Susan Collins

Ms. COLLINS

Ms. COLLINS. Mr. President, I ask unanimous consent that the following amendments be called up and reported by number: Senator Manchin's amendment No. 3553, Senator Paul's amendment No. 3543. I further ask consent that at 5:45 p.m. today, the Senate vote in relation to the Manchin and Paul amendments in the order listed and that there be no second-degree amendments in order to the amendments prior to the votes. Finally, I ask that there be 10 minutes, equally divided in the usual form, between the two votes.

Ms. COLLINS. Mr. President, I rise to urge my colleagues to oppose the amendment offered by the Senator from Kentucky. Make no mistake about what this amendment would do. It is an 11.4- percent, across-the-board, indiscriminate, meat-ax cut in important programs, and as the chairman of the Appropriations Committee has pointed out, it would violate the bipartisan agreement we just reached earlier this year. In addition, let me give you just one example of what the impact of Senator Paul's amendment would be. If you look at the section 8 housing program, which helps some of our most vulnerable citizens, this amendment's passage would mean that 275,000 low-income seniors, disabled individuals, homeless veterans, and families with small children would lose their housing assistance and become at risk of homelessness. I don't think that is what we want. Thank you.

Ms. COLLINS

Ms. COLLINS. Mr. President, in 1959, a new summer playhouse opened in Brunswick, ME, with a performance of the popular operetta ``Song of Norway.'' In 2018, the Maine State Music Theater presents its 60th season with professional productions that range from ``Singin' in the Rain'' to ``Saturday Night Fever.'' It is a pleasure to congratulate Maine State Music Theater on this landmark anniversary and to thank the casts, crews, supporters, and volunteers who, for six decades, have delighted audiences and enriched the cultural life of our State. The oldest professional musical theater in Maine, Maine State Music Theater was founded by Victoria Crandall, a truly remarkable entrepreneur and artist. Born in Cleveland, she studied piano at the prestigious Eastman School of Music, toured with the USO during World War II, and was an accompanist for such show business legends as Ethel Merman and Jimmy Durante. After working in theatrical productions on Broadway, Ms. Crandall struck out on her own in 1959 to pursue her dream of establishing her own theater company and chose the Bowdoin College campus in Brunswick as the place to make her dream come true. Rejecting the prepackaged shows often used in summer theaters, she presented originally designed productions--as many as nine per season--that earned rave reviews from audiences and critics alike. Ms. Crandall passed away in 1990 at the age of 81 while in New York City casting roles for that year's season. At the time of her death, she had staged 186 productions in Brunswick that were seen by more than 1.5 million people. Ms. Crandall's legacy is carried on by accomplished performers and technical personnel, many of whom have gone on to achieve success on Broadway and in Hollywood. With dedicated management and strong community support, Maine State Music Theater has expanded its offerings to children's programs, outdoor concerts, film and lecture series, and an educational fellowship program for those developing careers in the theater. The 2017 season set a new record for attendance, with more than 95 percent of the house sold for the four main productions. Maine State Music Theater is a true gem of the Maine arts scene and a highlight of the State's glorious summers. I offer the company all the best on this 60th anniversary and wish them great success for many years to come.

Ms. COLLINS

Ms. COLLINS. Madam President, I am pleased to begin the Senate debate on the fiscal year 2019 appropriations bill for Transportation, Housing and Urban Development, and Related Agencies. Our bill has been included in the appropriations package now before this Chamber. Let me begin my remarks this morning by thanking Chairman Shelby and Vice Chairman Leahy for their leadership in advancing these appropriations bills in record time. It is great to see the Senate getting back to regular order in moving the appropriations bills across the Senate floor, allowing for robust debate and amendment, and then bringing those bills to conference with our House counterparts. That is the way the system should work, as opposed to all of these bills being bundled together in an enormous, many thousand-page omnibus appropriations bill. I am very pleased to see the progress that we are making. I also want to acknowledge the hard work and commitment of my friend and colleague Senator Jack Reed, who serves as the ranking member of the T-HUD Subcommittee. I have worked very closely with Senator Reed in drafting this bill. We have also received input from more than 70 Senators, with in excess of 800 requests, each of which we very carefully evaluated. So I can assure this Chamber that this legislation is truly bipartisan. The T-HUD bill provides $71.4 billion for our Nation's critical infrastructure and housing programs. This bill continues the significant infrastructure investments provided in fiscal year 2018 for our Nation's highways, bridges, airports, transit, and rail networks. As a result, communities across this country will be able to improve their transportation infrastructure to enable more efficient and safer movement of people and goods. Improving our infrastructure is essential for our continued economic growth as well as for personal mobility. The fiscal year 2019 T-HUD bill continues the increases for infrastructure programs resulting from the 2-year budget agreement that was reached by Congress and the administration. I would note, however, that the budget agreement does not provide for the long-term funding structure necessary for our Nation's transportation infrastructure. I want to strongly encourage the administration to work with the authorizing committees to provide that long-term, sustainable funding for transportation before the FAST Act expires at the end of fiscal year 2020. Our bill provides $1 billion for BUILD grants, previously known as the popular TIGER grants program. These grants have supported not only much needed infrastructure projects but also jobs and economic growth in each and every one of our home States. I want to provide my colleagues with an indication of just how popular this program is and how strong the demand is. In the 2017 round of TIGER grant applications, the Department of Transportation received 452 applications requesting more than $6 billion, well above the $500 million provided last year, which could fund only 41 projects. You can see that the demand far exceeds the amount of funding. So we are taking action in this bill to double the funding for BUILD grants. That will help many more projects become a reality. I have seen in my own State the investments in bridges, ports, and transportation projects that have made such a difference. I would now like to turn to the aviation provisions in our bill. We provide $17.7 billion in budgetary resources for the Federal Aviation Administration, or the FAA, which fully funds air traffic control personnel, including more than 14,000 air traffic controllers and more than 25,000 engineers, maintenance technicians, safety inspectors, and operational support personnel. The bill also provides $1 billion for the FAA Next Generation Air Transportation Systems Program, also known as NextGen, and $168 million for the popular Contract Towers Program. The NextGen Program is so important to the modernization of our air traffic control system, and we have consistently funded that program, and it is being implemented in a way that is going to make a real difference. Consistent with the FAST Act, $46 billion is made available for the Federal-Aid Highway Program from the highway trust fund. In addition, the bill provides $3.3 billion from the general fund for our Nation's highways, of which $800 million is for bridge replacement and rehabilitation in rural areas of our country. The American Society of Civil Engineers conducts a comprehensive assessment of our Nation's infrastructure every 4 years. Its most recent report card from 2017 shows that America's infrastructure remains poor and in desperate need of investment. In fact, the engineers award a grade of only D-plus for our Nation's infrastructure. To give you some statistics to emphasize why we are receiving such a low grade, let me talk about our Nation's bridges. One in nine of our Nation's bridges is rated as structurally deficient, and the average age of our country's more than 600,000 bridges is 42 years old. Our national highway system contains infrastructure that is now well past its useful life. Some bridges are more than 100 years old, and many are unable to accommodate today's traffic volumes. I was recently in Piscataquis County, where a TIGER Grant Program was allowing the replacement of some very old rural bridges. The amount of rust on these bridges and the narrow width made them extraordinarily dangerous. They were at risk of being posted so that traffic could go across only in one direction. When you looked up at the trusses, you could see where trucks loaded with lumber had dented the trusses because they were far too low. They were built for a different era. It is important for safety reasons--as we have seen with bridges collapsing in this country or having to be posted--that we make this kind of investment. Our bill also invests in our Nation's rail infrastructure by providing $2.8 billion for the Federal Railroad Administration. This includes $1.9 billion to Amtrak for the Northeast Corridor and National Network, continuing service for all current routes. In May, our subcommittee held a hearing in response to serious rail accidents, such as the tragic derailment last December in Washington State. Our bill continues to fund positive train control implementation to improve the safety of our trains. In addition, the bill provides $255 million for the Consolidated Rail Infrastructure and Safety Improvement Grants Program and $300 million for the Federal-State partnership for the State of Good Repair Grants Program. These investments in rail will help ensure that both passengers and freight move more safely and efficiently throughout our country. The State maritime academies play a critical role in training the next generation of U.S. mariners. Our bill provides $40 million for the maritime academies as well as an additional $300 million for a special purpose vessel to be used as a training school ship. In accordance with MARAD's guidance, the new training ships will go to replace existing training ships in the order in which these ships are expected to reach the end of their useful life. That is the only logical way for us to proceed. Last year, we appropriated funds to replace the 57-year-old ship used by the New York State maritime academy, and this year's funding will go to replace the Massachusetts Maritime Academy's aging vessel. Again, we are going in the order that the Maritime Administration tells us these ships will be at the end of their useful life. It would be great to be able to replace all of the ships at the same time, but we simply can't afford to do that, and that is where prioritizing the ships as the agency recommends comes in. Replacing these ships is, however, important to providing training capacity for all six of the State maritime academies, including the one that I am very proud of, the Maine Maritime Academy in Castine, Maine. It will ensure that cadets receive the training hours they need to graduate on time and join the workforce. In the area of housing, our priority is to ensure that our Nation's most vulnerable families and individuals do not lose the assistance they are now receiving, which prevents many of them from being at risk of homelessness. Therefore, the bill provides the necessary funding to keep pace with the rising costs of housing these families in order to avoid their becoming homeless. Much of the increased funding covers the higher costs of rental assistance for the most vulnerable among us, including our homeless veterans, our youth, our disabled citizens, and low-income seniors. Senator Reed and I share a strong commitment to reducing, and someday ending, homelessness. We have therefore included $2.6 billion for homeless assistance grants. We have also made critical investments to reduce homelessness among our veterans, our youth, and survivors of domestic violence. Specifically, to assist our homeless youth, we have provided $80 million for grants targeting this underserved population. I visited a wonderful youth shelter in Lewiston, ME, called New Beginnings. I was so impressed with the work they were doing with teenagers, in particular, many of whom had been exiled from their homes--as much as I hate to say it--or abused or otherwise found themselves homeless. Because of the safety of this shelter, they were continuing their schooling, they were learning life skills, and they were safe. Yet, I will tell you, this is the only shelter in the State of Maine that is devoted solely to the needs of homeless youth. There is such a need in this country. There are other shelters that try to accommodate young people in the State of Maine and are doing their best, but this is an area where we need to provide more assistance. To better support youth who are exiting the foster care system, the bill includes $20 million for family unification vouchers. That is the real gap in our system. What happens--and I know that many Members share my concern--is young people ``age out'' of the foster care program, and they may have nowhere safe to go. For our Nation's senior population, many of our seniors receive section 8 housing, but our bill also includes $678 million for housing for older Americans. Of this amount, $10 million will provide grants to nonprofit and State and local entities to do home modifications for low-income seniors, enabling them to stay in their own homes and to age in place. I am very excited about this program because of hearings I have held in the Senate Aging Committee, which I am privileged to chair. What we have learned is, oftentimes, upgrading and putting grab bars in a bathroom, widening door openings, putting sensors on the refrigerator door--doing modifications like that can allow our seniors to stay where they want to be, in the comfort, security, and privacy of their own homes. Not only will these low-cost home modifications enable seniors to remain in their homes, but they also reduce the need for more costly nursing homes and other assisted housing options. For our Nation's homeless veterans, the bill provides $45 million for the highly successful HUD-VASH Program, including $5 million to serve our Native American veterans living on Tribal lands. Despite the administration, once again, proposing to eliminate this effective program, the subcommittee continues to provide adequate funding. This program is a real success story. Since we initiated it in 2010, veterans homelessness has fallen by 46 percent. Let's continue our work to reach the goal of ending homelessness altogether among our veterans. Another important issue--and a passion of our ranking member, Senator Reed, and I--that is addressed by the bill is lead paint in homes, which is of particular concern to families with children under the age of 6. Our bill provides $260 million to combat lead hazards. These grants will help communities protect children from the harmful effects of lead poisoning. Again, I have seen this in my home State. Lewiston, ME, our second largest city, has very old housing stock, and it has a great deal of lead paint. Grants are helping this city deal with this problem, thus improving the health and safety of pregnant women and young children and avoiding disability and developmental problems for those young children. These grants will help communities across America protect children from the harmful effects of lead poisoning. While our bill certainly helps vulnerable families, it also recognizes the challenges facing local communities. Boosting local communities is critical to job creation and helping our community neighborhoods thrive and our families obtain financial security. The bill supports local development efforts by providing $3.3 billion through the Community Development Block Grant Program. That is one of the most popular programs we provide. If you talk to any mayor or town council, they will tell you how flexible the CDBG Program is and how, as the mayor in Maine with whom I recently met told me, it helps them customize the funding to meet the program needs of their communities. It may be infrastructure. It may be affordable housing. It may be sprucing up the downtown. It may be supporting local businesses. This is a great program. It is not a Washington dictated program. It is one that responds to local needs. We also provide $1.4 billion for the HOME Program. The CDBG and the HOME Program support the development of infrastructure projects, community development, affordable housing, economic development, and job creation. I appreciate the opportunity to present this legislation to the Chamber. As we begin debate on the Transportation-HUD bill, I urge my colleagues to support the investments in this bill, which will pay dividends to our communities, our veterans, our children, our low- income families, and our seniors. Our bill was unanimously reported by the Senate Appropriations Committee. We are certainly open for business for amendments. I commend my friend and colleague Senator Reed for his hard work and for that of our staffs on both sides of the aisle in crafting this bill. I yield the floor.

