Benjamin Cardin

Mr. CARDIN

Mr. CARDIN. Mr. President, is there any time remaining on the Democratic side?

Mr. CARDIN. Mr. President, I ask for the yeas and nays.

Mr. CARDIN

Mr. CARDIN. First, Mr. President, I thank Senator Peters for the amendments he just offered. We had a hearing in the Small Business and Entrepreneurship Committee in regard to the patent issues. It is clearly a huge concern by the innovators, the small business, biotech, and high-tech firms. I thank the Senator very much for giving us an opportunity to act on that matter. Secondly, let me compliment the Senator on the research issues. I took to the floor yesterday and talked about the budgets of the National Institutes of Health and how critical that is, not only for their direct mission, which is to find answers to diseases, but also to provide the answers to building blocks for companies that do incredible work. I was at AstraZeneca in Frederick on Monday, where they do the biologics manufacturing, and they depend very much on the NIH budget. I thank the Senator for the amendments he offered. I know we will have a chance to act on them a bit later. Amendments Nos. 364, 367, 439, 440, 899, and 900 en bloc

Mr. CARDIN. Mr. President, I ask unanimous consent to set aside the pending amendment to call up the following amendments en bloc: Cardin amendments Nos. 364, 367, 439, 440, 899, and 900.

Mr. CARDIN

Mr. CARDIN. Mr. President, I ask my colleagues to join me in recognizing March as National Colorectal Cancer Awareness Month. This month provides us with an opportunity to reflect on the significant strides we have made in confronting colorectal cancer and to renew our commitment to beating this devastating disease. In 2000, President Clinton first dedicated National Colorectal Cancer Awareness Month in order to raise awareness of colorectal cancer and to remind us of the important steps we can take to prevent, detect, and ultimately defeat this disease. Colorectal cancer is the second leading cause of cancer death in the United States. This year, approximately 50,000 Americans will die from colorectal cancer, which means each one of us in this Chamber will lose an average of 1,000 constituents in 2015 alone. The likelihood of developing colorectal cancer is now greater than 1 in 20, and 133,000 Americans are expected to be newly diagnosed this year. The American Cancer Society estimates that 2,360 new cases of colorectal cancer will be diagnosed in Maryland and, sadly, 860 Marylanders are expected to die from the disease this year. Colorectal cancer affects men and women equally when we reach the age of 50 and beyond. Unfortunately, as I look around this room I know that some of you have known someone who has been impacted by this disease. Despite these grim statistics, however, the single most encouraging fact about this deadly disease is that colorectal cancer is among the most preventable of all cancers. Unlike other cancer screenings where the goal is to detect cancer at an early stage, colorectal cancer screenings can actually prevent cancer from occurring in the first place. Colorectal cancer arises from pre-cancerous growths, or polyps, that grow in the colon. If found early through appropriate screening and detection, these polyps can be removed, halting their progression into colorectal cancer. The way to beat this disease is with regular screening through a variety of methods, including colonoscopy. These are life-saving tests. In fact, a recent study in the New England Journal of Medicine concluded that of the nearly 50,000 people expected to die of colorectal cancer this year, screening could save more than half of them. At the same time, colorectal cancer screening is becoming a public health success story in the United States. While it remains the second leading cause of cancer deaths among men and women combined, both the incidence and death rate have been declining in recent years--something no other country can claim. The percentage of the population that is up to date with recommended colorectal cancer screening increased to 65 percent in 2010 and, among those aged 50 and older, incidence rates have dropped 30 percent over the last decade. This positive trend in lower incidence rates demonstrates the importance of screening and the power of preventive medicine. In Maryland, we can boast one of the highest screening rates among eligible populations in the country at 70 percent. However, that still means that three out of every ten people at risk are not getting screened. This highlights the need for policies to help achieve the Centers for Disease Control and Prevention's national goal of having 80 percent of eligible Americans screened by 2018. Furthermore, screening rates remain unacceptably low across the country, especially in the Medicare age population, who have the greatest risk for developing colorectal cancer. I am proud to rise in support of National Colorectal Cancer Awareness Month. The need for increased awareness about this disease and the importance of screening is a public health issue truly worthy of our attention in Congress. I ask my colleagues to join me in working to raise awareness that colorectal cancer is preventable, detectable, treatable and curable.

