[Congressional Record Volume 165, Number 87 (Thursday, May 23, 2019)]
[Senate]
[Pages S3109-S3113]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. WYDEN (for himself, Mr. Crapo, Mr. Merkley, and Mr.
Risch):
S. 1643. A bill to amend title 36, United States Code, to grant a
Federal charter to the Forest and Refuge County Foundation, to provide
for the establishment of the Natural Resources Permanent Fund, and for
other purposes; to the Committee on Energy and Natural Resources.
Mr. WYDEN. Mr. President, today Senator Crapo of Idaho, Senator
Merkley of Oregon, Senator Risch of Idaho, and I are introducing the
Forest Management for Rural Stability Act. This legislation replaces
the Secure Rural Schools and Community Self-Determination Act (SRS) to
provide revenue sharing with and compensation to over 700 rural
forested counties in the over 40 States that host America's treasured,
public forested lands and wildlife refuges.
In 2000, then-Senator Larry Craig, also of Idaho, and I, had signed
into law SRS: a 6-year long safety-net program to stabilize county
budgets following years of depleted revenue sharing payments from the
U.S. Forest Service (USFS) and the Oregon and California Grant Lands
managed by the U.S. Bureau of Land Management (BLM). Over its lifetime,
SRS has been a success, providing more than $6.8 billion nationwide for
rural roads, schools, and healthy forest projects. SRS also provided
the basis for the beginning of, and the now growing propensity for, the
USFS and the BLM to collaborate with local people and interests on the
management of these public lands, and for local folks and counties to
collaborate together and with the USFS and BLM, in return.
Despite its many successes, the continuation of SRS is in jeopardy.
The program expired in fiscal year 2016. Congress passed a two-year
extension of the program, but after its expiration. And this was not
the first time nor the last time Congress allowed it to expire--SRS is
expired right now, though Senator Crapo and I are attempting, in these
last moments of the 115th Congress, to reauthorize it again for at
least a year, perhaps two.
This stop and start existence of this program hits at the heart of
any attempts at collaboration. And it certainly undermines any attempts
for a county to budget. Our rural counties should not continue to
suffer neither this uncertainty, nor the market based uncertainty that
comes with simply relying on revenue sharing and forest management for
support.
That is why Senator Crapo and I propose an SRS modernization, funding
certainty while supporting active forest management. The Forest
Management for Rural Stability Act establishes a permanent endowment
fund,
[[Page S3110]]
the Natural Resources Permanent Fund, to provide stable, reliable,
increasing payments to counties, in perpetuity, removing them from the
vagaries of Congress or the market.
Under this legislation, Congress charters a fiduciary corporation,
the Forest and Refuge County Foundation, to manage the endowed fund.
The corporation will be independent from any instrumentality of the
U.S. government, including Congress, to ensure the principle balance is
held in perpetuity and is separate from annual appropriations. The
corporation will be overseen by a board of directors responsible for a
transparent governance structure. The principle of the fund will be
invested to earn interest. To grow the fund, in addition to the
investment income, the USFS, BLM, and the Fish and Wildlife Service
will deposit their annual revenue sharing receipts into the fund. The
interest the fund generates will constitute the payments to the
counties, distributed annually using the existing SRS formula. Initial
payments to counties will be equal what counties received for Fiscal
Year 2017 SRS payments.
The Forest Management for Rural Stability Act continues Congress's
commitment to fostering economic growth in rural counties by continuing
Forest Service Resource Advisory Committees. In addition, the bill
gives county governments greater flexibility in how these funds are
spent for economic development and rural jobs.
Passing the Forest Management for Rural Stability Act will update SRS
for 2018 and beyond--looking forward for our forested counties, rather
than backward to last century efforts.
This bill updates an already successful program that deserves action.
I urge my colleagues to support this important bill.
______
By Mr. WYDEN (for himself, Mr. Brown, Mr. Whitehouse, Mr. Leahy,
Ms. Warren, Ms. Hirono, Mr. Sanders, Mrs. Gillibrand, Mr.