Ms. COLLINS. I suggest the absence of a quorum.

Ms. COLLINS. Mr. President, I suggest the absence of a quorum.

Ms. COLLINS. Mr. President, before the two Senators from Missouri leave the floor, let me express my personal condolences to them, which I know are shared by each and every Member of this body. The tragedy in Missouri is absolutely heartbreaking for the families, for the community, and for the State, and I want our two colleagues from Missouri to know that we stand with them during this very difficult time. Amendments Nos. 3405 and 3422 to Amendment No. 3399

Ms. COLLINS. Mr. President, I ask unanimous consent that the following amendments be called up en bloc: Heller amendment No. 3405 and Durbin amendment No. 3422. I further ask consent that at 2:15 p.m. today, there be 5 minutes of debate, equally divided in the usual form, and that following the use or yielding back of that time, the Senate vote in relation to the Heller and Durbin amendments in the order listed and that there be no second-degree amendments in order to the amendments prior to the votes.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise in support of Senator Durbin and Senator Wicker's amendment. It would direct the Amtrak inspector general to update a report from 10 years ago that examined Amtrak's on- time performance. Some Amtrak routes, particularly along Amtrak's national network, are experiencing frequent delays, which makes train travel a less dependable option and discourages ridership. Ten years ago, the IG report found that the delays were the result of host railroad dispatching practices, track maintenance, speed restrictions, insufficient track capacity, and, often, external factors beyond the host railroad's control. The information that the Amtrak IG will collect in this report will be used to identify ways to improve coordination between Amtrak and the freight railroads. I commend the authors for their amendment, and I urge my colleagues to support it. Vote on Amendment No. 3405

Ms. COLLINS. I ask for the yeas and nays.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise to speak on my resolution supporting the goals and ideals of National Purple Heart Recognition Day. I am pleased to have been joined in sponsoring this resolution by the senior senator from West Virginia, Senator Manchin, and 22 of our Senate colleagues. The Purple Heart's history goes as far back as the founding of our Nation. General George Washington established what is now known as the Purple Heart Medal when he issued an order establishing the Military Badge of Merit on August 7, 1782. General Washington wished for the award to be used to recognize meritorious action performed by members of the Continental Army, and it took the form of a purple heart. The Military Badge of Merit was discontinued after the Revolution and was not revived until 1932, when the Purple Heart medal was authorized as its official successor decoration. On February 22, 1932, the 200th Anniversary of the birth of George Washington, then-Army Chief of Staff General Douglas MacArthur resurrected the award, and it was re- designated as the Purple Heart. Quite appropriately, this reestablished Purple Heart Medal exhibits the bust and profile of George Washington. It is around this time that the Purple Heart became synonymous with those unfortunate heroes who were killed or wounded in combat. Since 1932, the U.S. Military has awarded more than 1.8 million Purple Hearts. Just as the Purple Heart Medal has held a special meaning to its millions of recipients and their families, it also has special significance to me and my family. My father, who died earlier this year, was a proud World War II veteran who was wounded twice during the Battle of the Bulge. He earned two Purple Hearts and the Bronze Star, and it was from him that I first learned to honor and respect our veterans. Mr. President, the Purple Heart is a reminder that freedom is a gift purchased at the greatest possible price, and it is for that reason that I am sponsoring this resolution supporting the goals and ideals of National Purple Heart Recognition Day. I believe it is vitally important for all Americans to learn the history of this important military award, and to understand and honor the sacrifices of the many men and women in uniform who have earned the Purple Heart. I am grateful to all of my colleagues who have joined me in supporting this important resolution.

