Floor Statements

Madam President, I rise today to introduce legislation to reauthorize the Building Our Largest Dementia, BOLD, infrastructure for Alzheimer's Act, legislation I authored that was signed into law in 2018.

The Building Our Largest Dementia, BOLD, Infrastructure for Alzheimer's Reauthorization Act of 2024, which I am pleased to introduce today with my colleagues Catherine Cortez Masto, Shelley Moore Capito, and Tim Kaine, would continue our important work to create a public health infrastructure to combat Alzheimer's disease and preserve brain health.

Public health plays an important role in achieving population-level improvements, but for too long Alzheimer's and other dementias have been viewed as just a normal part of aging and not as the public health crisis it warrants. Through the BOLD Act, we started to change this narrative and for the first time put resources behind the interventions that can help improve the health and quality of life for people living with Alzheimer's, as well as reduce the costs associated with the disease.

Still, Alzheimer's disease remains one of the greatest public health threats of our time. Approximately 6.7 million Americans are living with the disease, and, barring any major breakthroughs to prevent, slow down, or cure Alzheimer's, that number is expected to more than double. In addition to the human suffering it causes, Alzheimer's is one of our Nation's most expensive diseases, costing an estimated $345 billion last year. In my home State of Maine, more than 29,000 seniors are living with the disease, and unfortunately that number is only increasing. In addition, more than 51,000 loved ones are providing care valued at nearly $1.9 billion. Every State across the country is experiencing a similar story, underscoring the need to invest in the development of a robust Alzheimer's public health infrastructure on a State, local, and Tribal level to combat this growing public health crisis.

Through coordinated Federal investments and a national strategy created by the National Alzheimer's Project Act I authored, we have accelerated our understanding of this complex disease and unlocked steps we can take to increase early detection and diagnosis, reduce risk, prevent avoidable hospitalizations, and support dementia caregivers. Groundbreaking research has also now led to a new age of treatment, with disease-modifying therapies now available to patients. These promising treatments could substantially change how the disease is perceived and managed, increasing the urgency to educate the public, and promote early diagnosis.

Now, after decades of increasing investments in biomedical research for Alzheimer's, we are nearing the next phase of effectively preventing, treating, and curing Alzheimer's--translating research into real-world interventions. The BOLD Infrastructure for Alzheimer's Act accelerated a multipronged public health approach for the prevention, treatment, and care of Alzheimer's and related dementias. The bill we are introducing today would reauthorize the BOLD Infrastructure for Alzheimer's Act for 5 years in order to ensure that these critical activities can continue to reach communities across the country.

Specifically, the BOLD Infrastructure for Alzheimer's Act directed CDC to establish Alzheimer's and Related Dementias Public Health Centers of Excellence, provide Federal funding to support State, local, and Tribal public health departments, and increase data analysis and timely reporting in order to inform interventions, research, and public policy.

The CDC's Centers of Excellence are now working to promote effective Alzheimer's disease management and caregiving interventions, as well as educating the public on Alzheimer's disease, cognitive decline, and brain health. Each center is focused on a key issue related to dementia--from risk reduction to early detection to

caregiving. The three current centers have established themselves as national resources and are supporting nationwide implementation of the actions outlined in the CDC's Healthy Brain Initiative's Road Map. This includes identifying, translating, and disseminating promising research findings and best practices for nationwide uptake. Our legislation would reauthorize the Alzheimer's Disease and Related Dementias Public Health Centers of Excellence and add a new focus on implementation science, which is essential to bridging the gap between research findings and practical application in real-world settings.

In addition, building upon the CDC's Healthy Brain Initiative and its Public Health Road Map, the BOLD Infrastructure for Alzheimer's Act has provided public health departments with the funding and support necessary to implement effective Alzheimer's interventions in communities across the country, including a focus on reducing the risk of dementia, increasing early detection and diagnosis, and supporting caregivers. Forty-three public health departments across the United States are now promoting a strong public health approach to Alzheimer's disease and related dementia with the support of BOLD awards.