Merkley, and Mr. Schatz):
S. 1649. A bill to restore protections for Social Security, Railroad
retirement, and Black Lung benefits from administrative offset; to the
Committee on Finance.
Mr. WYDEN. Mr. President, Social Security provides vital benefits to
millions of Americans who work and pay into the system with each
paycheck. Because Social Security is fundamental to workers' retirement
security, the law protected benefits from creditors. The only
exceptions were unpaid Federal taxes, child support or alimony
payments, and court-ordered victim restitution. These protections
ensured that the social safety net programs would be there for basic
needs. That protection was weakened over 20 years ago when the law was
changed. Now, more and more seniors face cuts in their Social Security
benefits because of student loan debts. The Wall Street Journal
recently highlighted the issue with an article titled, ``Over 60, and
Crushed by Student Loan Debt.'' We need to take action to restore the
strong protections to Social Security and other benefit programs.
We now realize what a profound effect the loss of these protections
has had on retirees and individuals with disabilities, who often live
on fixed incomes. More and more seniors and people with disabilities
are having their Social Security and other lifeline benefits taken away
to pay Federal debts. For example, according to recent data from the
U.S. Bureau of Fiscal Service, over 167,000 Americans had their
benefits garnished for student loan debt. Those 167,000 had nearly $200
million garnished from their earned benefits. This is just the tip of
the iceberg as more Americans start receiving benefits. Between 2008
and 2018, the number of individuals whose Social Security benefits were
offset to pay student loans debt increased by 133 percent, from about
72,000 to 169,000. Over that same period, the amount collected from
Social Security benefits ballooned from almost $63 million to nearly
$200 million, a 217 percent increase.
Social Security plays a critical role in keeping seniors and people
with disabilities out of poverty. In Oregon alone, Social Security cuts
the poverty rate of the elderly from about 35 percent to 5 percent.
However, despite Social Security's critical role in the safety net,
close to 1 out of every 10 seniors over age 65 and 1 in 5 disabled
workers still live in poverty and that is simply unacceptable.
I, along with Senators Brown, Whitehouse, Leahy, Warren, Hirano,
Sanders, Gillibrand, Merkley, and Schatz are reintroducing the
Protection of Social Security Benefits Restoration Act. The bill would
restore the strong protections in the law that prevented the government
from taking earned benefits to pay Federal non-tax debts, and help
ensure beneficiaries will be able to maintain a basic standard of
living. The bill is supported by AARP, the National Committee to
Preserve Social Security and Medicare, National Association of
Disability Representatives, AFL-CIO, National Organization of Social
Security Claimants' Representatives, Social Security Works, National
Organization for Women, Justice in Aging, American Federation of
Teachers, Alliance for Retired Americans, Economic Policy Institute.
I ask Unanimous Consent that a letter from the National Committee to
Preserve Social Security and Medicare endorsing our bill be printed in
the Record.
May 15, 2019.
Hon. Ron Wyden,
Dirksen Senate Office Building, Washington, DC.
Dear Senator Wyden: On behalf of the millions of members
and supporters of the National Committee to Preserve Social
Security and Medicare, I write to endorse your bill the
``Protection of Social Security Benefits Restoration Act.''
Since the inception of the Social Security program in 1935,
the Social Security Act provided strong protections against
loss of retirement income through the garnishment or
attachment of Social Security benefits for the purpose of
recovering debts owed by retirees. For decades the law
provided near iron-clad protection against impoverishment in
old age due to debt collection.
Unfortunately, in 1996 the Congress reversed course by
authorizing the garnishment of Social Security and other
earned benefits for the purpose of collecting debts owed by
seniors to the federal government. Figuring prominently in
this matter is the recovery of student loan debts from
seniors who are living on their all-too-modest monthly Social
Security benefits.
With student loan debt becoming an increasingly serious
problem in this country, we agree with you that now is the
time to act. The Congress must restore the historic
protections that once were provided by Social Security
against the spectacle of impoverishment in old age so that
the federal government can collect debts that all too often
were incurred years, even decades ago.