Ms. COLLINS

Ms. COLLINS. Mr. President, Ensuring that more Americans are better prepared financially for retirement is one of my top priorities. That is why I rise today to introduce the SIMPLE Plan Modernization Act with my colleague from Virginia, Senator Mark Warner. Our legislation will provide greater flexibility and access to both employees and their employers seeking to utilize the popular SIMPLE plans as an option for saving for retirement. According to the non-partisan Center for Retirement Research, there is an estimated $7.7 trillion gap between the savings American households need to maintain their standard of living in retirement and what they actually have. A recent Gallup poll found that only 51 percent of working Americans believe that they will have enough money to live comfortably in retirement. Though this is the highest percentage of confidence in nearly a decade, we must continue to work to ensure that even more Americans will have the resources they need to enjoy their ``golden years.'' Another contributing factor is that employees of small businesses are much less likely to participate in employer-based retirement plans. According to a study by the PEW Charitable Trusts, roughly 30 million U.S. private-sector full-time workers continue to lack access to a work-based plan to save for retirement. SIMPLE retirement plans were established in 1996 to encourage small businesses to provide their employees with retirement plans that are less costly and easier to navigate. A business with 100 or fewer employees can create a SIMPLE retirement savings account so long as it does not offer another employer-sponsored retirement plan. The SIMPLE Plan Modernization Act would help to expand access to SIMPLE plans by increasing the contribution limit for most small businesses. This would achieve two important goals, Mr. President: first, it would encourage more small businesses to offer a retirement savings benefit to their employees; and second, it would allow employees of small businesses to save even more for retirement each year on a tax-deferred basis. This legislation is a win-win proposition for retirement security. There are many small employers that simply cannot afford a 401(k) plan. For them, this legislation would provide enhanced savings opportunities. At the same time, the legislation is carefully constructed to prevent employers with a 401(k) plan from dropping that plan to adopt a SIMPLE plan. And the legislation preserves strong incentives for small businesses that become more successful to move from a SIMPLE plan to a 401(k) plan. We believe our approach will encourage businesses and their employees to take steps to save for retirement, and eventually move towards a more substantial retirement package, like a 401(k) plan. In my home state of Maine, the vast majority of businesses are eligible to sign their employees up for SIMPLE Plans. Financial advisors from Presque Isle to Portland have shared their concerns that neither employees nor their employers are in a good position to save for retirement. We must give small businesses and employees a better opportunity to save for retirement and this legislation will provide such an opportunity. I urge my colleagues to join Senator Warner and me in supporting the SIMPLE Plan Modernization Act. Thank you, Mr. President.

Ms. COLLINS

Ms. COLLINS. Mr. President, Ensuring that more Americans are better prepared financially for retirement is one of my top priorities. That is why I rise today to introduce the SIMPLE Plan Modernization Act with my colleague from Virginia, Senator Mark Warner. Our legislation will provide greater flexibility and access to both employees and their employers seeking to utilize the popular SIMPLE plans as an option for saving for retirement. According to the non-partisan Center for Retirement Research, there is an estimated $7.7 trillion gap between the savings American households need to maintain their standard of living in retirement and what they actually have. A recent Gallup poll found that only 51 percent of working Americans believe that they will have enough money to live comfortably in retirement. Though this is the highest percentage of confidence in nearly a decade, we must continue to work to ensure that even more Americans will have the resources they need to enjoy their ``golden years.'' Another contributing factor is that employees of small businesses are much less likely to participate in employer-based retirement plans. According to a study by the PEW Charitable Trusts, roughly 30 million U.S. private-sector full-time workers continue to lack access to a work-based plan to save for retirement. SIMPLE retirement plans were established in 1996 to encourage small businesses to provide their employees with retirement plans that are less costly and easier to navigate. A business with 100 or fewer employees can create a SIMPLE retirement savings account so long as it does not offer another employer-sponsored retirement plan. The SIMPLE Plan Modernization Act would help to expand access to SIMPLE plans by increasing the contribution limit for most small businesses. This would achieve two important goals, Mr. President: first, it would encourage more small businesses to offer a retirement savings benefit to their employees; and second, it would allow employees of small businesses to save even more for retirement each year on a tax-deferred basis. This legislation is a win-win proposition for retirement security. There are many small employers that simply cannot afford a 401(k) plan. For them, this legislation would provide enhanced savings opportunities. At the same time, the legislation is carefully constructed to prevent employers with a 401(k) plan from dropping that plan to adopt a SIMPLE plan. And the legislation preserves strong incentives for small businesses that become more successful to move from a SIMPLE plan to a 401(k) plan. We believe our approach will encourage businesses and their employees to take steps to save for retirement, and eventually move towards a more substantial retirement package, like a 401(k) plan. In my home state of Maine, the vast majority of businesses are eligible to sign their employees up for SIMPLE Plans. Financial advisors from Presque Isle to Portland have shared their concerns that neither employees nor their employers are in a good position to save for retirement. We must give small businesses and employees a better opportunity to save for retirement and this legislation will provide such an opportunity. I urge my colleagues to join Senator Warner and me in supporting the SIMPLE Plan Modernization Act. Thank you, Mr. President.

Ms. COLLINS

Ms. COLLINS. Mr President, I am pleased to introduce with my colleague from Alabama, Senator Jones, the Taxpayer Identity Protection Act of 2018, a bill that seeks to help prevent American taxpayers and seniors from falling victim to identity theft and tax refund fraud. As of May 17, the IRS had received more than 141.5 million individual income tax returns for the 2018 filing season. Of that number, nearly 75 percent were eligible for refunds. These refunds are not a gift from the Federal government--they are the return of funds belonging to taxpayers that were over-withheld from their paychecks last year. In the past few months, millions of American families have been eagerly awaiting these tax refunds, money they may need to pay off debts, medical bills, and plug gaps in the family budget. Unfortunately, for many Americans these refunds have not yet come. Taxpayers are not the only ones eagerly awaiting these refunds. Criminals have figured out that, in many instances, it is cheaper and easier for them to steal taxpayers' identities and hijack their tax refunds than it is to traffic in drugs or rob banks. Identity theft-refund fraud occurs when a criminal files a false tax return using a stolen Social Security Number and other sensitive personal information from sources like hospitals, schools, or assisted living facilities, often by recruiting employees to steal that information. The fraudster then uses this information to prepare fraudulent tax returns. The thieves make sure to file early, as soon as the tax filing season opens in January, to increase the odds that they can get a refund before the real taxpayer files his or her return. The criminals are known to hold what they call ``make it rain parties,'' where they bring stolen laptops to a motel room with Internet access, and work together churning-out scores of fake returns. These fraudsters work under the premise of ``file early, file often.'' Once the thieves file the fraudulent tax return, the IRS processes it and issues a refund. With each refund worth on average $2,778, the money can add up quickly. This is not a victimless crime. Last year, the Federal Trade Commission received more than 371,000 complaints of identity theft, including 82,000 complaints related to employment or tax-refund fraud. Taxpayers who have their refunds hijacked by fraudsters often have to wait years to get the refunds to which they are legally entitled. Many are re-victimized year after year. A substantial number become victims of other forms of identity theft. Worst of all, victims are often the most vulnerable: elderly citizens who earn so little they are not even required to file a tax return. The IG estimates that 76,000 low-income elderly citizens were victims of tax-fraud identity theft in 2010 alone. In 2016, the Lewiston Sun Journal published a story about a couple, Rick Zaccaro and his wife, Bonnie Washuk, who were victims of tax refund fraud. They had filed their taxes in late January 2015, and when Rick, a retired financial analyst for the Postal Service, was checking the status of their return online in early February, he learned that they were the victims of identity theft. Someone had filed and claimed a tax refund using their names, dates of birth, and Social Security Numbers. That claim was paid while their legitimate tax filing, with their appropriate W2s, was in limbo. It took months of worrying, frozen bank accounts, and a lot of calls to multiple government offices for them to try and straighten things out. When they did finally receive their refund, they also received something called an Identity Protection Personal Identification Number--better known as an IP PIN. To provide relief to some victims of identity theft, the IRS began issuing IP PINs to eligible taxpayers in fiscal year 2011. An IP PIN is a six-digit number assigned to eligible taxpayers that allows their tax returns and refunds to be processed without delay and helps prevent the misuse of their Social Security Numbers on fraudulent income tax returns. If a return is e-filed with their Social Security Number and an incorrect or missing IP PIN, the IRS's system automatically rejects the tax return until it is submitted with the correct IP PIN or they file on paper. If the same conditions occur on a paper-filed return, the IRS will delay its processing and any refund that may be due while the IRS determines if the return actually belongs to the taxpayer. In addition to victims of identity theft, in 2013, the IRS began a pilot program in which it offered IP PINs to all taxpayers, not just those who were victims of identity theft, who filed their federal tax returns as residents of Florida, Georgia, or the District of Columbia. According to the IRS, these three locations have the highest per-capita percentage of tax-related identity theft in the country. Taxpayers in these three jurisdictions are not required to use an IP PIN but may opt-in to the program if they want the extra layer of identity protection. In preparation for the 2018 Filing Season, the IRS issued nearly 3.5 million IP PINs to taxpayers, up from 770,000 in 2013. According to the IRS, as of February 28, 2018, it had rejected approximately 7,376 fraudulent e-filed tax returns, and as of March 15, 2018, it had stopped 1,442 paper-filed tax returns from posting to the Master File. The Taxpayer Identity Protection Act of 2018 would expand and make permanent the IRS's IP PIN pilot program to help combat identity theft refund fraud across the nation. Specifically, our bill would authorize the IRS to incrementally expand its pilot program nationally, in phases, over a five-year period. Scaling out the program would give all taxpayers the opportunity to further protect themselves from falling victim to tax refund fraud and identity theft, while also saving taxpayers billions of dollars every year. The IP PIN pilot program has worked to protect against identity theft and the IRS supports its expansion over the next five-years. I urge my colleagues on both sides of the aisle to support the adoption of Taxpayer Identity Protection Act of 2018.

