[Congressional Record Volume 169, Number 17 (Thursday, January 26, 2023)]
[Pages S122-S123]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


      By Mr. CARDIN (for himself, Mr. Crapo, Mr. King, and Mr. Cramer):
  S. 114. A bill to amend the Congressional Budget Act of 1974 
respecting the scoring of preventive health savings; to the Committee 
on the Budget.
  Mr. CARDIN. Madam President, today I am proud to reintroduce the 
Preventive Health Savings Act. This bipartisan legislation would reform 
the Congressional Budget Office's CBO, scoring to better reflect the 
savings from preventive health initiatives by expanding the budgetary 
window the CBO evaluates.
  Currently, the CBO scores the budgetary implications of legislation 
over a 10-year period. Oftentimes, however, the cost-savings of 
preventive care are not clear within the current 10-year ``scoring'' 
window. This legislation would direct the CBO to extend its analysis 
beyond the existing 10-year budget window to two additional 10-year 
periods, which will give a truer picture of the benefits of health 
initiatives and better enable Congress to pass effective policies.
  Chronic and mental health conditions account for 90 percent of our 
Nation's $4.1 trillion in annual medical expenditures. In 2018, more 
than half of U.S. adults had 1 of 10 chronic conditions, and 27.2 
percent had multiple chronic conditions, and this number is only 
expected to grow. Chronic diseases disproportionally affect racial and 
ethnic minorities. For example, when compared to non-Hispanic White 
adults, Black adults are 1.6 times, Asian American adults are 1.4 
times, Hispanic adults are 1.7 times, American Indian and Alaska Native 
adults are 2.9 times, and Native Hawaiian and Pacific Islander adults 
are 2.5 times more likely to be diagnosed with diabetes. Additionally, 
Black adults are 1.4 times, American Indian and Alaska Native adults 
are 1.2 times, and Native Hawaiian and Pacific Islander adults are 1.3 
times more likely to have asthma than non-Hispanic Whites.
  As more Americans experience chronic conditions, the healthcare costs 
in the United States will continue to rise. Not only are these costs a 
heavy burden on millions of Americans and their families, but they are 
also primary drivers of our annual Federal budget deficits and 
accumulated debt. As medical expenditures continue to rise, it is 
crucial that we capture the long-term savings that can be achieved by 
focusing our efforts on averting, halting, or slowing preventable 
diseases. This is why I have long been a champion for expanded access 
to affordable, high-quality preventive health care and am proud to have 
championed initiatives from coverage for colon screenings to increased 
access to oral health care. But we still have progress to make.
  I am encouraged by the cutting-edge research that world-class 
institutions in my home State of Maryland, such as the National 
Institutes of Health, NIH, are doing to address chronic diseases. 
Interventions, including screenings, vaccinations, and behavioral 
changes, can prevent or delay the onset of new cases and mitigate the 
progression of a preventable illness, which can result in large 
reductions in the financial, physical, and emotional toll of developing 
one or more chronic diseases. By having the data to enable us as 
lawmakers to look at cost-benefit analyses, we can most effectively use 
our Nation's resources to improve the health of Americans while 
reducing medical costs. The first step to altering the trajectory of 
chronic diseases and curbing healthcare costs is to have more accurate 
information on the cost savings of preventive care.
  I thank Senators Crapo, King, and Cramer for joining me in 
introducing this legislation and urge my other Senate colleagues to 
consider cosponsoring the measure.
      By Mr. DURBIN (for himself and Ms. Duckworth):
  S. 121. A bill to amend the Child Nutrition Act of 1966 to require 
the provision of training and information to certain personnel relating 
to food allergy identification and response, and for other purposes; to 
the Committee on Agriculture, Nutrition, and Forestry.
  Mr. DURBIN. Madam 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. 121

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


       This Act may be cited as the ``Protecting Children with 
     Food Allergies Act''.


       Section 7(g)(2) of the Child Nutrition Act of 1966 (42 
     U.S.C. 1776(g)(2)) is amended by adding at the end the 
       ``(C) Food allergy training and certification for all local 
     food service personnel.--
       ``(i) In general.--The Secretary shall develop, in 
     consultation with relevant stakeholder groups with food 
     allergy expertise, and publish training modules and other 
     educational materials in accordance with clause (ii).
       ``(ii) Training modules.--A training program carried out 
     under this subparagraph shall include training modules 
     relating to--

       ``(I) the prevention of allergic reactions to food, which 
     may include--

       ``(aa) communicating food allergen information in school 
     menus, food products, and recipes;
       ``(bb) best practices to avoid cross-contact; and
       ``(cc) the availability of appropriate food substitutions 
     for children with food allergies;

       ``(II) the identification of food-related allergic reaction 
     symptoms; and
       ``(III) the appropriate responses to an allergic reaction 
     to food.

       ``(iii) Certification of local personnel.--

       ``(I) In general.--In accordance with criteria established 
     by the Secretary, local food service personnel shall complete 
     training and receive a certification to demonstrate 
     competence with respect to the training provided under clause 
       ``(II) Treatment.--The Secretary may allow local food 
     personnel to apply a certification received under this clause 
     toward any other training requirements under this subsection.

       ``(iv) Methods for inclusion.--The training required under 
     this subparagraph shall be provided, as the Secretary 
     determines to be necessary, in--

       ``(I) relevant languages other than English, for 
     individuals with limited English proficiency; and
       ``(II) relevant alternative formats, for individuals with 
     disabilities (as defined in section 3 of the Americans with 
     Disabilities Act of 1990 (42 U.S.C. 12102)).