Mr. CARDIN

Mr. CARDIN. Mr. President, a budget is the statement of the principles and priorities of our country. I have heard a lot of my colleagues talk about specific amendments, some of which I support and some of which I oppose. But I think it is important first to talk about the underlying budget and what it stands for as far as the principles and priorities of America. On all counts, a review of the budget that is before us fails middle-income families in America. It doesn't invest in job growth or opportunity or U.S. competitiveness. It doesn't allow for a growing middle class, particularly to narrow the wealth disparities in America. It doesn't end sequestration. Let me talk for a moment about sequestration. We have had a lot of debate about this on the floor. Sequestration should never take place. It is across-the-board, mindless cuts, no priorities. When we have been subject to sequestration, we have heard from all of our agencies, how they can't plan, how they can't enter into long-term agreements in order to carry out the missions they are responsible to carry out. It does not allow them the flexibility to deal with the current needs. It is wasteful. It costs taxpayers money, and they are not getting the benefits of those dollars. When we take a look at the budget that is before us, it not only would maintain those levels, it actually accelerates some of the levels that would be established through these across-the-board cuts. Let me just give you the observations from the Center on Budget and Policy Priorities, which is a nonprofit, nonpartisan research organization which wrote that the Senate budget ``cut[s] funding below the already-damaging sequestration levels in the years after 2016 for non-defense discretionary programs--the part of the budget that funds education, job training, early intervention programs for children, basic scientific and medical research, and transportation, all of which are important to increasing opportunity, raising productivity, and boosting long-term economic growth.'' This budget is also not right for our Federal workforce. It does not give them the resources they need to carry out their very important missions to the American people. I want to underscore the fact that our Federal workers are the best in the world. They carry out their mission more efficiently and effectively than anyone in the world. My colleague Senator Durbin was talking about the National Institutes of Health. He talked about the important research being done there, and they need greater tools in order to get the job done. I was meeting with constituents today on Parkinson's who say, look, there are exciting things happening, but we need to fund the research. If we don't fund the research, we are not going to get the answers. We have the capacity. Today at NIH, one out of every six eligible grants goes forward, five out of six do not. A few years ago, it was one out of three. We are moving in the wrong direction. This budget continues moving us in the wrong direction on research. I can mention, I will be talking to the Alzheimer's groups, as Senator Durbin did. They need to understand. Last week, the cancer advocates were here to find a cure for cancer. They encouraged us to increase this year's budget at NIH by $2 billion in order to get back to where we were. That will not get us back to where we were, but if we continue with a $2 billion increase for a few years, we could get back to where we were a few years ago. The budget does not allow us to do it. This past week, I was visiting AstraZeneca at their biologics lab located in Frederick, MD. They are doing exciting things. I mention that because the research at NIH that will not go forward, as Senator Durbin pointed out when he was on the floor, not only affects NIH, it affects all the life science companies located in our communities. These are great jobs. This is job growth that is being held down. At AstraZeneca, they are working on the answers to deal with the diseases based upon our own individual DNA. That is what biologics lets us do. That is being slowed down because of a budget that will not allow NIH to reach its full potential. The budget we have will not give NIH the tools it needs. I could go to the FDA, which protects our food supply. We have the safest food supply in the world, but they need the resources to carry out their mission. I could go to the EPA. We all like clean water and clean air. The Chesapeake Bay is critically important to my State, our region, and this country. They depend upon the Environmental Protection Agency having the tools to protect our clean water and clean air. This budget does not allow for that type of resource so that we can reasonably expect the mission to be accomplished. As I pointed out earlier, it is also costing us economic growth because the partnership with the private sector is not there. I will point out another part of the environmental risk of this budget, and that is the EPA's popular Clean Water and Drinking Water State Revolving Loan Funds. All of us are fighting for those loan funds because our local governments need them to improve their drinking water capacity, wastewater treatment facility issues. And we have had a majority of Senators say: Let's increase those funds. In Maryland, those funds improve critical water infrastructure, which in turn helps us protect the water quality of the Chesapeake Bay. A healthy bay is critical to healthy Marylanders and a healthy Maryland economy. Without the support from the State revolving fund, many small communities--and these funds go to small communities--that are working hard to reduce their wastewater discharge in the bay will be without the critical financial resources they need to help protect the bay. Our large jurisdiction, the city of Baltimore, has used the State Water Quality Revolving Loan Fund that has funded the EPA's Clean Water State Revolving Fund to upgrade the Back River wastewater treatment work. Without adequate resources, they cannot move forward on that. My point is, take a look at this budget. I understand their numbers, but it doesn't tell us how we spend the money. We can't get the funds we need under the caps that are imposed on the nondefense discretionary spending, including the programs I just mentioned. This budget ignores tax expenditures. I think Americans would be surprised to learn that we spend more money in the Tax Code than we do in the appropriations bills that are passed every year by Congress. Yet, there is no attempt in this budget to rein in those tax expenditures. There are many loopholes that benefit the wealthiest and give incentives to companies to take their jobs overseas. There is no effort to rein in those types of wasteful tax expenditures. In fact, it has made it worse because it makes room for additional tax breaks for America's wealthiest. That is not what we should be doing. This is at the cost of our most vulnerable. Because we have made more room for those tax breaks, our most vulnerable are at risk. I will give one example in this budget document, which is Function 600. This category includes items such as SNAP, formerly known as food stamps, school lunch, and child nutrition programs. In the tax bill, this category includes the earned-income tax credit, the low-income part of the child tax credit. The budget allows the expansion of these tax credits to expire in 2017, thereby resulting in tax hikes for tens of millions of working families and their children. The budget would make major cuts in Pell grants, making it harder for low-income and middle-income families to send their children to college. We had a debate on the floor about the cost of a college education. It is much more difficult with this budget resolution, adding to the staggering debt American families are currently incurring. The budget fails to provide the resources so we can rebuild America, the infrastructure investments. We talked on both sides of the aisle about the need to increase transportation spending in this country so the United States can be more competitive, create more jobs, and maintain our existing systems. In Maryland, we have two major transit systems we want to move forward. Anyone who has experienced the traffic in this region knows how congested the traffic is in our part of the country. We have some help on the way with the Purple Line, but the budget that is submitted makes it difficult for these projects to move forward. I met with the people in regard to the modernization of our ports. The Port of Baltimore is critical to the economy of our State. It is important for U.S. competitiveness. It creates a lot of jobs. The dredging needs of the Port of Baltimore and other ports around our country will be difficult to meet under the budget caps in this budget agreement. Lastly, I have some initial observations about the overall budget agreement. It is partisan. There was really no effort made to come up with a bipartisan budget. We should have done that. The American people want us to have a bipartisan budget. It will not be the budget I want, it will not be the budget the Democratic Party wants, it will not be the budget the President wants, but it will be a budget that will allow us to move forward, Democrats and Republicans working with the White House, to give the predictability this country needs and provide the investments so important for the growth of our middle class and for job growth. I heard my colleague talk about the ability of this budget to allow for the repeal of the Affordable Care Act. We just celebrated the fifth anniversary of the Affordable Care Act this past month. The budget allows for the repeal, but it is interesting in that it doesn't repeal the revenues. It takes the revenues we put in place but repeals the benefits. There is a little bit of irony in that. And it will clearly add to the deficit. I will give the reason why, but they use a magic wand, so we don't have to worry about that. Why would the repeal of the Affordable Care Act add to the deficit? Because the Affordable Care Act has helped us reduce the growth rate of health care spending in this country. You don't have to take my word for it; the Congressional Budget Office said that Federal health care spending between 2011 and 2020 will be $600 billion less than they previously estimated. The Affordable Care Act is bringing down health care costs. It is bringing down the Federal deficit. The Federal deficit through 2025 was adjusted down by $400 billion since the January projection. It is saving health care consumers, those of us who buy our insurance and use our health care system--it is now projected that because of the savings between 2010 and 2014, the years of the Affordable Care Act, the average family is saving $1,800 a year. These are results from the Affordable Care Act that this budget will allow us to repeal. Look at the number of uninsured. It has been reduced by 16.4 million. We reduced the uninsured rate by 35 percent. We increased the number of individuals enrolled in Medicaid and CHIP. The increased rate is at 17.5 percent. In Maryland, that is 300,000 more in those programs. We improved insurance coverage. We now have much better coverage, such as coverage for preventive care and screening tests. There are no caps. There are no annual caps or lifetime caps. Parents can keep their children on their policy until age 26. Those enrolled in the program get value for their premiums. If not, the insurance company has to rebate the excess charges. Since 2011, $9 billion has been rebated to health care consumers. We ended preexisting conditions. If anyone doesn't think that makes a difference, I have a story about two Marylanders, Jack and Akisha. They came to my office last year for help in navigating the Maryland health marketplace. In August of 2014, they were able to apply for insurance through a special enrollment period, but while waiting to hear back about the status of their application, Jack suffered an injury. If that had happened in 1995 or 2005, that might have prevented Jack and Akisha from obtaining the coverage they so badly needed. But thanks to the Affordable Care Act, they got coverage and it covered everything. There was no exclusion. Coverage is now affordable. Seventy-one percent of the people who got insurance through the Maryland exchange got premium tax credits so they could afford their coverage. In Maryland, we reduced our uninsured rate from 12.3 percent in 2013 to 7.8 percent in 2015. We all benefit from that. It is not just people who have insurance who benefit. Our premiums cover the cost of people who don't have insurance. We don't have to pay for those people because they now have insurance. There are fewer people using emergency rooms. We are making health care more affordable. Since we closed the doughnut hole, 8.2 million seniors have saved $11.5 billion. In Maryland, the average savings for a Medicare beneficiary is $1,400. There are no copayments under the Medicare system. The solvency of the Medicare system is stronger today. I think the most exciting thing about the Affordable Care Act is how we are changing the delivery system in this country. Take a look at it. Deaths as a result of hospital-acquired conditions have been reduced by 17 percent since 2010. These are circumstances such as ulcers, infections, traumas, and falls--that has been reduced dramatically as a result of the Affordable Care Act. Medicare hospital readmissions are down. From 2012 until 2013, there were 150,000 fewer readmissions. The Affordable Care Act is working. All of these facts make one point abundantly clear: The Affordable Care Act has transformed our country for the better. It has brought quality, affordable care to millions of Americans. It has expanded coverage for young people, minorities, and working families. In a span of only 5 years, it has saved seniors billions of dollars on their prescriptions, strengthened our safety net, and recovered a recordbreaking $19.2 billion in taxpayer funds from those committing health care fraud. The Affordable Care Act will continue to save our country billions of dollars into the future, and the budget we are acting upon would repeal that progress. There are other aspects of the health care program that are affected by the budget, including the attempt to turn Medicaid into a voucher program--Medicaid, which is for our most vulnerable, our seniors, and their long-term care needs. I hope we would not want do that, but the budget allows that. The budget just doesn't add up. It creates deficits far beyond what we can do other than to use a magic wand to deal with it. This is not a budget we should be acting upon. A lot of amendments will be offered. I will be offering some amendments. I know some of my colleagues have offered amendments. First, I will point out that there are a lot of amendments that I hope we will not take up and pass. I urge my colleagues to take a good look at them. I will mention one, although I could mention many that give me a heartache. Senator Barrasso, my good friend, has introduced a bill concerning the waters of the United States. To me, it sends a signal that Congress is uninterested in providing the regulatory community clarity on the scope of the Clean Water Act. The proponents of this amendment used the vote to justify passing legislation, either through appropriation riders or stand-alone measures, to undermine the process the EPA is undertaking to provide clarification on the scope of the Clean Water Act. I question the stated purpose of the amendment to protect water quality. We have a better choice. I thank Senator Stabenow for offering what I expect to be a side-by-side amendment. The Stabenow amendment clarifies the agriculture exemptions under the Clean Water Act while maintaining important clean water protections. These two goals are not mutually exclusive. There are many amendments that have been offered. Senator Durbin mentioned one that I hope everyone will support on NIH funding and medical research. I am working on amendments dealing with small business. I am the ranking Democrat on the small business committee. We need to help provide more credit to our companies. The Affordable Care Act advanced oral health. I will be offering some additional amendments on oral health and racial profiling. I hope the Senate will go on record on voter enfranchisement. I hope we will go on record to make it easier for us to reach the consensus we need to pass these important bills. When the amendment process is over, I must urge my colleagues to reject the underlying budget. What we need is a bipartisan budget, one that invests in America's future with a growing middle class, keeps jobs in America, and reforms our Tax Code. Working together, we can build a stronger, more prosperous America for all Americans. With that, I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, I rise to discuss the ongoing crisis in Syria. Sunday, March 15, marked the fourth anniversary of the beginning of the Syrian civil war. Since this brutal war began, more than 3.8 million Syrians have fled Syria, 7.6 million have been displaced within Syria, and 12.2 million Syrians are in need of humanitarian assistance. Most tragically, more than 205,000 people have died as a result of the war. This past year was the deadliest year since the conflict began, with more than 76,000 dying in 2014 alone, including more than 3,500 children. One thing has remained clear over the last 4 years--the war tactics employed in Syria by both government and opposition forces represent gross violations of human rights and fly in the face of internationally accepted rules of war. The United Nations Independent International Commission of Inquiry on Syria has reported that the progovernment forces have murdered, tortured, assaulted, and raped civilians in Syria. Antigovernment groups have also engaged in murder, execution, torture, hostage-taking, and shelling of civilian neighborhoods. Medical workers and hospitals across Syria have also been targeted, but nowhere was the brutality of this war more evident than the events of August 21, 2013, when the Syrian Army, under the direction of President Assad, launched a chemical weapons attack in the Damascus suburbs killing 1,400 Syrians. The United States, along with the international community, has a long tradition of upholding international norms, including holding accountable those guilty of crimes against humanity and war crimes. The international community cannot stand by and allow the murder of innocent men, women, and children to go unchallenged. He must immediately bring Assad and all the perpetrators of gross human rights violations in Syria to justice. This cannot wait another year. Earlier this week, I reintroduced the Syrian War Crimes Accountability Act, along with my colleagues Senators Rubio, Menendez, Shaheen, and Peters. This bipartisan legislation establishes a Syria- specific standard of reporting and accountability for crimes against humanity. The bill will require the U.S. State Department to report to relevant congressional committees on war crimes and crimes against humanity committed in Syria. This would include an account of war crimes and crimes against humanity committed by the regime of President Bashar al-Assad and violent extremist groups and other combatants involved in the conflict. Today, as I stand on the floor of the Senate, the violence is continuing unabated. Some of my colleagues may be aware of a Syrian defector and photographer named Caesar. Caesar fled from Syria in 2013 with more than 55,000 photos documenting the torture and murder of more than 11,000 civilians. Last week, some of those photos were put on display at the United Nations. We must shine a light on the atrocities that have been committed in Syria and demand accountability. Ignoring these violations sends a message to the global community that war crimes and crimes against humanity are tolerable. The Syrian people deserve much more than that. On this fourth anniversary of the beginning of the Syrian war, we must recommit to supporting the Syrian people through humanitarian efforts and by holding those individuals and groups which are guilty of committing war crimes and crimes against humanity accountable for their atrocities. I ask my colleagues to stand with the Syrian people and join me in supporting the Syrian War Crimes Accountability Act. Lynch Nomination Mr. President, I will also take time to urge my colleagues to immediately bring Loretta Lynch's nomination to the floor of the U.S. Senate to be the next Attorney General of the United States. Ms. Lynch currently serves as the Senate-confirmed U.S. attorney for the Eastern District of New York. She has already been confirmed by the U.S. Senate. She served with great distinction as the U.S. attorney for the Eastern District. I had the chance to visit with her last January and talk to her firsthand about her vision to be the next Attorney General of the United States. She is extremely impressive, very well qualified, and has the right values to be the Attorney General of the United States. I will give a few examples. I know all of us are concerned about equal justice to the law. Well, Ms. Lynch has lived that through her own personal commitments. At Harvard Law School, she was a member of the Legal Aid Bureau, helping people who otherwise would not have been able to afford access to our legal system. Ms. Lynch has a long and distinguished record of prosecuting terrorists, sex traffickers, organized crime cartels, corrupt politicians, and dangerous gangs. She has been endorsed by a wide variety of law enforcement agencies and individuals. Put it this way: I have not heard anyone question her qualifications. I have not heard anyone question why she should not be confirmed to be the next Attorney General of the country. Loretta Lynch's nomination has been pending on the Senate floor as long as the five most recent Attorneys General combined. If we take five of the most recent Attorneys General and add all the time it took for their nominations to be confirmed, Loretta Lynch is now exceeding that. That is not fair. President Obama is entitled to have his team in place, and we have a responsibility to vote on his nominations. Let's do the right thing and take up this nomination, debate it, and then have Senators vote up or down, not maybe, on her nomination. We owe it to Ms. Lynch, the employees of the Justice Department, and the American people to have a newly designated Attorney General in place as the Nation's chief law enforcement officer and top defender of Americans' constitutional rights. With that, I suggest the absence of a quorum.