Ms. COLLINS

Ms. COLLINS. Mr President, I am pleased to introduce with my colleague from Alabama, Senator Jones, the Taxpayer Identity Protection Act of 2018, a bill that seeks to help prevent American taxpayers and seniors from falling victim to identity theft and tax refund fraud. As of May 17, the IRS had received more than 141.5 million individual income tax returns for the 2018 filing season. Of that number, nearly 75 percent were eligible for refunds. These refunds are not a gift from the Federal government--they are the return of funds belonging to taxpayers that were over-withheld from their paychecks last year. In the past few months, millions of American families have been eagerly awaiting these tax refunds, money they may need to pay off debts, medical bills, and plug gaps in the family budget. Unfortunately, for many Americans these refunds have not yet come. Taxpayers are not the only ones eagerly awaiting these refunds. Criminals have figured out that, in many instances, it is cheaper and easier for them to steal taxpayers' identities and hijack their tax refunds than it is to traffic in drugs or rob banks. Identity theft-refund fraud occurs when a criminal files a false tax return using a stolen Social Security Number and other sensitive personal information from sources like hospitals, schools, or assisted living facilities, often by recruiting employees to steal that information. The fraudster then uses this information to prepare fraudulent tax returns. The thieves make sure to file early, as soon as the tax filing season opens in January, to increase the odds that they can get a refund before the real taxpayer files his or her return. The criminals are known to hold what they call ``make it rain parties,'' where they bring stolen laptops to a motel room with Internet access, and work together churning-out scores of fake returns. These fraudsters work under the premise of ``file early, file often.'' Once the thieves file the fraudulent tax return, the IRS processes it and issues a refund. With each refund worth on average $2,778, the money can add up quickly. This is not a victimless crime. Last year, the Federal Trade Commission received more than 371,000 complaints of identity theft, including 82,000 complaints related to employment or tax-refund fraud. Taxpayers who have their refunds hijacked by fraudsters often have to wait years to get the refunds to which they are legally entitled. Many are re-victimized year after year. A substantial number become victims of other forms of identity theft. Worst of all, victims are often the most vulnerable: elderly citizens who earn so little they are not even required to file a tax return. The IG estimates that 76,000 low-income elderly citizens were victims of tax-fraud identity theft in 2010 alone. In 2016, the Lewiston Sun Journal published a story about a couple, Rick Zaccaro and his wife, Bonnie Washuk, who were victims of tax refund fraud. They had filed their taxes in late January 2015, and when Rick, a retired financial analyst for the Postal Service, was checking the status of their return online in early February, he learned that they were the victims of identity theft. Someone had filed and claimed a tax refund using their names, dates of birth, and Social Security Numbers. That claim was paid while their legitimate tax filing, with their appropriate W2s, was in limbo. It took months of worrying, frozen bank accounts, and a lot of calls to multiple government offices for them to try and straighten things out. When they did finally receive their refund, they also received something called an Identity Protection Personal Identification Number--better known as an IP PIN. To provide relief to some victims of identity theft, the IRS began issuing IP PINs to eligible taxpayers in fiscal year 2011. An IP PIN is a six-digit number assigned to eligible taxpayers that allows their tax returns and refunds to be processed without delay and helps prevent the misuse of their Social Security Numbers on fraudulent income tax returns. If a return is e-filed with their Social Security Number and an incorrect or missing IP PIN, the IRS's system automatically rejects the tax return until it is submitted with the correct IP PIN or they file on paper. If the same conditions occur on a paper-filed return, the IRS will delay its processing and any refund that may be due while the IRS determines if the return actually belongs to the taxpayer. In addition to victims of identity theft, in 2013, the IRS began a pilot program in which it offered IP PINs to all taxpayers, not just those who were victims of identity theft, who filed their federal tax returns as residents of Florida, Georgia, or the District of Columbia. According to the IRS, these three locations have the highest per-capita percentage of tax-related identity theft in the country. Taxpayers in these three jurisdictions are not required to use an IP PIN but may opt-in to the program if they want the extra layer of identity protection. In preparation for the 2018 Filing Season, the IRS issued nearly 3.5 million IP PINs to taxpayers, up from 770,000 in 2013. According to the IRS, as of February 28, 2018, it had rejected approximately 7,376 fraudulent e-filed tax returns, and as of March 15, 2018, it had stopped 1,442 paper-filed tax returns from posting to the Master File. The Taxpayer Identity Protection Act of 2018 would expand and make permanent the IRS's IP PIN pilot program to help combat identity theft refund fraud across the nation. Specifically, our bill would authorize the IRS to incrementally expand its pilot program nationally, in phases, over a five-year period. Scaling out the program would give all taxpayers the opportunity to further protect themselves from falling victim to tax refund fraud and identity theft, while also saving taxpayers billions of dollars every year. The IP PIN pilot program has worked to protect against identity theft and the IRS supports its expansion over the next five-years. I urge my colleagues on both sides of the aisle to support the adoption of Taxpayer Identity Protection Act of 2018.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise to commend Agriculture Committee Chairman Roberts and Ranking Member Stabenow for their leadership in crafting a bipartisan farm bill that will help support our Nation's farmers and growers, provide funding for critical agriculture research programs, and make important investments in nutrition and food security programs. It is an exciting time for agriculture in Maine. In fact, according to a recent study, Maine ranks first in the Nation for farming outlook, which considers factors such as farmer age, percentage of beginning farmers, and number of farms per 100 residents. According to the most recent Census data, the share of Maine farms owned and operated by farmers under the age of 45 is steadily growing. These factors show that Maine farms are poised for continued growth and long-term success. The bill we have just passed includes a number of provisions from the Next Generation in Agriculture Act, which I introduced with Senator Heitkamp, including a reauthorization of the Beginning Farmer and Rancher Development Grant Program at a higher funding level. Since this program was established nearly a decade ago, it has supported more than 60,000 beginning farmers across every region of the country. In Maine, these grants have helped to build the capacity and skills of beginning farmers, as well as implement a dairy farmer apprenticeship program. Maine's agricultural resurgence has also been bolstered by a rapidly expanding organic sector. According to the Maine Organic Farmers and Gardeners Association, Maine's organic agriculture sector has grown 76 percent over the past 5 years alone. In 2017, the association certified 535 farmers and producers representing more than 90,000 acres of farmland. The strong support for organic agriculture in this bill will help ensure that this sector continues its growth. Federal investment in organic agriculture research, however, has not kept pace with the growth of organic producers. This bill incorporates legislation I introduced with Senator Casey that will increase funding for the Organic Agriculture Research and Extension Initiative, OREI. These additional resources will help ensure our farmers and producers benefit from the rising demand for organic products. In addition to experiencing a resurgence in agriculture, Maine is also in the midst of reorienting its forest products industry following the downturn of traditional pulp and paper production in our State. I am encouraged to see that the bill supports innovative wood products research and development at institutions of higher learning. Based on provisions of the Timber Innovation Act, which I have cosponsored, the bill would authorize grants to advance the use of innovative wood products. Priority would be given to proposals that include the use or retrofitting of existing sawmill facilities with higher-than-average unemployment rates, which could be helpful to States such as Maine that are still recovering from the job losses from the closure of traditional mills. An amendment that I sponsored with Senator Cantwell to direct the Forest Service to continue using remote sensing technologies when conducting forest inventory and analysis activities has also been incorporated. This technology is faster and less expensive thanphysically surveying plots of land and would enable the Forest Service to provide more accurate data to inform forest management decisions. The bill also includes a number of provisions from the Local FARMS Act, legislation that I led with Senator Brown. One key provision provides mandatory funding for the Organic Certification Cost-Share Program, which helps to cover a portion of the costs associated with obtaining or renewing organic certifications. Another component from our Local FARMS Act is the Local Agriculture Market Program, which will provide grants to support the development and expansion of direct producer-to-consumer marketing, as well as value-added agricultural products. The bill also includes important provisions that help combat hunger, including the Local FARMS Act's establishment of a Harvesting Health pilot program through which fresh fruits and vegetables are provided to low-income individuals and households, as well as the reauthorization of the Seniors Farmers' Market Nutrition Program. The latter program is critically important for combating hunger among seniors and is complemented by the Farm Bill's reauthorization of the Commodity Supplemental Food Program, also known as the Senior Food Box Program. In an effort to help more seniors access and remain enrolled in the Senior Food Box Program, I am pleased that the bill includes a provision from legislation I authored with Senator Casey, the Nourishing Our Golden Years Act, which would allow States to establish a 3-year certification period for participants 60 years or older, effectively simplifying the process to provide this much-needed support. The Specialty Crop Block Grant program that has been so vital for farmers and producers in my State is reauthorized for another 5 years. These grants support research and extension activities that address key challenges facing specialty crops, including Maine's iconic potatoes and lowbush blueberries, aiming to improve production efficiency, address threats from pests and diseases, more accurately prevent and monitor potential food safety hazards, and enhance crop characteristics. The bill also makes important investments to support the export of U.S. agricultural products by reauthorizing both the Market Access Program, MAP, and the Foreign Market Development Program, which are critical to the success of Maine farmers and fishermen as they work to remain competitive in the