In September 2020, the Maine Department of Health and Human Services received one of the first BOLD Program Awards. This investment has allowed for the implementation of the Maine State Plan for Alzheimer's Disease and Related Dementias, as well as advancements in Maine's public awareness of brain health, early detection and diagnosis of Alzheimer's disease, and access to care and support. Maine's Department of Health and Human Services has even been able to publish county- specific data on cognitive decline to better understand risk factors and prevention across the State. In addition, the Bangor Public Health & Community Services Department and partners have educated its employees on how to respond to the Alzheimer's public health crisis, emphasizing early detection and diagnosis and brain health. Efforts such as these play a key role in bringing awareness to and ultimately reducing the growing prevalence of dementia in the State.

In September 2023, Maine received a second BOLD award from the CDC for Alzheimer's prevention programs. This implementation funding will allow Maine to build on its initial investments and carry out the Maine Alzheimer's Prevention Program and the CDC's Healthy Brain Initiative Road Map.

There continues to be an urgent need to translate what science tells us about the opportunity to reduce risk, delay onset, and ultimately reduce prevalence into effective public health practice. However, unless Congress acts to reauthorize these effective programs, BOLD programming is set to expire on September 30. The BOLD Infrastructure for Alzheimer's Reauthorization Act would continue our investment in a nationwide Alzheimer's public health response so that States, including Maine, can sustain the critical work being done in communities across the country and ensure this work has a real-world impact in the years ahead.

As founder and cochair of the Congressional Task Force on Alzheimer's Disease, the fight against Alzheimer's for me is both personal and a matter of crafting effective public policy. Virtually every family in the country has been touched by this disease, and I know the gravity of this disease firsthand as I lost my father, grandfather, and two uncles to Alzheimer's. I remain committed to advancing research, care, and support for individuals and families living with this devastating disease. Reauthorization of the BOLD Infrastructure for Alzheimer's Act will ensure communities across the country have access to resources to promote effective Alzheimer's interventions and better cognitive health that can lead to improved health outcomes.

This bipartisan legislation is endorsed by the Alzheimer's Association, the Alzheimer's Impact Movement, and UsAgainstAlzheimer's. I urge my colleagues to support this critical legislation.

Madam President, I rise today to introduce legislation to reauthorize the Building Our Largest Dementia, BOLD, infrastructure for Alzheimer's Act, legislation I authored that was signed into law in 2018.

The Building Our Largest Dementia, BOLD, Infrastructure for Alzheimer's Reauthorization Act of 2024, which I am pleased to introduce today with my colleagues Catherine Cortez Masto, Shelley Moore Capito, and Tim Kaine, would continue our important work to create a public health infrastructure to combat Alzheimer's disease and preserve brain health.

Public health plays an important role in achieving population-level improvements, but for too long Alzheimer's and other dementias have been viewed as just a normal part of aging and not as the public health crisis it warrants. Through the BOLD Act, we started to change this narrative and for the first time put resources behind the interventions that can help improve the health and quality of life for people living with Alzheimer's, as well as reduce the costs associated with the disease.

Still, Alzheimer's disease remains one of the greatest public health threats of our time. Approximately 6.7 million Americans are living with the disease, and, barring any major breakthroughs to prevent, slow down, or cure Alzheimer's, that number is expected to more than double. In addition to the human suffering it causes, Alzheimer's is one of our Nation's most expensive diseases, costing an estimated $345 billion last year. In my home State of Maine, more than 29,000 seniors are living with the disease, and unfortunately that number is only increasing. In addition, more than 51,000 loved ones are providing care valued at nearly $1.9 billion. Every State across the country is experiencing a similar story, underscoring the need to invest in the development of a robust Alzheimer's public health infrastructure on a State, local, and Tribal level to combat this growing public health crisis.

Through coordinated Federal investments and a national strategy created by the National Alzheimer's Project Act I authored, we have accelerated our understanding of this complex disease and unlocked steps we can take to increase early detection and diagnosis, reduce risk, prevent avoidable hospitalizations, and support dementia caregivers. Groundbreaking research has also now led to a new age of treatment, with disease-modifying therapies now available to patients. These promising treatments could substantially change how the disease is perceived and managed, increasing the urgency to educate the public, and promote early diagnosis.

Now, after decades of increasing investments in biomedical research for Alzheimer's, we are nearing the next phase of effectively preventing, treating, and curing Alzheimer's--translating research into real-world interventions. The BOLD Infrastructure for Alzheimer's Act accelerated a multipronged public health approach for the prevention, treatment, and care of Alzheimer's and related dementias. The bill we are introducing today would reauthorize the BOLD Infrastructure for Alzheimer's Act for 5 years in order to ensure that these critical activities can continue to reach communities across the country.