Mr. CARDIN

Mr. CARDIN. Mr. President, I come to the floor today to introduce the Water Infrastructure Resiliency and Sustainability Act with colleagues the Democratic Leader and the Ranking Member of the Senate Environment and Public Works Committee. The condition of our water infrastructure is in a state of crisis that is only exacerbated by the effects of climate change. The longer we ignore the problem, the more it costs us. The truth is that we are in a crisis that can be averted. There is no need to lose revenue from disrupted business and flooded streets. Our water infrastructure may be buried and out of sight and out of mind; but today we must elevate these systems to the priority level they deserve. Each year within my home State of Maryland I witness stark reminders of what cities across the nation are facing. In July of last year, Prince George's County, Maryland, experienced a breakdown of its most essential public infrastructure when a water main serving 100,000 people began to fail. Mandatory water restrictions were instituted, limiting access to water for homes and businesses during an intense heat wave that saw the heat index repeatedly reach the triple digits. At the National Harbor, one hotel evacuated three thousand guests and was forced to cancel upcoming reservations. Included in the affected area is Joint Base Andrews, which publicized plans to shut down a long list of services, including appointments at its medical center. There are incidents like this happening across America. The reports are startling. They confirm what every water utility professional knows: we need massive reinvestment in our water infrastructure now and over the coming decades. The Nation's drinking water infrastructure-- especially the underground pipes that deliver safe drinking water to America's homes and businesses--is aging. Like many of the roads, bridges, and other public assets on which the country relies, most of our buried drinking water infrastructure was built 50 or more years ago, in the post-World War II era of rapid demographic change and economic growth. Some of our systems are even older; in Baltimore, where I live, many of the pipes were installed in the 1800s. Some of these ``pipes'' are wooden. We need investment to deal with changing population needs and changing hydrological conditions. We have no other choice but to elevate it to a public safety priority and to take action now. The Water Infrastructure Resiliency and Sustainability Act aims to help local communities meet the challenges of upgrading water infrastructure systems to meet the hydrological changes we are seeing today. The bill directs the EPA to establish a Water Infrastructure Resiliency and Sustainability program. Grants will be awarded to eligible water systems to make the necessary upgrades. Communities across the country will be able to compete for Federal matching funds, which in turn will help finance projects to help communities overcome these threats. Improving water conservation, adjustments to current infrastructure systems, and funding programs to stabilize communities' existing water supply are all projects WIRS grants will fund. WIRS will never grant more than 50 percent of any project's cost, ensuring cooperation between local communities and the federal government. The EPA will try to award funds that use new and innovative ideas as often as possible. It is estimated that by 2020, the forecasted deficit for sustaining water delivery and wastewater treatment infrastructure, will trigger a $206 billion increase in costs for businesses. In a worst case scenario, a lack of water infrastructure investment will cause the United States to lose nearly 700,000 jobs by 2020. A healthy water infrastructure system is as important to America's economy as paved roads and sturdy bridges. Water and wastewater investment has been shown to spur economic growth. The U.S. Conference of Mayors has found that for every dollar invested in water infrastructure, the Gross Domestic Product is increased to more than $6. The Department of Commerce has found that that same dollar yields close to $3 worth of economic output in other industries. Every job created in local water and sewer industries creates close to four jobs elsewhere in the national economy. We know that a reactive mode causes us to lose billions in revenue in the short-term. Let us instead take a proactive approach, making strategic investments in innovative projects designed to meet the current and future needs of our water systems. That is the purpose of the Water Infrastructure Resiliency and Sustainability Act. 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:

Mr. CARDIN

Mr. CARDIN. Mr. President, I come to the floor today to introduce the Water Infrastructure Resiliency and Sustainability Act with colleagues the Democratic Leader and the Ranking Member of the Senate Environment and Public Works Committee. The condition of our water infrastructure is in a state of crisis that is only exacerbated by the effects of climate change. The longer we ignore the problem, the more it costs us. The truth is that we are in a crisis that can be averted. There is no need to lose revenue from disrupted business and flooded streets. Our water infrastructure may be buried and out of sight and out of mind; but today we must elevate these systems to the priority level they deserve. Each year within my home State of Maryland I witness stark reminders of what cities across the nation are facing. In July of last year, Prince George's County, Maryland, experienced a breakdown of its most essential public infrastructure when a water main serving 100,000 people began to fail. Mandatory water restrictions were instituted, limiting access to water for homes and businesses during an intense heat wave that saw the heat index repeatedly reach the triple digits. At the National Harbor, one hotel evacuated three thousand guests and was forced to cancel upcoming reservations. Included in the affected area is Joint Base Andrews, which publicized plans to shut down a long list of services, including appointments at its medical center. There are incidents like this happening across America. The reports are startling. They confirm what every water utility professional knows: we need massive reinvestment in our water infrastructure now and over the coming decades. The Nation's drinking water infrastructure-- especially the underground pipes that deliver safe drinking water to America's homes and businesses--is aging. Like many of the roads, bridges, and other public assets on which the country relies, most of our buried drinking water infrastructure was built 50 or more years ago, in the post-World War II era of rapid demographic change and economic growth. Some of our systems are even older; in Baltimore, where I live, many of the pipes were installed in the 1800s. Some of these ``pipes'' are wooden. We need investment to deal with changing population needs and changing hydrological conditions. We have no other choice but to elevate it to a public safety priority and to take action now. The Water Infrastructure Resiliency and Sustainability Act aims to help local communities meet the challenges of upgrading water infrastructure systems to meet the hydrological changes we are seeing today. The bill directs the EPA to establish a Water Infrastructure Resiliency and Sustainability program. Grants will be awarded to eligible water systems to make the necessary upgrades. Communities across the country will be able to compete for Federal matching funds, which in turn will help finance projects to help communities overcome these threats. Improving water conservation, adjustments to current infrastructure systems, and funding programs to stabilize communities' existing water supply are all projects WIRS grants will fund. WIRS will never grant more than 50 percent of any project's cost, ensuring cooperation between local communities and the federal government. The EPA will try to award funds that use new and innovative ideas as often as possible. It is estimated that by 2020, the forecasted deficit for sustaining water delivery and wastewater treatment infrastructure, will trigger a $206 billion increase in costs for businesses. In a worst case scenario, a lack of water infrastructure investment will cause the United States to lose nearly 700,000 jobs by 2020. A healthy water infrastructure system is as important to America's economy as paved roads and sturdy bridges. Water and wastewater investment has been shown to spur economic growth. The U.S. Conference of Mayors has found that for every dollar invested in water infrastructure, the Gross Domestic Product is increased to more than $6. The Department of Commerce has found that that same dollar yields close to $3 worth of economic output in other industries. Every job created in local water and sewer industries creates close to four jobs elsewhere in the national economy. We know that a reactive mode causes us to lose billions in revenue in the short-term. Let us instead take a proactive approach, making strategic investments in innovative projects designed to meet the current and future needs of our water systems. That is the purpose of the Water Infrastructure Resiliency and Sustainability Act. 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:

Mr. CARDIN

Mr. CARDIN. Mr. President, this Saturday, I will have the privilege and pleasure of visiting Kemp Mill Synagogue, KMS, for a Melava Malka on the occasion of its 25th anniversary. KMS held its first service on March 17, 1990, attended by a group of 50 worshipers in a Kemp Mill home, and held its first services in its current location on Kemp Mill Road on Shabbat of September 19, 1998. The Modern Orthodox Synagogue is a vibrant and loving community where members of the congregation gather to daven, learn, celebrate, and observe lifecycle events, smachot, and rituals together. In 1994, Rabbi Yaakov (Jack) Bieler officially became the first rabbi of KMS. As the leader of the KMS community, Rabbi Bieler has led and inspired the development of an ambitious program of shiurim, study groups, scholars-in-residence and educational programs. Weekly Divrei Tora by men and women enlighten the congregation by offering a diversity of perspectives. Youth groups and social activities contribute to creating a warm and engaged community. Rabbi Bieler is a great friend and true leader in Maryland's faith- based community. While he has been at KMS for over 20 years, his commitment to his faith and community has been a lifelong passion. Rabbi Bieler was raised in Bayside, Queens, and attended local public schools. In 1969, he graduated from the James Striar School of Jewish Studies in New York, where he honed his mastery of Jewish texts. He spent the years of 1969 to 1971 studying at Yeshivat Kerem B'Yavneh in Israel. When Rabbi Bieler returned to New York, he studied at Yeshiva University, where he was ordained by the Rabbi Isaac Eichanan Theological Seminary. This prestigious program, which dates back to 1886, challenges and trains leaders of Judaism to hold fast to the ways of the Torah while responding to the questions and demands of modern society. During this time, he also pursued a master of arts in Jewish Education from the Ferkauf Graduate School of Education, completing his studies in 1974. While Rabbi Bieler's studies prepared him to be a Jewish religious leader, he always sought new ways to share his knowledge with others. To this end, Rabbi Bieler has spent much of his life in the classroom. He served on the faculty and was a chairman of the Talmud Department of the Joseph H. Lookstein Upper School of Ramaz from 1974 to 1988. In these roles, he helped to educate children in Judaic and general studies, holding himself and others to high standards in the classroom and in the community. And he has always been committed to menschlichkeit, or the values of human dignity and mutual respect, and the strength of Jewish heritage. Today, he is still guided by these commitments. Rabbi Bieler served concurrently on the faculty of the Adult Education Institute of the Lincoln Square Synagogue between 1971 and 1977 and as a permanent scholar-in-residence of Congregation Kehilath Jeshurun from 1977 to 1988. This service speaks to Rabbi Bieler's belief that our education--in faith and in life--never ends; we are always learning, always seeking to become better versions of ourselves. His role as an educator grew and changed before he found his way to Kemp Mill Synagogue. In 1988, he assumed the position of lead teacher and chairman of the Judaic Studies Department at the Hebrew Academy of Greater Washington, now the Melvin J. Berman Hebrew Academy, a Modern Orthodox Jewish day school in Rockville, MD. He worked at the Hebrew Academy of Washington for a number of years and in a variety of roles, becoming the Upper School assistant principal in charge of Judaic Studies in 1991. During his tenure, Rabbi Bieler strove to provide students with a firm foundation in Torah and Jewish law, to encourage creativity and critical thinking, and promoted a deep sense of community and personal responsibility in students. Rabbi Bieler is a man who is much loved and respected by his community. And he is a humble man, so it falls to others to recite his many achievements. During his tenure at Ramaz, he was awarded the Gruss Outstanding Educator award. In 1985, he received a prestigious Jerusalem Fellows fellowship and spent the year with family, including his beloved wife Dr. Joanie Bieler, in Jerusalem. Among other achievements, Rabbi Bieler has published numerous articles on Jewish education and issues facing Judaism today, especially concerning Modern Orthodoxy. Rabbi Bieler will be retiring from his service as the leader of the Kemp Mill Synagogue community on June 30, 2015. He has faithfully served KMS for most of its 25-year history, leading and inspiring the development of an ambitious educational program indicative of his love for teaching, learning, and sharing Judaism. Under his leadership, KMS has encouraged a congregation of mutual enlightenment and diversified perspectives. Furthermore, youth groups and social activities have been cultivated and grown, creating a warm and engaged community. KMS is an important hub of community and faith in Silver Spring. KMS members are leaders in the Jewish Federation, local day schools, the Rabbinical Council, the Emunah Society, the Kemp Mill Civic Association, the Orthodox Union, and the larger community. They are committed to worship and to service, to the United States, and to the State of Israel. I ask my colleagues to join me in congratulating KMS on its 25th anniversary and acknowledging the inspired service, dedication, and leadership of Rabbi Yaakov and Dr. Joanie Bieler who will undoubtedly continue to be involved in their community and inspire others to serve even when their formal leadership roles at KMS come to an end. I wish them all the best.