For these reasons, the National Committee endorses your
bill, the ``Protection of Social Security Benefits
Restoration Act,'' and urges other members of the United
States Senate to cosponsor this vitally important measure. We
thank you for your leadership on this matter and look forward
to working with you to enact this bill.
Sincerely,
Max Richtman,
President and CEO, National Committee to Preserve Social
Security and Medicare.
Mr. WYDEN. 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. 1649
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 ``Protection of Social
Security Benefits Restoration Act''.
SEC. 2. PROTECTING SOCIAL SECURITY, RAILROAD RETIREMENT, AND
BLACK LUNG BENEFITS FROM ADMINISTRATIVE OFFSET.
(a) Prohibition on Administrative Offset Authority.--
(1) Assignment under social security act.--Section 207 of
the Social Security Act (42 U.S.C. 407) is amended by adding
at the end the following new subsection:
``(d) Subparagraphs (A), (C), and (D) of section 3716(c)(3)
of title 31, United States Code, as such subparagraphs were
in effect on the date before the date of enactment of the
Protection of Social Security Benefits Restoration Act, shall
be null and void and of no effect.''.
(2) Conforming amendments.--
(A) Section 14(a) of the Railroad Retirement Act of 1974
(45 U.S.C. 231m(a)) is amended by adding at the end the
following: ``. The provisions of section 207(d) of the Social
Security Act shall apply with respect to this title to the
same extent as they apply in the case of title II of such
Act.''.
(B) Section 2(e) of the Railroad Unemployment Insurance Act
(45 U.S.C. 352(e)) is amended by adding at the end the
following: ``The provisions of section 207(d) of the Social
Security Act shall apply with respect to
[[Page S3111]]
this title to the same extent as they apply in the case of
title II of such Act.''
(b) Repeal of Administrative Offset Authority.--
(1) In general.--Paragraph (3) of section 3716(c) of title
31, United States Code, is amended--
(A) by striking ``(3)(A)(i) Notwithstanding'' and all that
follows through ``any overpayment under such program).'';
(B) by striking subparagraphs (C) and (D); and
(C) by redesignating subparagraph (B) as paragraph (3).
(2) Conforming amendment.--Paragraph (5) of such section is
amended by striking ``the Commissioner of Social Security
and''.
(c) Effective Date.--The amendments made by this section
shall apply to any collection by administrative offset
occurring on or after the date of enactment of this Act of a
claim arising before, on, or after the date of enactment of
this Act.
______
By Ms. COLLINS (for herself, Ms. Smith, and Mr. King):
S. 1657. A bill to provide assistance to combat the escalating burden
of Lyme disease and other tick and vector-borne diseases and disorders;
to the Committee on Health, Education, Labor, and Pensions.
Ms. COLLINS. Mr. President, I rise today with my colleague from
Minnesota, Senator Tina Smith, to introduce the TICK Act. This stands
for Ticks: Identify, Control, and Knockout Act. I would also like to
recognize my colleague from Maine, Senator King, who is joining us as
an original cosponsor.
Our bipartisan legislation would provide local communities and States
with the resources needed to help prevent, detect early, and treat Lyme
and other tick-borne diseases.
Tick-borne diseases like Lyme have become a major public health
concern, with the incidence exploding over the past 15 years. The
number of Americans with tick-borne diseases has been rising at an
alarming rate. In 2003, Lyme disease infected approximately 30,000
Americans. Last year there were an estimated 450,000 cases--a
staggering 1,400-percent increase.
In Maine, last year alone, there were 2,000 new cases of Lyme
disease. That is a sharp increase from the 752 cases in 2010.
Other tick-borne diseases are also on the rise. Anaplasmosis, for
example, has more than tripled.
Far too many Americans with Lyme disease experience a complex
diagnostic odyssey that takes months or even years. One of my
constituents, Paula Jackson Jones, from Damariscotta, ME, shared with
me her harrowing tale that took 2 years, scores of tests, and 23
different physicians before she finally received the correct diagnosis
that she had Lyme disease. Her journey started one afternoon 10 years
ago after raking leaves in her backyard. A week later, unusual symptoms
began to appear: anxiety attacks, pain, muscle spasms, and fatigue.
