Department of Defense Appropriations Act, 2019

Floor Speech

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Ms. COLLINS. Thank you, Mr. President.

It has been 11 years since a Labor, Health and Human Services, and Education appropriations bill has been considered on the Senate floor, so let me begin my remarks this morning by commending the chairman and ranking member of the full Appropriations Committee, Senators Shelby and Leahy, for their determination to report each and every one of the appropriations bills so they can be considered, fully debated, and amended in the regular order. I also commend the subcommittee chairman, Senator Blunt, and the ranking member, Senator Murray, for their leadership in creating a bipartisan bill.

This bill will make critical investments in medical research, opioid abuse prevention and treatment, the education of our students, and strengthening America's workforce.

I appreciate so much that the subcommittee accommodated so many of my priorities in crafting this bill. It has my very strong support. I am particularly pleased that the bill includes another $2 billion increase for the National Institutes of Health. Robust investments in biomedical research will pay dividends for many American families struggling with disease and disability, just as such research has enabled us to prevent, treat, or cure other serious illnesses.

Notably, this year, for the first time, the bill reaches the milestone of providing at least $2 billion a year for Alzheimer's disease research--the amount that the advisory council to the National Plan to Combat Alzheimer's Disease has calculated is needed to find an effective treatment for this disease by the year 2025. Tomorrow, I will join Senator Blunt and others of my colleagues delivering separate remarks dedicated to this milestone achievement, but I did want to briefly highlight that investment now.

As founder and the cochair of the Senate Diabetes Caucus, I am also pleased this bill continues to recognize the importance of investing in diabetes research. Since founding the caucus in 1997, funding for diabetes has increased more than sixfold, from $319 million in 1997 to $2 billion in 2018, and that is only appropriate. We know treating and caring for older people with diabetes consumes approximately one out of three Medicare dollars, so this is a very expensive disease as well as one that causes a great deal of heartache and damage to those who are diagnosed with type 2 diabetes later in life. I have also worked very hard with the Juvenile Research Diabetes Foundation on type 1 diabetes, which is usually diagnosed in childhood and is a lifelong disease. The investments we have made have helped us make real breakthroughs in diabetes treatment. The bill provides a $60 million increase for the National Institute of Diabetes and Digestive and Kidney Disorders at NIH. As the NIH's lead agency for diabetes research, this continued investment is critical to preventing diabetes, improving the lives of more than 30 million Americans, including 12 million seniors already living with the disease, as well as providing the foundation to ultimately discover a cure for type 1 diabetes.

This bill provides $3.7 billion in the fight against the opioid epidemic that is gripping our country. Sadly, in my State of Maine, the crisis has actually worsened with drug-related overdoses claiming the lives of 407 people in Maine last year, according to the new statistics from the Centers for Disease Prevention and Control.

The crisis in Maine shows no signs of abating. Indeed, the contamination of heroin with fentanyl has made this crisis even worse, taking the lives of even more who are in the grips of addiction. While I am very hopeful the Senate will consider a comprehensive opioids package put together by the Senate HELP Committee, to which many of us contributed in the weeks ahead, it is imperative that the funds provided in this appropriations bill reach our communities without delay.

This legislation also funds key priorities for vulnerable seniors, including the Low Income Home Energy Assistance Program, which I know is of interest to the Presiding Officer because he represents the State of Alaska, and that program is critical there, as it is in the State of Maine. It funds the State Health Insurance Program, Meals on Wheels, and other essential programs that make such a difference to our seniors.

As chair of the Senate Committee on Aging, I am particularly delighted that this bill provides a $300,000 increase to the administration for community living for the establishment of the family caregivers advisory council. This council was created by a bipartisan bill that I introduced with Senator Baldwin, the RAISE Family Caregivers Act, and it will help develop a coordinated strategic plan to leverage our resources, promote best practices, and expand services and training for our Nation's caregivers.