Mr. CARDIN

Mr. CARDIN. Mr. President, I wish to take a few moments today to speak about Federal workers in general and some of the people at the National Institutes of Health in particular. Government workers guard our borders, protect us from terrorists, treat our wounded veterans, dispense Social Security checks to our retirees, find cures for diseases, guide the Nation's air traffic, explore the tiniest particles and the vast expanse of outer space, ensure our air is safe to breathe, our water is safe to drink, our food is safe to eat, support our service men and women in harm's way, and promote our interests and ideals abroad. For whom does the government work? Government works for America. The Washington Post recently reported that since reliable data first became available shortly before World War II, the percentage of all employed people working for the Federal Government hit an all-time low in December. Fewer than 2 percent of the total U.S. workforce is employed by the Federal Government. Over nearly the past half century, from 1966 to 2012--the most recent year for which comparable data is available--the number of Federal workers in the executive branch dropped by 83,000. During that time, the U.S. population increased from under 200 million to over 300 million people and the gross domestic product nearly quadrupled. We can argue over whether we want bigger government or smaller government, but we should all agree we want better government. We can't have better government when Federal workers are constantly under assault. We need to stop treating the Federal workforce like a rented mule. We need to treat the Federal workforce like the critical asset it is. A 2011 report by the National Academy of Public Administration and the Kettering Foundation concluded that programs operated by civil servants receive ``significantly higher'' scores for management and effectiveness than those run by ``grant- and contract-based third parties.'' I think part of the problem is that Americans have come to accept that Federal workers are nameless, faceless bureaucrats. They aren't. They are people who are patriotic Americans and dedicated to public service. They have families and support their communities. They have been asked to do more and more with less and less while being subjected to pay freezes, sequestration-related furloughs, government shutdowns, and threats to their benefits. They have contributed $150 billion to deficit reduction while still working hard on behalf of all Americans. Today, as I mentioned, I wish to focus on the Federal workers at the National Institutes of Health. I wish to introduce my colleagues and all Americans to a few of the Federal workers who are making life better for all of us. But first a description of the NIH so people can understand its mission. I can sum up its mission in two words: saving lives. The NIH is the world's premier biomedical and health-related research facility. Its job is to perform and fund the research that helps improve the Nation's health--a job it has carried out for over a century. I am proud the NIH is headquartered in Maryland, but it is important to understand that NIH support of medical research at other research institutions has created jobs and fostered economic growth in each and every State, while establishing and maintaining the United States as the global leader in the life sciences. NIH-supported research added $69 billion to our GDP and supported 7 million jobs in 2011 alone. In the weeks and months ahead, Congress and the administration will have to decide whether they have to replace sequestration with a more logical, coherent, strategic, and responsible form of budgeting. While we will have disagreements over the details, if anyone needs to be convinced about the value of replacing sequestration, look no further than the situation at NIH. Funding constraints there not only cost people their jobs, they are costing people their lives. NIH funding has multiple drivers, but comparing the fiscal year 2013 figures with the fiscal year 2012 figures, largely because of sequestration, approximately 640 fewer competitive research project grants were issued and approximately 750 fewer new patients were admitted to the NIH Clinical Center. Each these affects a person's life. Each of these has consequences when we do not move forward as we should. A recent survey determined that nearly 20 percent of the biomedical scientists have considered leaving the United States due to sequestration. We are losing our best. Nearly one-half of the scientists surveyed said they have laid off staff in their laboratories or are considering laying off staff due to losing NIH grants. More than 50 percent of the researchers say they have colleagues who have lost his or her job. What is the impact? Delays in lifesaving medical progress. Medical breakthroughs do not happen overnight. In almost all instances, breakthrough discoveries result from years of incremental research to understand how diseases start and progress. Cuts to research are delaying progress in medical breakthroughs, including developing better cancer drugs that zero in on a tumor with fewer side effects; research on a universal flu vaccine that could fight every strain of influenza without needing a yearly shot; preventing debilitating chronic conditions that are costly to society and delay development of more effective treatments for common and rare diseases affecting millions of Americans. NIH Director Dr. Francis Collins recently wrote the column ``Exceptional Opportunities in Medical Science'' in which he describes the excitement over ``personalized medicine,'' the BRAIN initiative, and development of the Ebola vaccine. He has also shared his concern about the budget challenges NIH faces. Let me quote from Dr. Collins: Although all of these ambitious scientific endeavors offer exceptional promise for advancing human health, the effect that unprecedented budget pressures are having on biomedical research cannot be ignored. Due to inflation, the NIH budget has lost almost 25 percent of its purchasing power over the last decade. The decline has had important consequences. The NIH once funded one in three research proposals, but now only has enough resources to support one in six. As a result, a great deal of excellent science is being left unfunded. Last October Dr. Collins stated that cuts in Federal funding slowed the development of vaccines and therapies for the deadly Ebola virus, saying: ``Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would have gone through clinical trials and would have been ready.'' Think about the lives that could have been saved. To Americans who wonder what their tax dollars do--well, some go to NIH to find treatments and cures for cancer, depression, arthritis, substance abuse, addiction, diabetes, and Alzheimer's disease. To date, 145 NIH-supported researchers have received or shared 85 Nobel Prizes. Not everyone wins a Nobel Prize, so let me talk about people who aren't in the spotlight--people some of our colleagues might refer to as ``nameless, faceless bureaucrats.'' I will highlight the work of two of them today who are making a tremendous contribution as public servants. Dr. Nancy Sullivan, Chief of the Vaccine Research Center, has been working on an Ebola vaccine for nearly two decades, dating back to when she was an investigator at the University of Michigan with the then-NIH grantee and now former Director, Dr. Gary Nabel. Most vaccines spur production of a person's immune system's antibodies that block a virus from entering the cells, but that approach doesn't work for Ebola. Gene-based vaccines can induce additional virus fighters called T- cells, so that is what Dr. Sullivan created, using pieces of Ebola genetic material. It is the most promising approach yet, and it is being tested in the parts of West Africa that have been hit the hardest with Ebola, where more than 9,000 people have died. The concept for Dr. Sullivan's vaccine has been 16 years in the making, beginning back when few people outside the global infectious disease community had even heard of the deadly disease. Over the years, Dr. Sullivan and her team continued to tweak her ideas, constantly improving on them. Eventually she followed Dr. Nabel to NIH. Many experts in the vaccine research community had begun to believe Ebola was insurmountable. They thought it was too aggressive for a vaccine to ever protect against it. But Dr. Sullivan never lost heart that her work would one day prove successful. The Ebola virus infection is a highly lethal disease for which there are no effective therapeutic or preventive treatments. Consequently, work with these viruses requires highly specialized BSL-4 containment labs--the highest biosafety labs. Dr. Sullivan is a leader in the field and has personally conducted many of the most critical experiments. Her work on immunology and vaccine development is widely considered as some of the very best in the field. In spite of the difficulties associated with access to BSL-4 labs, her work has consistently been the source of novel observations. Dr. Sullivan received her Ph.D. in cell biology from Harvard University in 1997. She received her master of science in environmental engineering in 1989, also from Harvard University. I brought a poster to the floor where we see President Obama visited NIH to personally congratulate Dr. Sullivan for her incredible work on behalf of world health. Some people may be familiar with the TV show ``House.'' The main character, Dr. Gregory House, is brilliant at diagnosing conditions and illnesses that baffle everyone else. The real-life Dr. House is Dr. William Gahl, the founding Director of the Undiagnosed Diseases Program at NIH. He is America's leading medical detective, a physician dedicated to finding answers for long-suffering patients with mysterious illnesses that long eluded diagnosis. Dr. Gahl has brought together a unique combination of elite medical specialists, researchers, and Federal resources to solve baffling illnesses and provide desperate patients and their families with information and possible solutions and treatments for their often life-threatening ailments. Results include diagnosis and treatment of diseases so rare they don't even have names, plus new genetic discoveries, improved disease management, and the advancement of medical knowledge. NIH Director Dr. Collins said the Undiagnosed Diseases Program, which Dr. Gahl conceived and started, serves as a kind of court of last resort for patients without a diagnosis. Dr. Gahl has convinced some of the best, brightest, and busiest physicians to participate, and has devoted tremendous energy to examining patient records, selecting cases for in- depth analysis, and helping people who are seriously ill. Under Dr. Gahl's stewardship, the program regularly involves a collective effort by more than 25 attending physicians of different specialties. The cooperation by a diverse group of experts has helped create a coherent view of each patient instead of the organ-by-organ orientation taken by most specialists. Patients are brought to the NIH campus in Bethesda for an intensive week. They meet with a parade of specialists who study their medical histories, perform thorough exams, and take numerous tests. The doctors then meet to discuss what they have seen, discovered, or may have missed. They also debate various theories, trying to connect the dots, and come up with a possible diagnosis and treatment. Scientists working with Dr. Gahl discovered the genetic cause of a vascular disorder not previously identified in the medical literature. The rare condition, identified in nine individuals, arises in adulthood and causes arterial calcification in the hands and feet, but does not affect arteries in the heart. The symptoms include acute pain after walking more than a short distance. The disorder previously baffled the medical field and evaded diagnosis when conventional methods were used. In another instance, physicians working with Dr. Gahl identified the reason why a woman's muscles had grown painfully large and hard underneath her skin, making it increasingly difficult for her to perform daily activities. This turned out to be an extremely rare, generally fatal complication of multiple myeloma, and the diagnosis by the NIH Undiagnosed Diseases Program resulted in a stem cell bone marrow transplant that allows her to lead a normal life. These are people who had no hope, no hope at all. They came to NIH, and they have gotten government-supported help to give them hope and to give them life. Dr. Gahl earned his B.S. in biology from the Massachusetts Institute of Technology in 1972 and his M.D. from the University of Wisconsin in 1976. He obtained a Ph.D. degree in oncology research from Wisconsin's McArdle Laboratory for Cancer Research in 1981. He has published more than 350 peer-reviewed papers and trained 36 biochemical geneticists. Dr. Gahl has made a number of seminal discoveries regarding rare diseases during his career. He said deciding who to admit into the Undiagnosed Diseases Program is always very difficult and much like triage on the battlefield. You have to make decisions about where you think you can do some good. The Undiagnosed Diseases Program serves people who feel helpless, have suffered greatly, have waited many years for answers, and must be treated with respect and attention. According to Dr. Gahl, the NIH caregivers understand the desperation the patients and their families feel and try to balance the difficulty finding solutions with a realistic measure of hope. Dr. John Gallin, Director of the NIH Clinical Center, said Dr. Gahl takes cases after everyone else has given up. He said that in a short time the program has developed new approaches for investigating, understanding, and diagnosing rare disorders, and has added to the body of medical knowledge. As Dr. Gallin put it, as a result of the NIH Undiagnosed Diseases Program, the language of medicine is changing. The different specialists working together now are beginning to find common ways. Nancy Sullivan and Bill Gahl are just two of the dedicated people who work in the Federal Government. They are not nameless, faceless bureaucrats. They are dedicated, hard-working Americans trying to make life better for all of us under difficult circumstances. At a minimum, they deserve our gratitude and respect. They also deserve a predictable and reasonable budget to support their critical work. In the weeks ahead I will be discussing the accomplishments of other outstanding Federal workers so that Americans can understand government works for America. I yield the floor.