These symptoms became debilitating.
Before receiving the correct diagnosis, Paula was diagnosed
incorrectly with multiple sclerosis, Parkinson's, and other diseases.
Once she finally received the proper diagnosis and treatment, Paula
founded Midcoast Lyme Disease Support & Education, a nonprofit that
raises public awareness about Lyme disease.
She told me:
This has been a 10-year crusade for me with the first 5
years fighting for my life and the latter, fighting on behalf
of others.
In addition to the physical and emotional toll that Lyme disease
takes, it is also expensive. Paula is still paying off more than
$250,000 worth of medical bills that she has incurred. Medical costs of
Lyme disease are estimated at $1.3 billion per year. When accounting
for indirect medical costs, including the loss of work, the annual cost
balloons to $75 billion per year.
A correct and early diagnosis can reduce costs, as well as improve
the prognosis, but we have a long way to go. When HIV became a public
health crisis, fortunately, a gold standard for identification and
treatment was developed within 10 years. Lyme disease, by contrast, was
identified more than 40 years ago; yet there still is no gold standard
treatment, and existing prevention, education, and diagnostic efforts
have proven to be inadequate.
The TICK Act would apply a three-pronged approach to addressing Lyme
and other tick and vector-borne diseases. First, it would establish an
office of oversight and coordination of vector-borne diseases at the
Department of Health and Human Services. This office would develop a
national strategy to prevent and treat Lyme and other tick-borne
diseases. It would expand research and improve testing, treatment
affordability, and public awareness. The office would also coordinate
with key Federal agencies, including the CDC, the Department of
Defense, USDA, and EPA to protect Americans from these diseases.
Second, our bill would reauthorize the Regional Centers for
Excellence in Vector-Borne Disease, which Congress established in 2017
in response to the Zika outbreak. Since then, tick-borne diseases have
accounted for three out of four vector-borne diseases in our country,
and these centers have been effective in leading the scientific
response. The Collins-Smith bill would reauthorize these centers for
another 5 years at $10 million per year.
Finally, our bill would establish CDC grants, which would be awarded
to State health departments to improve data collection and analysis,
support early detection and diagnosis, improve treatment and heighten
public awareness. The TICK Act takes a comprehensive approach to
address tick-borne diseases.
Mr. President, I ask unanimous consent to have printed in the Record
at the conclusion of my remarks letters of support signed by more than
2 dozen organizations supporting our bill, including the Midcoast Lyme
Disease and Support Education organization, the LivLyme Foundation, the
Northeast Regional Center for Excellence in Vector-Borne Diseases, the
National Association of County and City Health Officials, and the
Entomological Society of America.
I urge all of our colleagues to support this important legislation.
There being no objection, the material was ordered to be printed in
the Record, as follows:
May 22, 2019.
Re: Stakeholder Support for Bill on Vector-Borne Disease
Management.
Hon. Susan Collins,
Dirksen Senate Office Building,
Washington, DC.
Dear Senator Collins: On behalf of the Vector-Borne Disease
Network and allied organizations, we the undersigned write to
articulate our support for the objectives of ``Ticks:
Identify, Control, and Knockout Act'' or the ``TICK Act,''
which aims to combat the escalating burden of VBD. The
Vector-Borne Disease Network is a new stakeholder group of
non-profit organizations led by the Entomological Society of
America (ESA) that aims to reduce human and animal suffering
caused by arthropod disease vectors.
Illnesses such as Lyme disease, Zika virus, Malaria, and
West Nile virus are transmitted by vector organisms,
primarily blood-feeding insects or arthropods. Vectors ingest
disease-causing germs when biting an infected human or animal
and later inject them into a new host during a subsequent
bite.
Between 2004 and 2016, reported human disease cases in the
U.S. resulting from bites from arthropods--primarily ticks
and mosquitoes--tripled, according to the U.S. Centers for
Disease Control and Prevention (CDC). Meanwhile, nine new
germs spread by ticks and mosquitoes were discovered or
introduced in that same timeframe. Disease vectors also pose
significant threats to both livestock and companion animals.