I am sure everyone here has had the experience of a parent who is already older taking care of a disabled spouse--perhaps someone with Alzheimer's disease, which is 24/7 for that caregiver. Caregivers need more support and assistance. They need to know where to go. We need to expand respite care, which is the No. 1 concern I hear from caregivers. Respite care in rural areas is extremely difficult to find. The hearings we have held in the Aging Committee have also put a spotlight on the mobility challenges that many seniors face as they age, such as difficulty climbing steep staircases that can lead to devastating falls, performing routine household chores, taking care of themselves, or being able to drive. This bill provides a $4 million increase for the creation of a new aging and technology program to support the development of assisted technology for seniors with disabilities in rural areas. The University of Maine Center on Aging is doing such interesting work in this area after collaborating with assisted living facilities and talking directly to older Americans to find out what they need. Sometimes it is merely a matter of renovating a bathroom or putting up grab bars, installing sensors to make sure the refrigerator door is being opened regularly so you know the older American is eating properly. Sometimes it is more complicated than that. This center will help us explore how technology can allow more of our seniors to age in place and stay in the comfort, security, and privacy of their own homes, where many of them long to be.

Maintaining access to care in rural areas is essential, and, thus, I also support the inclusion of $71.5 million for the Rural Health Care Services Outreach Grant Program. This bill also calls on the Federal Government to remove arbitrary barriers around collaboration between rural and nonrural health providers that could inadvertently close off opportunities. We have seen that happen in my State, where a community health center that is located in Bangor, ME, is trying to help a very rural community, Jackman, ME, which unfortunately recently lost its nursing home and was using the local hospital for assistance. We need to have more collaboration and not let arbitrary bureaucratic rules prevent that kind of cooperation. It is paramount that we do not discourage innovative approaches in healthcare.

On a related note, I also applaud the inclusion of increased funding to support community health centers, which serve approximately 27 million Americans, including upward of 186,000 individuals in the State of Maine. Community health centers will only continue to play a larger role in healthcare delivery as we seek to reduce overall healthcare costs, as well as provide greater access to behavioral health and substance use disorder prevention and treatment services.

In addition to key health and aging priorities, this bill also supports essential programs at the Department of Education. Notably, this bill provides increased investments in title I, which helps our public schools serve low-income students. The student support in academic enrichment grants, which help to provide students with well- rounded education, is an important program that brings art, music, and technology to our rural community schools. I also strongly support the increased investment in the Individuals with Disabilities Education Act, IDEA, which has provided opportunities to children with disabilities and helped many of them reach their full potential. Across the State of Maine, superintendents, principals, and teachers tell me that one of the most effective ways we can support education overall is to better fund the Federal share of IDEA. That would help every single school district.

When IDEA became law in 1975, Congress set a goal of providing 40 percent of the excess cost of serving students with disabilities. I regret to say, we are nowhere near reaching that goal, but this increase in funding for IDEA represents a step forward toward fulfilling that commitment, and I hope we can do more next year.

This bill also funds teacher and school leader professional development, and the Rural Education Achievement Program, a law that I coauthored several years ago to bring additional resources to small and rural schools. Students in rural America should have the same access to Federal dollars and a good education as those living in urban and suburban communities. REAP has helped to provide equity for small rural schools in Maine and across the country. It has helped to support an array of activities, such as new technology in classrooms, distance learning opportunities, and professional development.

Here is a great example. REAP funding has helped Maine's small island schools connect together to create an island reading program using video conference technology that this program made affordable. In other parts of Maine, REAP has helped schools acquire new technology hardware, software, and to expand teacher training.

Having worked at a Maine college before I came to the Senate--Husson University--I know firsthand this bill's important investments in higher education, including Pell Grants and the TRIO Programs. The University of Maine is one of those institutions that has a great TRIO Program. It will help low-income and first-generation students access college education. TRIO often makes the difference in a student's ability to attend and complete a college education.

Funding for apprenticeships and workforce development programs are also key priorities that will strengthen Maine's workforce, preparing people with the skills and experience they need to succeed.

I could go on and on, but there are many others seeking recognition. Let me just end by urging my colleagues to support the fiscal year 2019 Labor, Health and Human Services, and Education appropriations bill. It is good and much needed legislation.

Thank you.

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