global marketplace. According to the Maine International Trade Center, MAP has allowed Maine companies to expand their markets and create more local jobs by facilitating the promotion and sale of Maine products like wild blueberries in the Middle East, maple syrup in Central Africa, and shellfish in the Far East. As we continue to promote products such as maple syrup abroad, we must also ensure that we are not hindering their success here at home. Pure maple sugar producers in my state have expressed serious concerns with the ``added sugar'' requirements in the FDA's updated nutrition facts label rule. The rule would require the label to state that all sugar in the product is ``added sugar.'' While the FDA intended for the rule to help consumers make better-informed dietary choices, it is clear that the Agency's proposal instead creates confusion. Producers believe that the term ``added sugar,'' when used with a single- ingredient sweetener such as pure maple syrup or honey, implies the addition of another sugar like corn syrup. I have raised this issue directly with FDA Commissioner Gottlieb, who is open to considering other approaches proposed by the industry, and have addressed it through language in the agriculture funding bill that directs FDA to evaluate alternate labeling proposals. Although I am encouraged to see that the FDA recently announced it would ``swiftly formulate a revised approach that makes key information available to consumers in a workable way,'' I have joined Senator King in offering an amendment to help ensure that this problem is rectified. Another reasonable reform I am pleased to see included is sponsored by Senator Grassley. It closes a loophole allowing an unlimited number of passive ``managers'' to be designated by farm entities for the purpose of collecting farm subsidies. These subsidies are intended to support workers who are truly ``actively engaged.'' This provision will save an estimated $211 million, $100 million of which will be reallocated to The Emergency Food Assistance Program, TEFAP, which supports food pantries around the country. It is a testament to the leadership of Chairman Roberts and Ranking Member Stabenow that they have produced a strongly bipartisan farm bill, and I am pleased to have supported it.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce legislation with my colleague from Ohio, Senator Sherrod Brown, that would remove an unnecessary, outdated barrier for Medicare beneficiaries managing diabetes. Our legislation would allow physician assistants (PAs) and nurse practitioners (NPs) to satisfy the Medicare documentation requirement certifying a patient's need for therapeutic, or diabetic, shoes, which will improve access to care, reduce barriers to proper diabetic management, and help to reduce the prevalence of costly complications that can arise if diabetic symptoms are not managed properly. This bipartisan bill, the Promoting Access to Diabetic Shoes Act, is a companion to H.R. 1617 from my fellow Diabetes Caucus Co- Chair, Representative Tom Reed of New York, which has growing support on both sides of the aisle in the House. As the founder and co-chair of the Senate Diabetes Caucus, I have worked since the very beginning of my Senate service to increase awareness of the threats posed by diabetes, invest in research, and improve access to treatment options for the over 30 million Americans, including twelve million seniors, who suffer from diabetes. In addition to the human toll, diabetes is also the most expensive chronic illness in the country. A new American Diabetes Association report released in March titled, ``Economic Costs of Diabetes in the U.S. in 2017,'' found that the direct and indirect costs of diagnosed diabetes in the U.S. cost $327 billion in 2017, which is a 26 percent increase in just the last five years. Preventable complications contribute enormously to the influx of dollars being spent on diabetic care and management. Today, more than one in five health care dollars and one in three Medicare dollars are spent on care for people with diabetes. Under the current Medicare statute, physician assistants or nurse practitioners are required to refer their patients with diabetes to a physician in order to certify the patient's need for therapeutic shoes, which often results in delays in treatment and added costs. The Promoting Access to Diabetic Shoes Act would fix this problem by allowing nurse practitioners and physician assistants to certify a Medicare beneficiary's need for therapeutic shoes, which will improve timeliness and access to care while reducing costs. Therapeutic shoes are a cost effective, preventive treatment option intended to avoid the costly complications that can arise if maintenance of diabetic care is delayed or unavailable. Types of complications that can result from unmanaged diabetic symptoms include poor circulation, infections, and foot ulcers that can require hospitalization, or even result in the amputation of toes, feet, or legs. In addition to preventable complications and additional costs that can result from delays in treatment, the current documentation requirement under Medicare can also disrupt the trusted patient- provider relationship many patients have with an NP or PA. Current statute requires the certifying physician to be a patient's provider for diabetic care moving forward, which is often in conflict with a patient's preference. Moreover, in rural areas, including many parts of my home state of Maine, access to diabetic management though a PA or NP is not only necessary, but it is sometimes unavoidable due to the shortage of primary care providers in the area. Maine alone has 68 designated Health Professional Shortage Areas for primary care practitioners. These health care professionals are already providing accessible, high quality diabetic care across the country. In fact, a March 2018 article in the American Journal of Medicine concluded that PAs and NPs are able to perform as well as physicians in the management of diabetes at diagnosis through the first five years of follow-up care. Stephanie Podolski, President of the Maine Association of Physician Assistants, which represents over 700 PAs in Maine, reiterated these points and the importance of the physician assistant profession in diabetes management in a letter of support for our bill saying, ``In a State like Maine, there are many rural communities that at times are served only by a PA as a primary care provider (PCP). The inability to order diabetic shoes is an outdated barrier to care that impacts both middle-aged and older Americans who frequently live in areas facing provider shortages.'' The Promoting Access to Diabetic Shoes Act is endorsed by the American Association of Nurse Practitioners, the American Academy of Physician Assistants, and the American Podiatric Medical Association. I am pleased to join Senator Brown in introducing the Promoting Access to Diabetic Shoes Act, which will improve access to diabetic care, and I encourage my colleagues to support its adoption.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to introduce legislation with my colleague from Ohio, Senator Sherrod Brown, that would remove an unnecessary, outdated barrier for Medicare beneficiaries managing diabetes. Our legislation would allow physician assistants (PAs) and nurse practitioners (NPs) to satisfy the Medicare documentation requirement certifying a patient's need for therapeutic, or diabetic, shoes, which will improve access to care, reduce barriers to proper diabetic management, and help to reduce the prevalence of costly complications that can arise if diabetic symptoms are not managed properly. This bipartisan bill, the Promoting Access to Diabetic Shoes Act, is a companion to H.R. 1617 from my fellow Diabetes Caucus Co- Chair, Representative Tom Reed of New York, which has growing support on both sides of the aisle in the House. As the founder and co-chair of the Senate Diabetes Caucus, I have worked since the very beginning of my Senate service to increase awareness of the threats posed by diabetes, invest in research, and improve access to treatment options for the over 30 million Americans, including twelve million seniors, who suffer from diabetes. In addition to the human toll, diabetes is also the most expensive chronic illness in the country. A new American Diabetes Association report released in March titled, ``Economic Costs of Diabetes in the U.S. in 2017,'' found that the direct and indirect costs of diagnosed diabetes in the U.S. cost $327 billion in 2017, which is a 26 percent increase in just the last five years. Preventable complications contribute enormously to the influx of dollars being spent on diabetic care and management. Today, more than one in five health care dollars and one in three Medicare dollars are spent on care for people with diabetes. Under the current Medicare statute, physician assistants or nurse practitioners are required to refer their patients with diabetes to a physician in order to certify the patient's need for therapeutic shoes, which often results in delays in treatment and added costs. The Promoting Access to Diabetic Shoes Act would fix this problem by allowing nurse practitioners and physician assistants to certify a Medicare beneficiary's need for therapeutic shoes, which will improve timeliness and access to care while reducing costs. Therapeutic shoes are a cost effective, preventive treatment option intended to avoid the costly complications that can arise if maintenance of diabetic care is delayed or unavailable. Types of complications that can result from unmanaged diabetic symptoms include poor circulation, infections, and foot ulcers that can require hospitalization, or even result in the amputation of toes, feet, or legs. In addition to preventable complications and additional costs that can result from delays in treatment, the current documentation requirement under Medicare can also disrupt the trusted patient- provider relationship many patients have with an NP or PA. Current statute requires the certifying physician to be a patient's provider for diabetic care moving forward, which is often in conflict with a patient's preference. Moreover, in rural areas, including many parts of my home state of Maine, access to diabetic management though a PA or NP is not only necessary, but it is sometimes unavoidable due to the shortage of primary care providers in the area. Maine alone has 68 designated Health Professional Shortage Areas for primary care practitioners. These health care professionals are already providing accessible, high quality diabetic care across the country. In fact, a March 2018 article in the American Journal of Medicine concluded that PAs and NPs are able to perform as well as physicians in the management of diabetes at diagnosis through the first five years of follow-up care. Stephanie Podolski, President of the Maine Association of Physician Assistants, which represents over 700 PAs in Maine, reiterated these points and the importance of the physician assistant profession in diabetes management in a letter of support for our bill saying, ``In a State like Maine, there are many rural communities that at times are served only by a PA as a primary care provider (PCP). The inability to order diabetic shoes is an outdated barrier to care that impacts both middle-aged and older Americans who frequently live in areas facing provider shortages.'' The Promoting Access to Diabetic Shoes Act is endorsed by the American Association of Nurse Practitioners, the American Academy of Physician Assistants, and the American Podiatric Medical Association. I am pleased to join Senator Brown in introducing the Promoting Access to Diabetic Shoes Act, which will improve access to diabetic care, and I encourage my colleagues to support its adoption.