Mr. CARDIN

Mr. CARDIN. Mr. President, next week the Nation will celebrate the 50th anniversary of Bloody Sunday, when we commemorate the series of marches of nonviolent civil rights protestors from Selma to the Alabama State capital of Montgomery. They were marching for the right to vote, which had been guaranteed by the adoption of the 15th Amendment to the Constitution in 1870. The first section of the amendment reads: ``The right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of race, color, or previous condition of servitude.'' These marches gripped the attention of the Nation because of the violence reaction from the Alabama State troopers, who attacked the marchers on the Edmund Pettus Bridge after leaving Selma. The State troopers attacked the marchers using billy clubs, tear gas, fire hoses, and dogs, and numerous marchers were wounded and were beaten unconscious. The images shown on television galvanized the American public in support of voting rights. President Lyndon Johnson called on Congress to enact voting rights legislation and make good on both the promise of the 15th Amendment as well as the responsibility of Congress to enforce the amendment ``by appropriate legislation.'' One of those protestors beaten on the bridge was a Freedom Rider, speaker at the March on Washington, and a leader of the Student Nonviolent Coordination Committee. That protestor was John Lewis. I was honored and privileged to enter Congress in 1987 at the same time as Congressman John Lewis. John Lewis has been a friend and mentor of mine for many years and is known as the ``conscience of the Congress.'' And while I did leave the House in 2006 to enter the Senate in 2007, I have continued to be inspired by Congressman Lewis and his continuing struggle to make sure all Americans enjoy the benefits of equal justice under the law. Just last week during Black History Month, I had the honor, along with Congressman John Lewis, to address a group of students from Baltimore who took their own pilgrimage to Selma as we approach the 50th anniversary of Bloody Sunday. High School students and teachers from Park School, Baltimore City College, City Neighbors High School, and Cristo Rey Jesuit High School participated in a trip to southern cities such as Greensboro, Atlanta, Selma, Little Rock, the Mississippi Delta, and Memphis, focusing on the civil rights movement. I wish to share some of the stories that the students told to Congressman Lewis and me last week, because their idealism, determination, and knowledge of both the past and present is very inspirational. Let me begin with a brief history of how this trip came into being. In 2004, the first group of students and faculty from the Park School of Baltimore and Baltimore City College High School traveled throughout the American South, visiting with participants in the Civil Rights Movement and touring the museums, sites, and memorials that stand in witness to the foot soldiers, heroes, and martyrs of the movement. The trip was the dream of three Park School faculty members: Carol Kinne, Traci Wright, and Stradine Harris. They envisioned young people from different schools and different backgrounds learning together and becoming inspired to be agents of change upon their return. Money to cover the expenses of the trip is raised each year by the students. They sell pizza and candy, rake leaves, write grant proposals, and solicit funds from various benefactors. While learning about the Civil Rights Movement is a primary goal of the trip, equally important is inspiring students to raise awareness of civil rights issues facing people today and to become activists for justice in their own communities. In 2015, four Baltimore schools--City Neighbors and Cristo Rey having joined the original two--sent 38 students on the trip. The January 2015 trip was a special one, as the group had the chance to meet with former Ambassador Andrew Young in Atlanta and to attend an event for the movie, Selma, that took place on the Edmund Pettus Bridge in Selma, in honor of the 50th anniversary of Bloody Sunday. The group also visited the International Civil Rights Center in Greensboro, NC, attended church service at Ebenezer Baptist Church, toured the Rosa Parks Museum, met with activists at the Equal Justice Initiative and the Southern Poverty Law Center, and learned about the movement in other museums in Birmingham, Memphis, and Little Rock. More importantly, the group was able to meet and learn from people who fought for change: Cleopatra Goree, Catherine Burks-Brooks, Kurt Carrington, Roscoe Jones, Dr. Sybil Hampton, and others. I wish to share just a few of the many stories from students who went on this trip, as related in their blog: Amber Smiley is a 12th grader at Cristo Rey. Amber wrote: Across from the museum was this statue of people being attacked by dogs and hit with high amounts of pressured water. In these statues you could see the emotion in every one of them. You could see the fit and the drive to make changes. After leaving we had lunch with 3 women that marched, taught, and fought for rights. The women's names are Ms. Cleopatra Goree, Ms. Catherine Burks-Brooks, and Ms. Mimes. Each one of their stories varied but all built up to the bigger theme that we have to strive to make the world better. These words stuck with me like glue on two pieces of paper. Also, they said it's our turn to make a change its make thing about how can each school community to come and make a change in Baltimore. These women impacted my life and the whole group to change the injustices in our world. I was really honored to have them come and give us these points of views and life stories. It was really a blessing. Latonyah Williams is a 12th grader at City Neighbors. She wrote: At the Little Rock Central visitor center, I found a quote that immediately grabbed my attention as I walked through the doors. It goes ``If not us, then who? If not now, then when?''--John Lewis. It grabbed at me because it shows the mindset behind how the leaders were thinking back when they were fighting for our rights. They weren't thinking of themselves or their lives, but of the future and the many generations to come. So now I want to have the mindset of if not me, then who will take a stand? If not now, then most likely it will not ever happen. I am confident that this trip continues to impact students long after they return to Baltimore. So today, while we recognize the achievements and accomplishments of heroes like Dr. Martin Luther King, Jr., Rosa Parks, Thurgood Marshall, and John Lewis, we cannot shy away from the painful history of race relations in our country. To do so would be a disservice to all those who struggled and sacrificed in the name of equality. Slavery and segregation were dark and painful chapters in American history, and those abhorrent practices occurred in Maryland and throughout the rest of our Nation. Today, we must confront the issue of racial profiling. Racial profiling is the practice of discriminatory profiling based on race, ethnicity, religion or any other stereotype, and it is a matter that needs to be addressed from its root causes. I ask: how many more cases like Trayvon Martin, Michael Brown, and Eric Garner must we have? How many more families will have to suffer until we get this right? It has been heartbreaking to see several other American towns--from Ferguson, MO, to New York City, gripped by such a tragedies that resulted from racial profiling. Eighteen-year old Michael Brown was just days away from starting his first college classes, but he no longer has the chance to pursue his dreams. In the Senate I have introduced the End Racial Profiling Act. This legislation is a step in the direction of ensuring equal treatment of all people under the law, conserving resources, and restoring trust in the men and women who risk their lives by signing up to protect our communities. Racial profiling is un-American. It has no place within the values of our country. It turns communities against the partnerships needed to keep our neighborhoods safe. Racial profiling is defined in a standard, consistent definition as the practice of a law enforcement agent relying on race, ethnicity, religion or national origin as a factor in their investigations and activities. The legislation I have introduced creates an exception for the use of these factors where there is trustworthy information, relevant to the locality and time frame, which links persons of a particular race, ethnicity or national origin to an identified incident or scheme. Law enforcement agencies would be prohibited from using racial profiling in criminal or routine law enforcement investigations, immigration enforcement, and national security cases. The legislation I have introduced is supported by a broad coalition of civil rights groups such as the NAACP, Leadership Conference on Civil and Human Rights, ACLU, Rights Working Group, ACLU, and numerous other national, State, and local organizations. While some may predict further gridlock and political polarization with a Congress led by one party and the President of another, I firmly believe that we will find ways to work together on the issues most important to the American public--and racial profiling is clearly one of those issues. Congress overwhelmingly reauthorized the Voting Rights Act in 2006 after building an extensive record that made a compelling case for the continued need to protect minority voters from discrimination. As much as we wish it wasn't so, racism has not disappeared from America and there continue to be individuals and groups who would use our voting system to deliberately minimize the rights of minority voters. Congress should act to revitalize the Voting Rights Act. Protecting the right to vote also extends to restoring the rights of nearly 4 million Americans across the country who have been released from prison but barred from the voting booth, often for life. I have been leading the fight for the Democracy Restoration Act, which would restore voting rights to individuals after they have served their time and have been released from incarceration. If we truly want to break the cycle of recidivism, we need to reintegrate former prisoners back into society. When prisoners are released, they are expected to obey the law, get a job, and pay taxes as they are rehabilitated and reintegrated into their community. With these responsibilities and obligations of citizenship should also come the rights of citizenship, including the right to vote. The current patchwork of State laws results in the lack of a uniform standard for eligibility to vote in Federal elections. I believe that Congress should take strong action now to remedy this problem and enact a nationwide standard for restoration of voting rights. That is why I have introduced the Democracy Restoration Act. As we commemorate the 50th anniversary of Bloody Sunday, let us continue the march for justice for all Americans. I urge Congress to address the issues of voting rights and racial profiling during this session.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I am introducing the Water Resources Research Amendments Act. First authorized in 1964, the Water Resources Research Act established 54 Water Resources Research Institutes at top land grant universities in each of the 50 States and the U.S. territories. These institutes created a grant program and provided opportunities for applied water supply research. The bill I introduce today would reauthorize the grant program for the next 5 years and would add a program focused on research and development of green infrastructure. Water and the availability thereof is a defining characteristic of U.S. landscape, culture, wealth, and security. Clean water is a relatively rare and invaluable resource. Last year's funded projects included research into the impacts of climate change on water supply lakes, the development of better detection methods for pathogens in drinking water, and the impacts of drought on farm supply chains. In my own State, some of the tools we use for restoration of the Chesapeake Bay were products of these same grants in previous years. WRRA Researchers across the Mid-Atlantic States have developed ways to keep the Chesapeake waters cleaner through urban stormwater treatment, improved roadway design, and eco-friendly poultry farming practices. WRRA-funded projects develop innovative and cost-effective solutions for similar water resources issues across the country. Undoubtedly, funding WRRA is an intelligent and necessary investment in the future of our water resources. WRRA authorizes two types of annual grants. First, it supplies grants to each Water Resources Research Institute for research that fosters improvements in water supply reliability, explores new ways to address water problems, encourages dissemination of research to water managers and the public, and encourages the entry of new scientists, engineers and technicians into the water resources field. Second, WRRA authorizes a national competitive grant program to address regional water issues. All WRRA grants leverage non-federal dollars at a minimum ratio of 2 to 1, but often far beyond that level, as high as 5 to 1. The Water Resources Research Act was most recently reauthorized in 2006, in PL 109-471. In that period, the program was authorized at $12,000,000 per year, providing $6,000,000 each to state and competitive project grants. Authorization for these grants expired in fiscal year 2011. Today's bill would reauthorize both grant programs for an additional 5 years by providing $7,500,000 for institutional grants and $1,500,000 for national competitive grants. This lower authorization level reflects our efforts to adjust for present fiscal limitations. The proposed authorization maximizes the economic efficiency of the program without compromising its efficacy. An independent review panel has judged that the Water Resources Research Institutes command significant funding leverage for the modest amount of appropriations required to support it. Thus, we can be sure that we are supporting top-notch science while maximizing cost-effectiveness. Moreover, by funding this network of institutes we are investing in our future. The Water Resources Research Institutes are the country's single largest training program for water scientists, technicians, and engineers. Today, floods, droughts, and water degradation issues pervade the nation. Simultaneously, water resources are increasingly critical for production of resources, economic stability, and the health and well- being of the citizenry. WRRA grants provide us with improved understanding of water-related issues and better technology to address them. Nearly half a century after the Water Resources Research grant program was first put in place, this program is relevant, critical, and deserving of our support. 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:

Mr. CARDIN

Mr. CARDIN. Mr. President, today I am introducing the Water Resources Research Amendments Act. First authorized in 1964, the Water Resources Research Act established 54 Water Resources Research Institutes at top land grant universities in each of the 50 States and the U.S. territories. These institutes created a grant program and provided opportunities for applied water supply research. The bill I introduce today would reauthorize the grant program for the next 5 years and would add a program focused on research and development of green infrastructure. Water and the availability thereof is a defining characteristic of U.S. landscape, culture, wealth, and security. Clean water is a relatively rare and invaluable resource. Last year's funded projects included research into the impacts of climate change on water supply lakes, the development of better detection methods for pathogens in drinking water, and the impacts of drought on farm supply chains. In my own State, some of the tools we use for restoration of the Chesapeake Bay were products of these same grants in previous years. WRRA Researchers across the Mid-Atlantic States have developed ways to keep the Chesapeake waters cleaner through urban stormwater treatment, improved roadway design, and eco-friendly poultry farming practices. WRRA-funded projects develop innovative and cost-effective solutions for similar water resources issues across the country. Undoubtedly, funding WRRA is an intelligent and necessary investment in the future of our water resources. WRRA authorizes two types of annual grants. First, it supplies grants to each Water Resources Research Institute for research that fosters improvements in water supply reliability, explores new ways to address water problems, encourages dissemination of research to water managers and the public, and encourages the entry of new scientists, engineers and technicians into the water resources field. Second, WRRA authorizes a national competitive grant program to address regional water issues. All WRRA grants leverage non-federal dollars at a minimum ratio of 2 to 1, but often far beyond that level, as high as 5 to 1. The Water Resources Research Act was most recently reauthorized in 2006, in PL 109-471. In that period, the program was authorized at $12,000,000 per year, providing $6,000,000 each to state and competitive project grants. Authorization for these grants expired in fiscal year 2011. Today's bill would reauthorize both grant programs for an additional 5 years by providing $7,500,000 for institutional grants and $1,500,000 for national competitive grants. This lower authorization level reflects our efforts to adjust for present fiscal limitations. The proposed authorization maximizes the economic efficiency of the program without compromising its efficacy. An independent review panel has judged that the Water Resources Research Institutes command significant funding leverage for the modest amount of appropriations required to support it. Thus, we can be sure that we are supporting top-notch science while maximizing cost-effectiveness. Moreover, by funding this network of institutes we are investing in our future. The Water Resources Research Institutes are the country's single largest training program for water scientists, technicians, and engineers. Today, floods, droughts, and water degradation issues pervade the nation. Simultaneously, water resources are increasingly critical for production of resources, economic stability, and the health and well- being of the citizenry. WRRA grants provide us with improved understanding of water-related issues and better technology to address them. Nearly half a century after the Water Resources Research grant program was first put in place, this program is relevant, critical, and deserving of our support. 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:

Mr. CARDIN. Mr. President, I rise today to introduce the Rafael Ramos and Wenjian Liu National Blue Alert Act of 2015. Every day, more than 900,000 Federal, State and local law enforcement officers put their lives on the line to keep our communities safe. Unfortunately these officers can become targets for criminals and those seeking to evade our justice system, and we must make sure our officers have all the tools they need to protect themselves and each other. Each year thousands of law enforcement officers are assaulted while performing their duties and many suffer serious injuries or even lose their lives. In December 2014, New York City Police Department officers Rafael Ramos and Wenjian Liu were assassinated while sitting in their marked police patrol car in Brooklyn. This legislation is named after those officers in honor of the ultimate sacrifice that they made to serve and protect their fellow citizens. According to preliminary data compiled by the National Law Enforcement Officers Memorial Fund, law enforcement fatalities in the U.S. rose 24 percent in 2014, reversing what had been two years of dramatic declines in line of duty deaths. The report indicates that 126 federal, state, local, tribal and territorial officers were killed in the line of duty this year, compared to 102 in 2013. Ambush-style attacks such as those that took the lives of officers Ramos and Liu were the number one cause of felonious officer deaths for the fifth year in a row. Fifteen officers nationwide were killed in ambush assaults in 2014, matching 2012 for the highest total since 1995. I thank my original cosponsors who have joined me in introducing this legislation, including my lead co-sponsor Senator Graham. The rapid dissemination of critical, time-sensitive information about suspected criminals is essential to keeping our communities safe. This legislation would encourage, enhance, and integrate Blue Alert programs through the United States. The Attorney General would establish a national Blue Alert communications network within the Department of Justice. The Blue Alert system could be used when a law enforcement officer is: seriously injured or killed in the line of duty; missing in connection with the officer's official duties; or an imminent or credible threat that an individual intends to cause the serious injury of death of a law enforcement officer is received. The Blue Alert system could be used when the suspect has not been apprehended, and where there is sufficient descriptive information of the suspect and any vehicles involved, if applicable. This information can be used by local law enforcement, the public and the media to help facilitate capture of such offenders and ultimately reduce the risk they pose to our communities and law enforcement officers. Currently there is no national alert system that provides immediate information to other law enforcement agencies, the media or the public at large. Many states have created a state Blue Alert system in an effort to better inform their local communities. The State of Maryland, under the leadership of former Governor Martin O'Malley, created their Blue Alert system in 2008 after the murder of Maryland State Trooper Wesley Brown. Blue Alert programs have been created in 20 states to date, with a growing number of states considering establishing Blue Alert programs. The purpose of our National Blue Alert legislation is to keep our law enforcement officers and our communities safe. And based on the success of the AMBER Alert and the SILVER Alert, I believe this BLUE Alert will be equally successful in helping to apprehend criminal suspects who have seriously injured or killed our law enforcement officers. I am also pleased to say this legislation has the endorsement of the Fraternal Order of Police, the National Association of Police Organizations, the Sergeants Benevolent Association of the New York City Police Department, and many other law enforcement associations. Passing this legislation can help us live up to our commitment to help better protect those who serve us. I urge my colleagues to support this legislation.