The underlying causes for these trends are varying and
complex, and so are the potential solutions.
Due to all the challenges mentioned above, and the growing
threat to American health and security posed by vector-borne
disease (VBD), the Vector-Borne Disease Network is pleased to
see new legislation that aims to establish an Office of
Oversight and Coordination for VBD within the Department of
Health and Human Services to promote interagency
coordination; develop and maintain a national plan for
responding to VBD; reauthorize the CDC Regional Centers of
Excellence in VBD for five years; and authorize a cooperative
agreement through CDC to support state health department
efforts to improve management, surveillance, diagnosis, and
education.
On behalf of this coalition of stakeholders invested in the
mission to reduce the public-health and economic risks posed
by ticks and mosquitoes, we thank you for your commitment to
this critical issue.
Sincerely,
Anastasia Mosquito Control District of St. Johns County
(FL); Associated Executives of Mosquito Control Work in New
Jersey; Drexel University, College of Medicine; Entomological
Society of America; Colorado Tick-Borne Disease Awareness
Association; College of Agricultural and Life Sciences,
University of Wisconsin-Madison; Hudson Valley Lyme Disease
Association; Lyme Association of Greater Kansas City, Inc.;
Midwest Center of Excellence for Vector Borne Disease;
National Association of Vector-Borne Disease Control
Officials; New Jersey Mosquito Control Association; North
Fork Deer Management Alliance;
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Northeast Regional Center for Excellence in Vector Borne
Diseases; Pacific Southwest Center of Excellence in Vector-
Borne Diseases; School of Veterinary Medicine at UW-Madison;
Southeastern Regional Center of Excellence in Vector Borne
Diseases; University of Miami Miller School of Medicine;
University of Rhode Island Center for Vector-Borne Disease;
University of Rhode Island TickEncounter Resource Center; US
Biologic; Western Gulf Center of Excellence for Vector-borne
Disease.
____
Letter of Support for the TICK Act--May 21, 2019
Please pass along my sincere gratitude to Senator Collins
for taking on this fight on our behalf. This has been a 10-
year crusade for me with the first 5 years fighting for my
life and the latter, fighting on behalf of others.
Bit by a tick in Oct 2009 while outside doing fall clean up
with my husband, I was misdiagnosed for the next 2.5 years by
23 doctors and specialist from panic attacks to chronic
fatigue to fibromyalgia. When a scan revealed lesions on my
brain appeared and my neurological symptoms intensified, I
was tested and diagnosed with MS. When my symptoms became
even more severe and I was not responding to treatment, I was
reevaluated and my diagnosis changed to Parkinson's. When I
began to have trouble swallowing and using my arms and legs
was a daily challenged, my medical providers wanted me tested
for ALS. I knew that was a death sentence for me and it was
at this point I knew that I needed to fight. This was when I
spoke out for the first time and advocated for myself.
Thanks to my sister in law who kept pressing me to be
checked for Lyme disease, even though I had 4 negative tests,
I demanded to see a provider who knew about Lyme. My primary
refused to give me a referral because that was not what they
thought I had. The intern gave me a scrap of paper with the
name of someone he knew saw Lyme patients and that doctor,
number 24, saved my life.
Shortly thereafter, with bloodwork and additional tests, I
was diagnosed with late stage neurological Lyme, Babesia,
Bartonella, Rocky Mountain Spotted Fever and Erlichiosis.
These medical providers who knew more about Lyme and tick-
borne disease not only saved my life but gave my life back to
me.
Today, I am in full remission going on 5 years.