Ms. COLLINS

Ms. COLLINS. Mr. President, in 1993, American journalist and author John Wallach hosted a dinner with leaders from Israel, Egypt, and the Palestinian Authority. As he toasted his guests, he urged each country to send 15 youngsters to a new summer camp he had established in Otisfield, ME. That year, 46 teens, ages 13 to 18, and including three Americans, comprised the first class of the Seeds of Peace Camp. Twenty-five years later, Seeds of Peace now has 6,698 alumni throughout the Middle East, South Asia, Europe, and the United States. They came to Maine from 27 countries, many from places of conflict, for 3 weeks of camping and social activities to promote understanding, reconciliation, acceptance, dialogue, coexistence, and peace. They returned home uniquely positioned to lead change and with the courage to dispel the fear, mistrust, and prejudice that fuel conflict. It is a pleasure to congratulate this remarkable organization on its landmark 25th anniversary. Seeds of Peace is able to bridge borders and foster peace in the midst of longstanding global conflicts. Many of those early campers are now holding decisionmaking positions in their home countries, and I believe that the ``seeds of peace'' that were planted during their time in Maine will blossom into lasting, visionary solutions to conflicts perpetuated by cycles of violence. Building on the success of the international program, Seeds of Peace launched the Maine Seeds leadership program in 2000 in response to the changing demographics in our State resulting from a growing refugee population. These Maine Seeds organize year-round community and school activities that bridge divisions and create positive change. Seeds of Peace reveals the human face of youth who are too often exposed to hatred by engaging campers in both guided coexistence sessions and ordinary summer camp activities, such as sharing meals, canoeing, swimming, playing sports, and exploring creativity through the arts and computers. These interactions and the lasting friendships formed are creating new generations of leaders who will choose dialogue and understanding over violence and hatred. In addition to the summer camp in Maine, Seeds of Peace provides year-round opportunities, through regional programming and the innovative use of technology, to enable former participants to build on the relationships forged at camp, so that the learning processes begun at camp may continue in the participants' home countries, where they are most needed. Seeds of Peace is strongly supported by participating governments and many world leaders. Federal funding for Seeds of Peace demonstrates and recognizes the importance of Seeds of Peace in promoting the foreign policy goals of the United States. The Seeds of Peace mission--to inspire and cultivate new generations of leaders to accelerate the social, economic, and political changes essential for peace--is more essential than ever before. From a small summer camp in Maine a quarter of a century ago to a global movement today, Seeds of Peace has carried out that vital mission and brought new hope to the world.

Mrs. COLLINS

Mrs. COLLINS. Mr. President, I rise today to introduce legislation, with my colleague from Pennsylvania, Senator Casey, that would reauthorize the only federally funded programs specifically designed to develop a health provider workforce to care for older Americans. The Geriatrics Workforce Improvement Act would reauthorize the Geriatrics Workforce Enhancement Program, known as GWEP, and also reinstate the Geriatric Academic Career Awards program, known as GACA. The number of Americans aged 65 and older is growing rapidly. In Maine, we are reaching an aging milestone faster than other States--by 2020, the number of seniors is projected to outnumber children. This is 15 years aheadV the national projected date of 2035, at which point the number of Americans 65 and older will outnumber those under age 18 for the first time in U.S. history. The United States is facing a critical shortage of geriatric health professionals and direct service workers to support our aging population. Today, we need 20,000 geriatricians; however, fewer than 7,300 of our Nation's nearly one million physicians are board-certified geriatricians. By 2030, we will need 3.1,000 geriatricians and even more geriatric health professionals and direct service workers. We need to train 1,600 geriatricians per year over the next 12 years to reach the targeted need by 2030. As many as 90 percent of older adults are expected to have one or more chronic health conditions. Multiple chronic conditions, multiple medications, and changes that occur in aging make caring for older adults complex and challenging, yet also rewarding to healthcare professionals who choose this specialty. In any given year, it is expected that 30 percent of older adults and their families will require specialized geriatric care. Today there are 44 geriatric workforce enhancement programs or GWEPs in 29 states. GWEP sites include 25 schools of medicine, ten schools of nursing, five healthcare facilities, two schools of allied health, a school of social work, and a certified nurse assistant program. GWEPs have the flexibility to tailor training in geriatrics to the unique needs of their own communities. GWEP programs focus on Geriatric Education by: 1. Changing clinical training environments so that geriatrics is integrated into primary care delivery systems; 2. Training providers to assess and address the needs of older adults, their families, and caregivers at multiple levels within their communities; 3. Delivering community-based programs for patients, families and caregivers; and 4. Providing Alzheimer's disease education for families and caregivers, including direct care workers and other providers. In 2016, the 44 GWEPs produced significant outcomes. They provided continuing education courses to 94,000 practicing public health professionals, from disciplines such as medicine, nursing, allied health, heath services administration, social work, and psychology. They have also created opportunities for healthcare providers in rural and underserved areas to learn from and consult with top experts in geriatric care through tele-consults, and educational webcasts, as well as online geriatric education programs that are publicly available and accessible online, 24 hours a day, 7 days a week, for free. GACA programs focus on Resource Optimization. Established in 1998, GACA programs were funded to increase the number of faculty engaged in geriatric education. Transitioning from clinical training and practice into an academic faculty role is particularly challenging, and requires gaining new skills as an educator. These skills are not typically taught in clinical training programs. Following a restructuring of the geriatric workforce program, GACA has gone unfunded since 2015. GACA would be reauthorized as a stand- alone resource within our legislation in order to optimize future growth and stability of early-career geriatric faculty. GACA supports early career development for emerging leaders by providing funding that supports 50 percent of their effort to develop skills as an inter- professional educator in geriatrics. The Geriatrics Workforce Improvement Act would reauthorize the GWEP program at $45 million per year over the next five years, and reinstate GACA at $6 million per year. Together, these programs would train the current workforce and family caregivers, while simultaneously developing a cadre of emerging leaders in geriatric education, in a variety of disciplines. By doing both, we will assure that older Americans will be cared for by a health care workforce specifically trained to meet their unique and complex health needs for decades to come. This training to use the most efficient and effective methods for older adults will result in improved care while saving valuable resources, and reducing unnecessary costs. Exposure to geriatrics, particularly through pre-clinical and clinical education, has been identified as an important factor for increasing interest in the field. This exposure provides faculty the opportunities needed to demonstrate the specialty is a viable, complex, yet rewarding specialty. The Geriatrics Workforce Improvement Act would provide these critical platforms by creating the infrastructure needed to attract the best and the brightest into the field of geriatrics. This legislation already has broad support. I ask to enter into the record a letter of support from the National Association for Geriatric Education and the National Association of Geriatric Education Centers. Mr. President. I urge my colleagues to support this bipartisan legislation that would ensure geriatric education for our current workforce, while optimizing resources to bolster academic careers in geriatrics. Together, GWEP and GACA would develop a high-quality geriatric workforce ready to provide care for Americans as we grow older. National Association for Geriatric Education, National Association of Geriatric Education Centers, May 21, 2018. Hon. Susan Collins, Chair, Special Committee on Aging, U.S. Senate, Washington, DC. Hon. Bob Casey, Ranking Member, Special Committee on Aging, U.S. Senate, Washington, DC. Dear Chairman Collins and Ranking Member Casey: On behalf of the HRSA Title VII and Title VIII funded Geriatrics Workforce Enhancement Programs (GWEPs) across the country, thank you for your past support of geriatric education and for introducing the Geriatrics Workforce Improvement Act. The National Association for Geriatric Education (NAGE) is pleased to offer our support for this important legislation, which will reauthorize the GWEP and once again make the Geriatrics Academic Career Award program (GACA) a part of the effort to prepare the geriatrics workforce for the aging of our population. We and the growing numbers of older adults, caregivers, and clinicians caring for elders will urge Congress to move quickly to pass your bill and provide the resources to address our nation's growing demand for geriatric care. We appreciate the many discussions that your staff facilitated with NAGE, as well as with the Eldercare Workforce Alliance, the American Geriatrics Society, and The Gerontological Society of America during the process of developing this legislation. This authorization and related funding is needed for the development of a health care workforce specifically trained to care for older adults and to support their family caregivers. Currently there are only 44 GWEP sites in 29 states. The modest increase in the authorization in your bill will have an important impact on training in geriatric care. Likewise, the funds you have authorized for the GACA program will assist in ensuring that rural and underserved areas will have geriatrics education programs. NAGE is a non-profit membership organization representing GWEP sites, Centers on Aging, and Geriatric Education Centers that provide education and training to health professionals in the areas of geriatrics and gerontology. Our mission is to help America's healthcare workforce be better prepared to render age-appropriate care to today's older Americans and those of tomorrow. Thank you for your continued support for geriatric education programs. Sincerely, Maura Brennan, MD, FACP, AGSF, FAAHPM, CHMD, President NAGE/NAGEC; Project Director, Baystate Health, Geriatrics Workforce Enhancement Program; Chief, Div. of Geriatrics, Palliative Care & Post-Acute Medicine; Prof. of Medicine, Univ. of Massachusetts-Baystate; Adjunct Prof. of Medicine, Tufts University School of Medicine.