Mr. CARDIN

Mr. CARDIN. Mr. President, I rise today to introduce the Rafael Ramos and Wenjian Liu National Blue Alert Act of 2015. Every day, more than 900,000 Federal, State and local law enforcement officers put their lives on the line to keep our communities safe. Unfortunately these officers can become targets for criminals and those seeking to evade our justice system, and we must make sure our officers have all the tools they need to protect themselves and each other. Each year thousands of law enforcement officers are assaulted while performing their duties and many suffer serious injuries or even lose their lives. In December 2014, New York City Police Department officers Rafael Ramos and Wenjian Liu were assassinated while sitting in their marked police patrol car in Brooklyn. This legislation is named after those officers in honor of the ultimate sacrifice that they made to serve and protect their fellow citizens. According to preliminary data compiled by the National Law Enforcement Officers Memorial Fund, law enforcement fatalities in the U.S. rose 24 percent in 2014, reversing what had been two years of dramatic declines in line of duty deaths. The report indicates that 126 federal, state, local, tribal and territorial officers were killed in the line of duty this year, compared to 102 in 2013. Ambush-style attacks such as those that took the lives of officers Ramos and Liu were the number one cause of felonious officer deaths for the fifth year in a row. Fifteen officers nationwide were killed in ambush assaults in 2014, matching 2012 for the highest total since 1995. I thank my original cosponsors who have joined me in introducing this legislation, including my lead co-sponsor Senator Graham. The rapid dissemination of critical, time-sensitive information about suspected criminals is essential to keeping our communities safe. This legislation would encourage, enhance, and integrate Blue Alert programs through the United States. The Attorney General would establish a national Blue Alert communications network within the Department of Justice. The Blue Alert system could be used when a law enforcement officer is: seriously injured or killed in the line of duty; missing in connection with the officer's official duties; or an imminent or credible threat that an individual intends to cause the serious injury of death of a law enforcement officer is received. The Blue Alert system could be used when the suspect has not been apprehended, and where there is sufficient descriptive information of the suspect and any vehicles involved, if applicable. This information can be used by local law enforcement, the public and the media to help facilitate capture of such offenders and ultimately reduce the risk they pose to our communities and law enforcement officers. Currently there is no national alert system that provides immediate information to other law enforcement agencies, the media or the public at large. Many states have created a state Blue Alert system in an effort to better inform their local communities. The State of Maryland, under the leadership of former Governor Martin O'Malley, created their Blue Alert system in 2008 after the murder of Maryland State Trooper Wesley Brown. Blue Alert programs have been created in 20 states to date, with a growing number of states considering establishing Blue Alert programs. The purpose of our National Blue Alert legislation is to keep our law enforcement officers and our communities safe. And based on the success of the AMBER Alert and the SILVER Alert, I believe this BLUE Alert will be equally successful in helping to apprehend criminal suspects who have seriously injured or killed our law enforcement officers. I am also pleased to say this legislation has the endorsement of the Fraternal Order of Police, the National Association of Police Organizations, the Sergeants Benevolent Association of the New York City Police Department, and many other law enforcement associations. Passing this legislation can help us live up to our commitment to help better protect those who serve us. I urge my colleagues to support this legislation.

Mr. CARDIN

Mr. CARDIN. Mr. President, today I am proud to introduce the Justice Thurgood Marshall's Elementary School Study Act. The elementary school that Justice Marshall attended, known as PS 103, located in my hometown of Baltimore, is a place of national significance because it marks the site where one of our nation's greatest legal minds began his education. Thurgood Marshall is well known as one of the most significant historical figures of the American civil rights movement. By the time he was 32 he was appointed the chief legal counsel for the National Association for the Advancement of Colored People, NAACP. He served at the NAACP a total of twenty-five years and was a key strategist to end racial segregation throughout the United States. Perhaps the greatest illustration of this effort was his victory before the Supreme Court overturning the Plessy doctrine effectively ending school segregation with the landmark decision in Brown v. Board of Education of Topeka, KS, in 1954. Not only did this case open up educational opportunity and sparked the civil rights movement in this nation, it also marked the beginning of Thurgood Marshall's career, still a young attorney from Baltimore, as one of the greatest legal minds in all the land. This case was just one of the 29 cases he won before the U.S. Supreme Court. Fittingly, Marshall was the first African American confirmed to the Supreme Court. He was nominated by President Lyndon B. Johnson in 1967 and served 24 years, until 1991. On the high court, Marshall continued his fight for the Constitutional protection of individual human rights. But Thurgood Marshall was not always a legal giant. He was once a young boy growing up in West Baltimore. He received the first 6 years of his public education at PS 103. An apocryphal story goes that a young Thurgood Marshall studied the U.S. Constitution in the basement of the building while serving detention. Regardless of whether or not this is true, the building powerfully tells the story of racial segregation in America, PS 103 was a ``blacks only'' school when Justice Marshall was a student, and marks the academic beginning of one of the country's most brilliant legal thinkers and a pioneer of the civil rights movement. The building is located at 1315 Division Street in the Upton Neighborhood of Old West Baltimore. The building is part of the Old West Baltimore National Register Historic District, and is listed as a contributing historic resource for the neighborhood. The Old West Baltimore historic district is one of the largest predominately African American historic districts in the country, and its significance is centered on the African American experience in the area. In Baltimore, we are fortunate to have the National Park Service operate two historical sites, Fort McHenry and the Hampton Mansion. Adding PS 103 is a unique opportunity for the National Park Service to work in Baltimore's inner-city and to reach out and engage people about African American history. Needless to say, Thurgood Marshall's legacy is one that should be preserved. He was one of our country's greatest legal minds and a prominent historical figure of one chapter of our country's great history--the civil rights movement. This bill authorizes the Secretary of the Interior to conduct a special resource study of PS 103 to evaluate the suitability and feasibility of establishing the building as a unit of the National Park Service. Preserving the building that was Justice Marshall's elementary school will give Americans insight into Justice Marshall's childhood. 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:

Mr. CARDIN

Mr. CARDIN. Mr. President, today I am proud to introduce the Justice Thurgood Marshall's Elementary School Study Act. The elementary school that Justice Marshall attended, known as PS 103, located in my hometown of Baltimore, is a place of national significance because it marks the site where one of our nation's greatest legal minds began his education. Thurgood Marshall is well known as one of the most significant historical figures of the American civil rights movement. By the time he was 32 he was appointed the chief legal counsel for the National Association for the Advancement of Colored People, NAACP. He served at the NAACP a total of twenty-five years and was a key strategist to end racial segregation throughout the United States. Perhaps the greatest illustration of this effort was his victory before the Supreme Court overturning the Plessy doctrine effectively ending school segregation with the landmark decision in Brown v. Board of Education of Topeka, KS, in 1954. Not only did this case open up educational opportunity and sparked the civil rights movement in this nation, it also marked the beginning of Thurgood Marshall's career, still a young attorney from Baltimore, as one of the greatest legal minds in all the land. This case was just one of the 29 cases he won before the U.S. Supreme Court. Fittingly, Marshall was the first African American confirmed to the Supreme Court. He was nominated by President Lyndon B. Johnson in 1967 and served 24 years, until 1991. On the high court, Marshall continued his fight for the Constitutional protection of individual human rights. But Thurgood Marshall was not always a legal giant. He was once a young boy growing up in West Baltimore. He received the first 6 years of his public education at PS 103. An apocryphal story goes that a young Thurgood Marshall studied the U.S. Constitution in the basement of the building while serving detention. Regardless of whether or not this is true, the building powerfully tells the story of racial segregation in America, PS 103 was a ``blacks only'' school when Justice Marshall was a student, and marks the academic beginning of one of the country's most brilliant legal thinkers and a pioneer of the civil rights movement. The building is located at 1315 Division Street in the Upton Neighborhood of Old West Baltimore. The building is part of the Old West Baltimore National Register Historic District, and is listed as a contributing historic resource for the neighborhood. The Old West Baltimore historic district is one of the largest predominately African American historic districts in the country, and its significance is centered on the African American experience in the area. In Baltimore, we are fortunate to have the National Park Service operate two historical sites, Fort McHenry and the Hampton Mansion. Adding PS 103 is a unique opportunity for the National Park Service to work in Baltimore's inner-city and to reach out and engage people about African American history. Needless to say, Thurgood Marshall's legacy is one that should be preserved. He was one of our country's greatest legal minds and a prominent historical figure of one chapter of our country's great history--the civil rights movement. This bill authorizes the Secretary of the Interior to conduct a special resource study of PS 103 to evaluate the suitability and feasibility of establishing the building as a unit of the National Park Service. Preserving the building that was Justice Marshall's elementary school will give Americans insight into Justice Marshall's childhood. 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:

Mr. CARDIN

Mr. CARDIN. Mr. President, today Senators Toomey and Collins and I are introducing the Improving Access to Emergency Psychiatric Care Act of 2015, which will build on the current 3-year Medicaid Emergency Psychiatric Demonstration Project to provide timely and cost-effective treatment to people who are experiencing an emergency psychiatric crisis. We know that emergency psychiatric care delivered in general hospitals and freestanding psychiatric hospitals is a life-saving service for individuals with severe mental illnesses. In addition, a Government Accountability Office report, GAO-09-347, on hospital emergency departments concluded the difficulties in transferring, admitting, or discharging psychiatric patients from the emergency department contribute to overcrowding in our Nation's emergency rooms. Community-based psychiatric hospitals, like Sheppard Pratt Health System in my home State of Maryland, could help relieve these back-ups in emergency departments; however, due to a longstanding Medicaid statutory provision called the Institution for Mental Disease, IMD, exclusion, patients receiving care in these freestanding psychiatric hospitals are not covered if the patients are between the ages of 21 and 64, and the hospitals cannot get Medicaid Federal matching payments for these services. In response to this problem, bipartisan legislation was first introduced in the Senate in 2003 by Senators Olympia Snowe and Kent Conrad, who were joined by Senators Susan Collins and Ron Wyden, to address this problem by allowing Federal Medicaid matching payments to freestanding psychiatric hospitals for emergency psychiatric cases. In 2010, based on this legislation, Congress authorized a three-year demonstration that was intended to expand the number of emergency inpatient psychiatric beds available in communities. Currently, 11 States, including my State of Maryland, and the District of Columbia are participating in this demonstration. The purpose of the demonstration is to determine whether allowing Federal Medicaid matching payments to freestanding psychiatric hospitals for emergency psychiatric cases improves access to and quality of medically necessary care, improves discharge planning for demonstration beneficiaries, and has a positive impact on Medicaid cost and utilization. The preliminary data shows that, of the total number of Medicaid beneficiaries admitted to these freestanding psychiatric hospitals, 84 percent had just one admission during the entire first year of the demonstration. The average length of stay was a short 8.2 days and, in 88 percent of the admissions, the patients were discharged home. The current demonstration project would end no later than December 31, 2015; however, the final evaluation of this project by CMS is not expected to be completed until 1 year later, in the fall of 2016. The purpose of the bipartisan legislation we are introducing today is to allow the Secretary of Health and Human Services to continue the current demonstration project until the Secretary submits a report to Congress with her recommendations, based on the final evaluation, regarding whether the current demonstration should be extended for an additional 3 years and whether additional States should be allowed to participate in the demonstration, or September 30, 2016, whichever occurs first. Importantly, in order to extend the current demonstration project until the report is submitted, the Secretary must determine that overall Medicaid spending in the participating state is not expected to increase during the extension of the demonstration project for a maximum of nine months, and the Chief Actuary of CMS must also certify that the extension is not projected to result in an increase in net Medicaid program spending. If, in her report, the Secretary recommends extending the demonstration project for an additional three years and/ or expanding it to include other States, the same requirements regarding Medicaid spending would need to be met, ensuring budget neutrality. At the completion of those additional 3 years, the demonstration project would come to a close unless Congress passes authorizing legislation to continue and/or expand the demonstration project. We have a real crisis in this country for millions of Americans who cannot get timely access to life-saving emergency inpatient psychiatric treatment. The Medicaid program is a vital source of support for people with mental disorders, funding more than 50 percent of state and local spending on mental health services. This outdated IMD policy is penalizing the disabled and poor. It is also contributing to inefficiencies in our health care system and likely adding to the cost of care. The legislation introducing today would help ensure that the neediest have access to hospital care when they need it and strengthen our Nation's health care system. It is an incremental, targeted approach with built-in cost safeguards, so I hope my colleagues will join with me to support this legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CARDIN. Mr. President, I rise in support of the bipartisan Chronic Kidney Disease Improvement in Research and Treatment Act of 2015, which I am introducing with Senators Crapo and Nelson today. This legislation seeks to make a real difference in the lives of Americans suffering from kidney disease and end-stage renal disease. Kidney disease is the 9th leading cause of death in the United States, and unfortunately, more than one in ten Americans today suffer from some form of kidney disease. More than 615,000 Americans are living with kidney failure or end-stage renal disease, which is an irreversible condition that can be fatal without a kidney transplant or life-sustaining dialysis. 430,000 patients in our country rely on life- sustaining dialysis care to survive. This legislation seeks to promote research, expand patient choice, and improve care coordination for these hundreds of thousands of patients. Specifically, it would identify the gaps in research and improve the coordination of Federal research efforts. The bill would require the Government Accountability Office to submit a comprehensive report analyzing current federally funded research projects regarding chronic kidney disease and identifying knowledge gaps that are not being addressed through those research efforts. It would also direct the Department of Health and Human Services to evaluate and report on the biological, social, and behavioral factors related to kidney disease and efforts to slow the progression of disease in minority populations disproportionately affected by this disease. This legislation would improve access to pre-dialysis kidney education programs to better manage patients' kidney disease and even prevent kidney failure in some cases. Nephrologists and other health professionals would be incentivized to work in underserved rural and urban areas, and current payment policies would be modified to encourage home dialysis, which is not incentivized under the current Medicare payment structure. Patients with acute kidney injury would also be allowed to receive treatments through dialysis providers, therefore reducing costs associated with care provided in the more expensive hospital outpatient setting. Perhaps most importantly, our legislation would establish a voluntary coordinated care program that would incentivize doctors and dialysis facilities to work together to improve the coordination of care and reduce costly hospitalization. Lastly, the bill would expand the options for patients by allowing individuals diagnosed with kidney failure to enroll in the Medicare Advantage program and reauthorizing on a permanent basis the Medicare Advantage Special Needs Plan for patients with kidney failure. I urge my colleagues to join me, Senator Crapo and Senator Nelson in supporting the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015, which will improve the care of patients who suffer from kidney disease and end-stage renal disease. 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:

Mr. CARDIN

Mr. CARDIN. Mr. President, I rise in support of the bipartisan Chronic Kidney Disease Improvement in Research and Treatment Act of 2015, which I am introducing with Senators Crapo and Nelson today. This legislation seeks to make a real difference in the lives of Americans suffering from kidney disease and end-stage renal disease. Kidney disease is the 9th leading cause of death in the United States, and unfortunately, more than one in ten Americans today suffer from some form of kidney disease. More than 615,000 Americans are living with kidney failure or end-stage renal disease, which is an irreversible condition that can be fatal without a kidney transplant or life-sustaining dialysis. 430,000 patients in our country rely on life- sustaining dialysis care to survive. This legislation seeks to promote research, expand patient choice, and improve care coordination for these hundreds of thousands of patients. Specifically, it would identify the gaps in research and improve the coordination of Federal research efforts. The bill would require the Government Accountability Office to submit a comprehensive report analyzing current federally funded research projects regarding chronic kidney disease and identifying knowledge gaps that are not being addressed through those research efforts. It would also direct the Department of Health and Human Services to evaluate and report on the biological, social, and behavioral factors related to kidney disease and efforts to slow the progression of disease in minority populations disproportionately affected by this disease. This legislation would improve access to pre-dialysis kidney education programs to better manage patients' kidney disease and even prevent kidney failure in some cases. Nephrologists and other health professionals would be incentivized to work in underserved rural and urban areas, and current payment policies would be modified to encourage home dialysis, which is not incentivized under the current Medicare payment structure. Patients with acute kidney injury would also be allowed to receive treatments through dialysis providers, therefore reducing costs associated with care provided in the more expensive hospital outpatient setting. Perhaps most importantly, our legislation would establish a voluntary coordinated care program that would incentivize doctors and dialysis facilities to work together to improve the coordination of care and reduce costly hospitalization. Lastly, the bill would expand the options for patients by allowing individuals diagnosed with kidney failure to enroll in the Medicare Advantage program and reauthorizing on a permanent basis the Medicare Advantage Special Needs Plan for patients with kidney failure. I urge my colleagues to join me, Senator Crapo and Senator Nelson in supporting the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015, which will improve the care of patients who suffer from kidney disease and end-stage renal disease. 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:

Mr. CARDIN

Mr. CARDIN. Mr. President, today Senators Toomey and Collins and I are introducing the Improving Access to Emergency Psychiatric Care Act of 2015, which will build on the current 3-year Medicaid Emergency Psychiatric Demonstration Project to provide timely and cost-effective treatment to people who are experiencing an emergency psychiatric crisis. We know that emergency psychiatric care delivered in general hospitals and freestanding psychiatric hospitals is a life-saving service for individuals with severe mental illnesses. In addition, a Government Accountability Office report, GAO-09-347, on hospital emergency departments concluded the difficulties in transferring, admitting, or discharging psychiatric patients from the emergency department contribute to overcrowding in our Nation's emergency rooms. Community-based psychiatric hospitals, like Sheppard Pratt Health System in my home State of Maryland, could help relieve these back-ups in emergency departments; however, due to a longstanding Medicaid statutory provision called the Institution for Mental Disease, IMD, exclusion, patients receiving care in these freestanding psychiatric hospitals are not covered if the patients are between the ages of 21 and 64, and the hospitals cannot get Medicaid Federal matching payments for these services. In response to this problem, bipartisan legislation was first introduced in the Senate in 2003 by Senators Olympia Snowe and Kent Conrad, who were joined by Senators Susan Collins and Ron Wyden, to address this problem by allowing Federal Medicaid matching payments to freestanding psychiatric hospitals for emergency psychiatric cases. In 2010, based on this legislation, Congress authorized a three-year demonstration that was intended to expand the number of emergency inpatient psychiatric beds available in communities. Currently, 11 States, including my State of Maryland, and the District of Columbia are participating in this demonstration. The purpose of the demonstration is to determine whether allowing Federal Medicaid matching payments to freestanding psychiatric hospitals for emergency psychiatric cases improves access to and quality of medically necessary care, improves discharge planning for demonstration beneficiaries, and has a positive impact on Medicaid cost and utilization. The preliminary data shows that, of the total number of Medicaid beneficiaries admitted to these freestanding psychiatric hospitals, 84 percent had just one admission during the entire first year of the demonstration. The average length of stay was a short 8.2 days and, in 88 percent of the admissions, the patients were discharged home. The current demonstration project would end no later than December 31, 2015; however, the final evaluation of this project by CMS is not expected to be completed until 1 year later, in the fall of 2016. The purpose of the bipartisan legislation we are introducing today is to allow the Secretary of Health and Human Services to continue the current demonstration project until the Secretary submits a report to Congress with her recommendations, based on the final evaluation, regarding whether the current demonstration should be extended for an additional 3 years and whether additional States should be allowed to participate in the demonstration, or September 30, 2016, whichever occurs first. Importantly, in order to extend the current demonstration project until the report is submitted, the Secretary must determine that overall Medicaid spending in the participating state is not expected to increase during the extension of the demonstration project for a maximum of nine months, and the Chief Actuary of CMS must also certify that the extension is not projected to result in an increase in net Medicaid program spending. If, in her report, the Secretary recommends extending the demonstration project for an additional three years and/ or expanding it to include other States, the same requirements regarding Medicaid spending would need to be met, ensuring budget neutrality. At the completion of those additional 3 years, the demonstration project would come to a close unless Congress passes authorizing legislation to continue and/or expand the demonstration project. We have a real crisis in this country for millions of Americans who cannot get timely access to life-saving emergency inpatient psychiatric treatment. The Medicaid program is a vital source of support for people with mental disorders, funding more than 50 percent of state and local spending on mental health services. This outdated IMD policy is penalizing the disabled and poor. It is also contributing to inefficiencies in our health care system and likely adding to the cost of care. The legislation introducing today would help ensure that the neediest have access to hospital care when they need it and strengthen our Nation's health care system. It is an incremental, targeted approach with built-in cost safeguards, so I hope my colleagues will join with me to support this legislation. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. CARDIN

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.

Mr. CARDIN

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.

Mr. CARDIN

Mr. CARDIN. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.