       ``(v) Availability to other personnel.--The Secretary shall 
     make the training provided under this subparagraph available 
     to personnel under child nutrition programs not covered under 
     this subsection, including personnel under--

       ``(I) the special milk program under section 3;
       ``(II) the summer food service program for children under 
     section 13 of the Richard B. Russell National School Lunch 
     Act (42 U.S.C. 1761); and
       ``(III) the child and adult care food program under section 
     17 of that Act (42 U.S.C. 1766).

       ``(vi) Authorization of appropriations.--There is 
     authorized to be appropriated to the Secretary to carry out 
     this subparagraph $1,000,000 for each of fiscal years 2024 
     through 2028.''.

                   IMPACTED BY FOOD ALLERGIES.

       Section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 
     1786) is amended--
       (1) by redesignating subsections (l) through (s) as 
     subsections (m) through (t), respectively;
       (2) by inserting after subsection (k) the following:
       ``(l) Activities to Support WIC-eligible Individuals 
     Impacted by Food Allergies.--
       ``(1) In general.--In accordance with subsection (e), the 
     Secretary shall--

[[Page S123]]

       ``(A) submit to the Secretary of Health and Human Services 
     for comment proposed nutrition education materials for use 
     under subsection (e), which shall--
       ``(i) incorporate evidence-based findings from the United 
     States Dietary Guidelines for Americans relating to food 
     allergies and potentially allergenic foods; and
       ``(ii) include nutrition education materials for--

       ``(I) individuals with food allergies during pregnancy and 
     in the postpartum period;
       ``(II) infants impacted by prenatal food allergy exposure; 
       ``(III) children with food allergies; and

       ``(B) after submitting the materials in accordance with 
     subparagraph (A), publish and disseminate the materials for 
     use under subsection (e).
       ``(2) Requirements for inclusion.--
       ``(A) In general.--The nutrition education materials under 
     paragraph (1) shall be provided, as the Secretary determines 
     to be necessary, in--
       ``(i) relevant languages other than English for individuals 
     with limited English proficiency; and
       ``(ii) relevant alternative formats for individuals with 
     disabilities (as defined in section 3 of the Americans With 
     Disabilities Act of 1990 (42 U.S.C. 12102)).
       ``(B) Outreach.--In carrying out this paragraph, the 
     Secretary shall conduct outreach to individuals who are, or 
     may be--
       ``(i) eligible to participate in--

       ``(I) the program under this section; or
       ``(II) a training program of a State agency under 
     subsection (e)(2); and

       ``(ii) impacted by food allergies.
       ``(3) Authorization of appropriations.--There is authorized 
     to be appropriated to the Secretary to carry out this 
     subsection $1,000,000 for fiscal year 2024.'';
       (3) in subsection (q) (as redesignated by paragraph (1))--
       (A) in paragraph (1), by striking ``subsection (o)(1)(A)'' 
     and inserting ``subsection (p)(1)(A)''; and
       (B) in paragraph (2)(B), by striking ``subsection 
     (o)(1)(A)'' and inserting ``subsection (p)(1)(A)''; and
       (4) in paragraph (5) of subsection (t) (as redesignated by 
     paragraph (1)), by striking ``subsection (r)'' and inserting 
     ``subsection (s)''.
      By Mr. DURBIN (for himself, Ms. Hirono, and Mr. Sanders):
  S. 126. A bill to make individuals responsible for undermining free 
and fair democratic elections inadmissible to the United States; to the 
Committee on the Judiciary.
  Mr. DURBIN. Madam President, America must never become a safe haven 
for anyone who assaults the values for which this Nation stands--values 
like democracy, human rights, the rule of law, and the sanctity of free 
and fair elections.
  We already deny visas to those who are human traffickers, drug 
traffickers, money launderers, corrupt kleptocrats, and those who 
commit serious violations of religious freedom. I agree with that 
policy. We have passed laws to allow for the prosecution in U.S. courts 
of anyone who has committed war crimes or used children as soldiers in 
deadly conflict. I have written some of those policies, and I certainly 
agree with them.
  Today, I am introducing legislation to further align our immigration 
system with our values as a nation. The bill I am introducing would 
prevent foreign officials who interfere with democratic elections or 
prevent the democratic transfer of power of their country from taking 
refuge in the United States.
  In recent years, autocrats around the world have used a toxic brew of 
nationalism, authoritarianism, corruption, and social media to weaken 
and attack the very foundations of democracy. Fortunately, democracy is 
winning this battle. Much of the world is unified in support of 
Ukraine, for example, against Putin's attempt to seize the sovereign 
democratic nation of Ukraine, and we have the allies in the NATO 
alliance and others who stand with us with strength and formidable 
determination to stop Putin.
  In late October, the people of Brazil--the largest democracy in Latin 
America--chose a new President to replace the increasingly 
authoritarian Jair Bolsonaro. After years of baseless lies by Bolsonaro 
about the integrity of Brazil's elections, polls show that three-
fourths of his supporters no longer trust the electoral process in 
  Sound familiar?
  After Bolsonaro lost in October's Presidential election, his 
supporters turned to violence. They blocked highways throughout Brazil. 
Many called openly for the military to overturn the election.
  Sound familiar?
  And, on January 8, as Mr. Bolsonaro took selfies with his supporters 
in the State of Florida, thousands of his far-right supporters 
violently stormed Brazil's Presidential palace, Congress, and Supreme 
Court--breaking windows and injuring dozens of police officers.
  Sound familiar?
  It was a disgrace. It was an assault on democracy--not only in Brazil 
but an assault on democracy everywhere.
  Under the bill I am introducing, if the Secretary of State determines 
a foreign official has interfered with free and fair elections or has 
sought to prevent the peaceful, democratic transfer of power, that 
official cannot escape justice by fleeing to the United States.
  I ask my colleagues to join in supporting this important measure to 
hold those who interfere with democratic elections accountable. America 
should never be a safe haven for enemies of democracy.