Mrs. COLLINS

Mrs. COLLINS. Mr. President, I rise today to introduce legislation, with my colleague from Pennsylvania, Senator Casey, that would reauthorize the only federally funded programs specifically designed to develop a health provider workforce to care for older Americans. The Geriatrics Workforce Improvement Act would reauthorize the Geriatrics Workforce Enhancement Program, known as GWEP, and also reinstate the Geriatric Academic Career Awards program, known as GACA. The number of Americans aged 65 and older is growing rapidly. In Maine, we are reaching an aging milestone faster than other States--by 2020, the number of seniors is projected to outnumber children. This is 15 years aheadV the national projected date of 2035, at which point the number of Americans 65 and older will outnumber those under age 18 for the first time in U.S. history. The United States is facing a critical shortage of geriatric health professionals and direct service workers to support our aging population. Today, we need 20,000 geriatricians; however, fewer than 7,300 of our Nation's nearly one million physicians are board-certified geriatricians. By 2030, we will need 3.1,000 geriatricians and even more geriatric health professionals and direct service workers. We need to train 1,600 geriatricians per year over the next 12 years to reach the targeted need by 2030. As many as 90 percent of older adults are expected to have one or more chronic health conditions. Multiple chronic conditions, multiple medications, and changes that occur in aging make caring for older adults complex and challenging, yet also rewarding to healthcare professionals who choose this specialty. In any given year, it is expected that 30 percent of older adults and their families will require specialized geriatric care. Today there are 44 geriatric workforce enhancement programs or GWEPs in 29 states. GWEP sites include 25 schools of medicine, ten schools of nursing, five healthcare facilities, two schools of allied health, a school of social work, and a certified nurse assistant program. GWEPs have the flexibility to tailor training in geriatrics to the unique needs of their own communities. GWEP programs focus on Geriatric Education by: 1. Changing clinical training environments so that geriatrics is integrated into primary care delivery systems; 2. Training providers to assess and address the needs of older adults, their families, and caregivers at multiple levels within their communities; 3. Delivering community-based programs for patients, families and caregivers; and 4. Providing Alzheimer's disease education for families and caregivers, including direct care workers and other providers. In 2016, the 44 GWEPs produced significant outcomes. They provided continuing education courses to 94,000 practicing public health professionals, from disciplines such as medicine, nursing, allied health, heath services administration, social work, and psychology. They have also created opportunities for healthcare providers in rural and underserved areas to learn from and consult with top experts in geriatric care through tele-consults, and educational webcasts, as well as online geriatric education programs that are publicly available and accessible online, 24 hours a day, 7 days a week, for free. GACA programs focus on Resource Optimization. Established in 1998, GACA programs were funded to increase the number of faculty engaged in geriatric education. Transitioning from clinical training and practice into an academic faculty role is particularly challenging, and requires gaining new skills as an educator. These skills are not typically taught in clinical training programs. Following a restructuring of the geriatric workforce program, GACA has gone unfunded since 2015. GACA would be reauthorized as a stand- alone resource within our legislation in order to optimize future growth and stability of early-career geriatric faculty. GACA supports early career development for emerging leaders by providing funding that supports 50 percent of their effort to develop skills as an inter- professional educator in geriatrics. The Geriatrics Workforce Improvement Act would reauthorize the GWEP program at $45 million per year over the next five years, and reinstate GACA at $6 million per year. Together, these programs would train the current workforce and family caregivers, while simultaneously developing a cadre of emerging leaders in geriatric education, in a variety of disciplines. By doing both, we will assure that older Americans will be cared for by a health care workforce specifically trained to meet their unique and complex health needs for decades to come. This training to use the most efficient and effective methods for older adults will result in improved care while saving valuable resources, and reducing unnecessary costs. Exposure to geriatrics, particularly through pre-clinical and clinical education, has been identified as an important factor for increasing interest in the field. This exposure provides faculty the opportunities needed to demonstrate the specialty is a viable, complex, yet rewarding specialty. The Geriatrics Workforce Improvement Act would provide these critical platforms by creating the infrastructure needed to attract the best and the brightest into the field of geriatrics. This legislation already has broad support. I ask to enter into the record a letter of support from the National Association for Geriatric Education and the National Association of Geriatric Education Centers. Mr. President. I urge my colleagues to support this bipartisan legislation that would ensure geriatric education for our current workforce, while optimizing resources to bolster academic careers in geriatrics. Together, GWEP and GACA would develop a high-quality geriatric workforce ready to provide care for Americans as we grow older. National Association for Geriatric Education, National Association of Geriatric Education Centers, May 21, 2018. Hon. Susan Collins, Chair, Special Committee on Aging, U.S. Senate, Washington, DC. Hon. Bob Casey, Ranking Member, Special Committee on Aging, U.S. Senate, Washington, DC. Dear Chairman Collins and Ranking Member Casey: On behalf of the HRSA Title VII and Title VIII funded Geriatrics Workforce Enhancement Programs (GWEPs) across the country, thank you for your past support of geriatric education and for introducing the Geriatrics Workforce Improvement Act. The National Association for Geriatric Education (NAGE) is pleased to offer our support for this important legislation, which will reauthorize the GWEP and once again make the Geriatrics Academic Career Award program (GACA) a part of the effort to prepare the geriatrics workforce for the aging of our population. We and the growing numbers of older adults, caregivers, and clinicians caring for elders will urge Congress to move quickly to pass your bill and provide the resources to address our nation's growing demand for geriatric care. We appreciate the many discussions that your staff facilitated with NAGE, as well as with the Eldercare Workforce Alliance, the American Geriatrics Society, and The Gerontological Society of America during the process of developing this legislation. This authorization and related funding is needed for the development of a health care workforce specifically trained to care for older adults and to support their family caregivers. Currently there are only 44 GWEP sites in 29 states. The modest increase in the authorization in your bill will have an important impact on training in geriatric care. Likewise, the funds you have authorized for the GACA program will assist in ensuring that rural and underserved areas will have geriatrics education programs. NAGE is a non-profit membership organization representing GWEP sites, Centers on Aging, and Geriatric Education Centers that provide education and training to health professionals in the areas of geriatrics and gerontology. Our mission is to help America's healthcare workforce be better prepared to render age-appropriate care to today's older Americans and those of tomorrow. Thank you for your continued support for geriatric education programs. Sincerely, Maura Brennan, MD, FACP, AGSF, FAAHPM, CHMD, President NAGE/NAGEC; Project Director, Baystate Health, Geriatrics Workforce Enhancement Program; Chief, Div. of Geriatrics, Palliative Care & Post-Acute Medicine; Prof. of Medicine, Univ. of Massachusetts-Baystate; Adjunct Prof. of Medicine, Tufts University School of Medicine.