Specifically, the BOLD Infrastructure for Alzheimer's Act directed CDC to establish Alzheimer's and Related Dementias Public Health Centers of Excellence, provide Federal funding to support State, local, and Tribal public health departments, and increase data analysis and timely reporting in order to inform interventions, research, and public policy.

The CDC's Centers of Excellence are now working to promote effective Alzheimer's disease management and caregiving interventions, as well as educating the public on Alzheimer's disease, cognitive decline, and brain health. Each center is focused on a key issue related to dementia--from risk reduction to early detection to

caregiving. The three current centers have established themselves as national resources and are supporting nationwide implementation of the actions outlined in the CDC's Healthy Brain Initiative's Road Map. This includes identifying, translating, and disseminating promising research findings and best practices for nationwide uptake. Our legislation would reauthorize the Alzheimer's Disease and Related Dementias Public Health Centers of Excellence and add a new focus on implementation science, which is essential to bridging the gap between research findings and practical application in real-world settings.

In addition, building upon the CDC's Healthy Brain Initiative and its Public Health Road Map, the BOLD Infrastructure for Alzheimer's Act has provided public health departments with the funding and support necessary to implement effective Alzheimer's interventions in communities across the country, including a focus on reducing the risk of dementia, increasing early detection and diagnosis, and supporting caregivers. Forty-three public health departments across the United States are now promoting a strong public health approach to Alzheimer's disease and related dementia with the support of BOLD awards.

In September 2020, the Maine Department of Health and Human Services received one of the first BOLD Program Awards. This investment has allowed for the implementation of the Maine State Plan for Alzheimer's Disease and Related Dementias, as well as advancements in Maine's public awareness of brain health, early detection and diagnosis of Alzheimer's disease, and access to care and support. Maine's Department of Health and Human Services has even been able to publish county- specific data on cognitive decline to better understand risk factors and prevention across the State. In addition, the Bangor Public Health & Community Services Department and partners have educated its employees on how to respond to the Alzheimer's public health crisis, emphasizing early detection and diagnosis and brain health. Efforts such as these play a key role in bringing awareness to and ultimately reducing the growing prevalence of dementia in the State.

In September 2023, Maine received a second BOLD award from the CDC for Alzheimer's prevention programs. This implementation funding will allow Maine to build on its initial investments and carry out the Maine Alzheimer's Prevention Program and the CDC's Healthy Brain Initiative Road Map.

There continues to be an urgent need to translate what science tells us about the opportunity to reduce risk, delay onset, and ultimately reduce prevalence into effective public health practice. However, unless Congress acts to reauthorize these effective programs, BOLD programming is set to expire on September 30. The BOLD Infrastructure for Alzheimer's Reauthorization Act would continue our investment in a nationwide Alzheimer's public health response so that States, including Maine, can sustain the critical work being done in communities across the country and ensure this work has a real-world impact in the years ahead.

As founder and cochair of the Congressional Task Force on Alzheimer's Disease, the fight against Alzheimer's for me is both personal and a matter of crafting effective public policy. Virtually every family in the country has been touched by this disease, and I know the gravity of this disease firsthand as I lost my father, grandfather, and two uncles to Alzheimer's. I remain committed to advancing research, care, and support for individuals and families living with this devastating disease. Reauthorization of the BOLD Infrastructure for Alzheimer's Act will ensure communities across the country have access to resources to promote effective Alzheimer's interventions and better cognitive health that can lead to improved health outcomes.

This bipartisan legislation is endorsed by the Alzheimer's Association, the Alzheimer's Impact Movement, and UsAgainstAlzheimer's. I urge my colleagues to support this critical legislation.

Mr. President, I, too, urge our colleagues to reject this motion that calls for the Appropriations Committee to put forward a year-long continuing resolution for fiscal year 2024.

Adopting this motion would wipe out the work of the appropriations committee that led to 12 stand-alone bills being reported last summer with overwhelming bipartisan support. It would also lock in dangerously inadequate funding levels for our national security and lead to cuts in other vital programs serving our veterans, older Americans, low-income families. It would stall biomedical research, harm our farmers, and slow progress that we are making on our infrastructure.