In April of 2014, I co-founded and became President of
Midcoast Lyme Disease Support & Education (MLDSE), a
charitable nonprofit 501c3 organization that travels
statewide, hosting year-round free educational and prevention
talks and event. We advocate for changes at state and federal
levels and provide support to those in Maine afflicted by
tick-borne disease by connecting them to medical providers
and financial assistance programs. We are the Maine partner
of the national Lyme Disease Association, members of Maine's
CDC Vector-borne Work Group and active in Maine's Lyme
legislation. In 2018, I wore a federal hat as the co-chair to
the HHS Tick-borne Disease Working Group's Access to Care
Services and Patient Support subcommittee. I honored to have
been selected for that role as it defines who I am these
days, sitting in the trenches alongside patients and their
families and connecting them with whatever services they need
as they journey back towards health and wellness. I am not a
victim but a survivor and one who advocates for those who
cannot advocate for themselves.
This is a fulltime job for and one that I do on a voluntary
basis without pay.
Sen Collins, your support is so greatly needed as funding
is crucial to our work here on the ground as well as on the
hill. You see, when people are personally touched by
something, they fight and they fight hard to make changes. We
will not stop fighting until the status quo changes. Until
the new science is embraced and patients are treated with
fairness and equality, irregardless of the disease that they
may have. We will fight to protect the doctors who put their
careers on the line each and every day to save their
patients.
When a cancer doctor thinks outside the box and heals their
patient, they are deemed a hero. When a Lyme provider does
it, they are brought up under medical scrutiny and
disciplined beyond belief.
The governing body that exists and controls all things to
do with disease (IDSA) wrote in their guidelines a foot note
that reads as follows:
These guidelines were developed and issued on behalf of the
Infectious Diseases Society of America.
It is important to realize that guidelines cannot always
account for individual variation among patients. They are not
intended to supplant physician judgment with respect to
particular patients or special clinical situations. The
Infectious Diseases Society of America considers adherence to
these guidelines to be voluntary, with the ultimate
determination regarding their application to be made by the
physician in the light of each patient's individual
circumstances.
In 2013, ILADS introduced another set of diagnostic and
treatment options and after passing a rigorous qualifying
process, it was introduced into the National Guidelines
Clearinghouse but ignored by IDSA and dismissed by mainstream
medicine.
In 2015 advocates, patients and medical providers were
forced to pushed through a bill of protection [Maine Public
law LD422] to protect those knowledgeable about tick-borne
disease who choose to do just that--focus on the individual
circumstances of each patient and treat accordingly
Sen Collins, Lyme and tick-borne disease is not a cookie
cutter disease and a cookie cutter approach has failed time
and time again. With your bill, a strong push and more
funding will help with provider and patient education and
access to better diagnostic and treatment services.
Thank You so much,
Paula Jackson Jones, President and Co-Founder, Midcoast
Lyme Disease Support & Education, Co-Chair of Access to Care
Services and Patient Support, subcommittee of the HHS Federal
Tick-borne Disease Working, Group; Maine partner of the
National Lyme Disease Association; Member of Maine CDC
Vector-Borne Workgroup; Active in Maine's Lyme Legislation
movement.
Ms. SMITH. Mr. President, I thank Senator Collins for her leadership
on this issue. I am very happy to have a chance to work with her on
this.
Today, my colleague Senator Collins and I are introducing a bill to
help fight Lyme disease, so we are introducing this bill today here in
the Senate as many Minnesotans and Mainers get ready to head out to our
beautiful national parks, lakes, and coastline to go fishing, hiking,
and all of the things that we love, love, love to do.
In Minnesota, we have more than 10,000 lakes and a lot of space for
outdoor activities, and we also have a growing tick population due to
warmer summer months. With so many lakes and our excitement to get
outside after a long winter, Minnesotans have become more at risk of
contracting Lyme disease and other vector-borne illness.
A vector-borne illness means an illness that is carried by an insect,
like ticks. Unfortunately, the number of Lyme disease cases in
Minnesota is on the rise. Over the past 10 years, the number of
reported cases has increased by nearly a third.
Our bill, the TICK Act, aims to reduce the number of cases by
establishing an interagency office of oversight and coordination to
target, prevent, and treat Lyme disease and other vector-borne
illnesses. In our legislation, we made sure to enable collaboration
between universities and public health agencies, and it is important we
train and equip our public health first responders in how best to
prevent and treat vector-borne illnesses.