Ms. COLLINS

Ms. COLLINS. Mr. President, I rise today to express my support for the nomination of Gina Haspel to become the next Director of the Central Intelligence Agency. Ms. Haspel is an accomplished intelligence professional who will bring 33 years of experience to her new role. She has dedicated her entire life to the service of our country and has performed extraordinarily well in a number of challenging positions-- often, in some of the most dangerous places in the world. Ms. Haspel has widespread support among the national security community. More than 50 leaders signed a bipartisan letter endorsing her nomination. The list includes eight former CIA Directors and Acting CIA Directors who were appointed by both Republican and Democratic Presidents, ranging from Ronald Reagan to Barack Obama. Michael Morell, a former CIA Acting Director under President Obama, describes her as a person of ``deep integrity,'' and John Brennan, another former CIA Director under President Obama, said she will provide ``unvarnished, apolitical, objective intelligence input to Donald Trump and others.'' At Ms. Haspel's hearing before the Senate Select Committee on Intelligence, I questioned Ms. Haspel regarding the enhanced interrogation program that was started after the September 11, 2001, terrorist attacks. I have long believed and have consistently stated that this program was completely unacceptable and that waterboarding is tantamount to torture. In fact, in 2015, I cosponsored the McCain- Feinstein amendment to the defense authorization bill to ensure that techniques such as waterboarding are never used again and that the Army Field Manual governs interrogations of detainees. In response to my questions, Ms. Haspel, who was not a high-ranking CIA official at the time, indicated that she played no role in the creation of the interrogation program and that she wasn't even aware of its existence until more a year after it began. Furthermore, she said that she supported the 2015 law changes and made clear that she does not believe that the CIA should be in the ``interrogation business.'' She testified that, under her leadership, the CIA would follow the law and would not resume enhanced interrogations and that she would not seek to repeal the law. Moreover, in a letter to the vice chairman of the Senate Select Committee on Intelligence, Senator Mark Warner, Ms. Haspel said that she would ``refuse to undertake any proposed activity'' that is contrary to her moral and ethical values, CIA's mission and expertise, or the law. ``The United States,'' she said, ``must be an example to the rest of the world'' and ``the enhanced interrogation program is not one the CIA should have undertaken.'' Another issue I closely examined was Ms. Haspel's role in the Agency's decision to destroy tapes involving one detainee who was subjected to enhanced interrogation. The accountability review from then-Acting Director Morell exonerated Ms. Haspel and stated conclusively that it was the CIA's then-Director of the National Clandestine Service who ordered the destruction of the tapes. As Mr. Morell, an Obama administration appointee, stated: ``Ms. Haspel did not destroy the tapes, she did not oversee the destruction of the tapes, and she did not order the destruction of the tapes.'' I will conclude by saying that it speaks very well of Ms. Haspel's nomination that she was reported favorably by a bipartisan majority of members on the Senate Select Committee on Intelligence, earning the support of both the chairman and vice chairman. I hope that Ms. Haspel will be confirmed quickly to be the next Director of the CIA, and I look forward to working with her in this new capacity to counter the wide range of national security challenges facing our country.

Ms. COLLINS

Ms. COLLINS. I yield the floor.

Ms. COLLINS. Mr. President, I rise today in support of legislation I have introduced with several of my colleagues--Senators Murkowski, Barrasso, Stabenow, and Cassidy--that would remove a barrier that prevents patients from getting the most affordable prescription drug prices at the pharmacy counter. Mr. President, Americans have the right to know which payment method--whether it is using insurance or paying with cash out of pocket--would provide the most savings when they are purchasing prescription drugs. The two bills we have introduced would establish some clarity in this incredibly opaque drug pricing system. Nearly 60 percent of Americans, including roughly 90 percent of seniors, take at least one prescription drug. In 2016, Americans spent more than $330 billion, including a staggering $45 billion out of pocket, on retail prescription drugs. The Federal Government picked up another $139 billion through Medicare, Medicaid, and other programs. Prescription drugs amount to nearly 18 percent of all healthcare expenditures and are the second fastest growing expenditure within healthcare. Moreover, two-thirds of personal bankruptcies in our country have been attributed to the cost of medical care, including prescription drugs. To make informed decisions, at the very least, we should have the right to know how much our prescription drugs cost. At a series of hearings held by the Senate HELP Committee, I have questioned repeatedly one particularly egregious practice that conceals prices from patients at the pharmacy counter. This practice is the result of what are known as ``pharmacy gag clauses.'' These are contract terms that prohibit pharmacists from proactively telling consumers if their prescription would actually cost less if they paid for it themselves rather than using their insurance plan. In other words, if the consumer is using insurance, pharmacists can actually be prohibited from disclosing whether the consumer is paying the lowest possible price. In fact, the pharmacist is prohibited from sharing this vital information unless the consumer explicitly asks. Most consumers would never guess that it would be cheaper for them to pay out of pocket than to use their insurance plan to purchase the medicine they need. Insurance is intended to save consumers money in this situation, but that is not always the case. Gag clauses in contracts that prohibit pharmacists from telling patients how to obtain best prices obscure what the true cost of the drug could be and the fact that it could be lower than what the patient is paying. Several recent investigations, including by the New York Times and NBC News, have highlighted this unacceptable practice. For example, a consumer paid a copay of $43 for a cholesterol drug; however, had that same consumer paid cash rather than using his insurance, the cost would have been only $19. Another investigation told the story of a consumer who used insurance to pay $129 for a drug when the cost would have been just $18 had he paid out of pocket. From Maine to California, the stories are endless. And this practice is not an outlier issue. According to a survey by the National Community Pharmacists Association, more than 50 percent of community pharmacists reported that gag clause restrictions prevented them from telling patients about other less expensive options, such as paying in cash, at least 10 times in the past month. Recently, I was at the pharmacy counter at a grocery store in Maine, and the couple in front of me decided not to take the prescription they needed because the copay of $111 was more than they could afford. I could not help but wonder: If they hadn't used their insurance, would they have been able to purchase that drug at a lower price? It is so counterintuitive that very few consumers are going to think to ask the pharmacist that question. I first learned about these gag clauses from pharmacists in Maine who were frustrated that they were prohibited from providing their patients with information on the most cost-effective way for them to purchase the medication they had been prescribed. Pharmacists are barred from speaking up, and those who do face penalties for doing so. Pharmacists are on the frontlines in helping patients manage multiple medications, and they would also like to help ensure that their patients are getting the best, most affordable price. The first bill we have introduced, the Patient Right to Know Drug Prices Act, which is S. 2554--which I have cosponsored with the four Senators I mentioned, Senators McCaskill, Barrasso, Stabenow, and Cassidy--would prohibit pharmacy gag clauses in healthcare plans that are sold on the exchange and in group plans as well. The second bill, the Know the Lowest Price Act, which is S. 2553--which I am a lead cosponsor on with Senator Stabenow--would ban these clauses in Medicare Part D and Medicare Advantage plans. Specifically, both bills would prohibit health insurance plans and any pharmacy benefit managers with whom they contract from restricting the ability of a pharmacist to provide a plan enrollee with information about any price difference that may exist between the price of the drug under the insurance plan and the price of the drug purchased out of pocket. Our bills would also prohibit penalties from being imposed on any pharmacist who shares such vital and valuable information. Some States have already taken action to combat this problem. For example, the State of Maine enacted a law last year that prohibits charging an insurance enrollee a copayment or other charge that is higher than the cost of the drug to the pharmacy provider. The Maine law also protects pharmacists who disclose information related to out- of-pocket costs from being penalized by insurance companies or PPMs under gag clauses. These are commonsense solutions. In announcing his drug pricing plan last week, the President, I am pleased to say, stated his intent to ban any gag clauses that would apply to pharmacies. While the administration can take some steps administratively to curb this practice, the enactment of our two bills would ensure that this protection for pharmacists and for patients is required under law. As consumers continue to face skyrocketing prescription drug prices, we ought to do all we can to ensure that Americans are getting the best prices possible. As Congress looks at innovative ways to bring down prices and to increase transparency throughout the healthcare system, our bills tackle an overlooked issue that directly affects consumers and pharmacies across our country. Our legislation has already received strong endorsements from more than a dozen organizations, including Patients for Affordable Drugs, the American Pharmacists Association, the Pharmaceutical Care Management Association, and other groups, ranging from the Arthritis Foundation to the AIDS Institute. I ask unanimous consent that these letters and statements be printed in the Record at the conclusion of my remarks. It is only logical that pharmacists want to be able to provide their customers with information that will help them afford the medications they have been prescribed. It is absolutely unacceptable for pharmacists in this country to be banned, under gag clauses, from providing that invaluable information to patients, particularly those who may be struggling with the cost of prescription drugs. I urge my colleagues to support banning pharmacy gag clauses and the passage of both S. 2554 and S. 2553.

Ms. COLLINS

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