A year-long CR would result in defense funding levels that are nearly $27 billion less than the President's request in the Fiscal Responsibility Act. According to the chairman of the Joint Chiefs of Staff, under a year-long CR:

Thousands of [defense] programs will be impacted with the

most devastating impacts being to personnel, the nuclear

triad modernization, shipbuilding and maintenance, munitions

productions and replenishments, and the U.S. Indo-Pacific

Command priorities.

A year-long CR would result in our military being less ready to respond to the serious security threats around the globe.

I urge my colleagues to reject this motion and support the reasonable approach of completing our work.

Mr. President, our colleagues are aware that there is a group of Senators who are meeting with the administration officials to try to carefully craft an urgently needed solution to the border security crisis. I rise today to discuss the urgent need for bipartisan solutions to address that crisis.

Yesterday set a new record that demonstrates the magnitude of our border security crisis. U.S. Customs and Border Protection officers encountered a record 12,381 foreign nationals who were entering the United States along our southwest border without authorization.

So far this fiscal year, we are averaging nearly 8,500 encounters per day, and, this month, the average is nearly 10,000 per day. That means that for the month of December, we are likely to reach a record of more than 300,000 people crossing the southwest border without legal authorization. At the current rate, we are on pace for more than 3 million encounters in fiscal year 2024, which would shatter the previous high set last fiscal year.

To put this in perspective, that is more than twice as many encounters at the southwest border as there are people in the entire State of Maine, and these enormous numbers do not include what Border Patrol agents describe as the ``got-aways''--in other words, those who do not turn themselves in and, instead, elude capture.

These numbers have grown dramatically in the past 3 years. Since fiscal year 2021, we have seen almost 6.6 million encounters and are on pace to see nearly 9.7 million individuals by the end of fiscal year 2024. Jeh Johnson, who served as Secretary of Homeland Security under President Obama, once said that, when he was Secretary, a thousand migrant encounters a day overwhelms the system. So just think what 10,000 individuals crossing does to the system.

And this problem is not limited to the southwest border, even though that is where the problem is most acute. We are increasingly seeing surges of migrant encounters along our northern border, including the State of Maine. According to Customs and Border Protection, migrant encounters at the northern border increased 73 percent in fiscal year 2023 over the previous year and a staggering 700 percent over fiscal year 2021 levels.

In the State of Maine, encounters have increased over 450 percent since fiscal year 2021. Increasingly, what we are seeing is that migrants are flying to Canada, knowing that they will have an easier time crossing the enormous 5,525-mile northern border.

Just recently, the U.S. Border Patrol encountered a group of 20 Romanians illegally crossing into the United States near Houlton, ME, in northern Maine. Two of these individuals were flagged as ``transnational criminal organized crime'' matches and detained for expedited removal proceedings. The remaining 18 were simply released into the local community.

Communities in Maine and throughout our country are struggling to absorb this influx of people who are being released into the interior. The majority of migrants are released pending an adjudication of their asylum claims. But that is a process that can take years.

In Portland, ME, a city of 68,000 residents, more than 1,600 asylum seekers have arrived since January.

Sanford, ME, which has a population of only 22,000, has had approximately 400 migrants arrive since May. Over the past 6 months, the city of Sanford has spent $1.3 million to provide food, housing, and other required assistance to asylum seekers and their families.

Now, the irony here is these asylum seekers are not allowed to go to work immediately upon filing their asylum applications. I have introduced a bill that could help lessen the impact on local communities by helping asylum seekers support themselves, as they want to do. And employers in Maine want to hire them while they await their immigration proceedings.

Specifically, my bill would shorten the waiting period for asylum seekers who come through legal ports of entry to apply for employment authorization, provided that their applications are not frivolous, that they are not detained, and that their identities have been verified with their names run through the Federal Government's Terrorist Watchlist.

An out-of-control border, which is what we have now, poses a very real threat to our homeland and our people. This is a national security challenge for our country.

Since fiscal year 2021, 294 individuals who were apprehended by Border Patrol at the southwest border were on the Terrorist Watchlist. That compares to only 11 such individuals in the previous 4 years combined. And just think how many others are part of the ``got-aways,'' those who did not turn themselves in or were not apprehended by our Border Patrol.