The TICK Act is supported by a coalition of researchers, as Senator
Collins just said, also frontline medical professionals and government
officials from across the country, so I urge my colleagues to listen to
the professionals on the ground fighting vector-borne diseases and
quickly take up and pass this bill.
May is Lyme disease awareness month. We must be aware of and prepare
for future vector-borne disease outbreaks, and this bill will be an
important first step.
So I want to thank Senator Collins, my colleague on the HELP
Committee, for her leadership on this important issue. I am glad we are
able to work together on this bill.
______
By Mr. BLUNT (for himself and Mr. Reed):
S. 1659. A bill to amend the Public Health Service Act to provide for
the participation of pediatric subspecialists in the National Health
Service Corps program, and for other purposes; to the Committee on
Health, Education, Labor, and Pensions.
Mr. REED. Mr. President, I am pleased to be joining Senator Blunt in
introducing the Ensuring Children's Access to Specialty Care Act.
According to the American Association of Child and Adolescent
Psychiatry, there are currently only 8,300 child and adolescent
psychiatrists (CAPs) in the United States--many of whom are not
practicing full time--far short of the estimated need of over 30,000
CAPs. On average, patients wait almost two months to see a CAP, a
startling concern given that the incidence rates of mental illness and
behavioral disorders among children in the United States continue to
grow. Fifty percent of all lifetime cases of mental illness begin at
age 14; seventy-five percent by age 24.
The National Health Service Corps Loan Repayment Program (NHSCLRP)
was created by Congress over forty years ago to help recruit and place
trained individuals in underserved communities to provide needed health
care services. Licensed health care providers may earn up to $50,000
toward
[[Page S3113]]
student loans in exchange for a two-year commitment at an NHSC-approved
site, within two years of completing their residency. Accepted
participants may serve as primary care medical, dental, or mental/
behavioral health clinicians.
NHSCLRP provides critical relief to physicians who have completed
pediatrics or psychiatry residency training programs; however,
pediatric subspecialists, such as child and adolescent psychiatrists,
are effectively barred from participating due to the extra training
these physicians are required to take after completing their residency.
This extra training, which often results in increased student debt,
typically consists of a fellowship that takes place in the two-year
window of eligibility for NHSCLRP. The creation of NHSCLRP preceded the
expansion of many pediatric subspecialties, not taking into account the
extra years of training required for these physicians.
The Ensuring Children's Access to Specialty Care Act would correct
this loophole and allow pediatric subspecialists practicing in
underserved areas to benefit from the NHSCLRP. By so doing, this bill
would increase access to specialty care for children and improve mental
health parity for children.
Providers across the spectrum of care support this bipartisan
legislation including: the American Association of Child and Adolescent
Psychiatry, the American Academy of Pediatrics, the Arthritis
Foundation, Children's Hospital Association, March of Dimes, and the
National Alliance on Mental Illness. I look forward to working with
these and other stakeholders as well as Senator Blunt and our
colleagues to pass the Ensuring Children's Access to Specialty Care Act
in order to help ensure children have greater access to the health care
they need.
______
By Mr. KENNEDY:
S. 1693. A bill to reauthorize the National Flood Insurance Program;
considered and passed.
S. 1693
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 ``National Flood Insurance
Program Extension Act of 2019''.
SEC. 2. REAUTHORIZATION OF NATIONAL FLOOD INSURANCE PROGRAM.
(a) Financing.--Section 1309(a) of the National Flood
Insurance Act of 1968 (42 U.S.C. 4016(a)) is amended by
striking ``May 31, 2019'' and inserting ``June 14, 2019''.
(b) Program Expiration.--Section 1319 of the National Flood
Insurance Act of 1968 (42 U.S.C. 4026) is amended by striking
``May 31, 2019'' and inserting ``June 14, 2019''.
(c) Retroactive Effective Date.--If this Act is enacted
after May 31, 2019, the amendments made by subsections (a)
and (b) shall take effect as if enacted on May 31, 2019.
____________________