC Debenture program has been incredibly 
successful. SBICs have invested more than $70 billion in nearly 170,000 
small businesses. Recently, the program has experienced rapid growth. 
In 2013, SBA guaranteed loans to SBICs equaling $3.5 billion, a 70 
percent increase in financing dollars from three years ago and the 
highest amount of financings in the past decade.
  This success is largely attributed to Congressional action that 
raised the ceiling for maximum investments for the SBIC program each 
year from $3 billion to $4 billion. Senator Landrieu, Senator Risch, 
and I worked with a bipartisan coalition to increase this ceiling and 
ensure SBIC funds have access to sufficient capital to invest in 
promising small businesses.
  Nowhere is the success of this increase seen more than in Maryland. 
Since the start of fiscal year 2015, SBICs have already invested nearly 
$65 million in Maryland small businesses. Yet, this success could be 
enhanced even more if Congress increased the amount SBICs with a family 
of funds can borrow from the SBA.
  SBICs that run multiple funds at a time are known as ``families of 
funds.'' While many of our Nation's most successful and reliable SBICs 
have a family of funds, their success is being restricted by the 
current lending limit. Simply raising the limit from $225 million to 
$350 million would provide these proven fund managers the additional 
capital needed to invest in small businesses and stimulate local 
economies.
  Put simply, by increasing the ``family of funds'' lending limit to 
$350 million, proven investors can invest in more promising small 
businesses. The SBIC Act enhances the SBA's ability to support these 
successful investors as they finance small businesses that will 
continue to create jobs in this country.

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