There are also tens of thousands of migrants arrested at our southern and northern borders who have criminal convictions or who are wanted by law enforcement, such as the two Romanians recently encountered in Maine.

Not only has the failure to control our border led to unchecked migration, but it has also contributed to the serious illegal drug crisis that is affecting communities throughout our country.

Mexican drug cartels are using the chaos at the southern border to facilitate their trafficking operations. They are sending record amounts of fentanyl into this country, enough to kill every American many times over.

Maine, like so many States, has seen record increases in recent years in the number of overdose deaths, nearly 80 percent of which are fentanyl related. We lost 513 Mainers in the first 10 months of 2023 to fatal overdoses, and 373 of these deaths were fentanyl related.

In addition, the Mexican cartel used the chaos and the uncontrolled southern border for human trafficking.

This is a crisis. It is a humanitarian crisis, and it is a national security crisis. And we cannot allow it to continue.

I have long supported creating legal immigration pathways with appropriate guardrails. Immigrants contribute to our great country and our communities in so many important ways. However, it is clear that we must act to address the ongoing and ever worsening crisis at our borders, which adversely affects communities throughout our country.

We cannot delay any longer. I am a strong supporter for continuing to provide assistance to Ukraine to repel Russian aggression. Make no mistake about it, Putin will not stop with Ukraine. He will go on to re-create, if he possibly can, his vision of, once again, having the old Soviet Union. I believe that if he is successful in Ukraine, he will next seize Moldova. He then will begin to menace and threaten our NATO allies--the Baltic States, Poland.

So far, we have been able to assist Ukraine without one American soldier losing his life or her life. We should continue to do so.

We need to help our greatest ally, Israel, in its fight against the terrorist group Hamas.

These, in many ways, are border disputes as well, but we cannot ignore the border crisis that we have in our own country. And that is why we need to work on all of these issues and bring them together in a supplemental funding bill.

The time to act is now. It is unfortunate that the administration has been so late to these negotiations, but I still have hope that we can put together a package that will address all of these crises: the border crisis in our own country, the border crisis in Ukraine, the border crisis in Israel with the terrorist attacks from Hamas, and the coming border crisis that we are going to see, I fear, with China increasingly threatening Taiwan. All of those issues need to be addressed in the supplemental. Let's get the job done.

Mr. President. I rise today to commemorate the 200th anniversary of the incorporation of Richmond, ME. As community events throughout this bicentennial year demonstrate, Richmond has a fascinating history that exemplifies the determination and ingenuity that defines the State of Maine.

For thousands of years, the woods and waters where the Kennebec River meets the sea at Merrymeeting Bay sustained the Abenaki people. In 1605, the explorers Samuel de Champlain and George Weymouth led the first European expeditions to the area. In the decades following a land purchase from the Tribes in 1649, the first English settlers established farms, grain and lumber mills, a trading post, and, in 1719, Fort Richmond. Originally part of the town of Bowdoinham, a community named for the fort grew and prospered on land granted to Revolutionary War veteran John Plummer, and Richmond incorporated as a separate town in 1823.

The Kennebec River flows through Richmond's history. With vast lumber supplies and nearby ocean access, the town became a key center for the seafaring trade and shipbuilding in early America. An estimated 200 ships were built in Richmond during the days of sail, about half of them by Thomas Jefferson Southard. Known as ``the father of Richmond village,'' Southard rose from blacksmith apprentice to master shipbuilder and property developer, and his memory lives on in the stunning architecture that distinguishes the town today.

Throughout the 19th century and well into the 20th, Richmond also was a center for the ice trade, sending massive blocks of pure frozen Kennebec water all over the world. Before the invention of powered refrigeration, some 50 huge ice houses, some as big as 10 football fields and up to 7 stories high, operated on the Richmond riverfront. Every winter, up to 4,000 workers would come to town for the 2-month ice harvest season.

An important thread that runs through Richmond's story is the love of liberty. Throughout American history, patriots from the town have stepped forward to defend freedom. During the Cold War, Richmond was home to as many as 500 Russian, Ukrainian, Polish, and Belorussian immigrants who sought refuge from Communist oppression in a place where the countryside reminded them of their homeland. The St. Alexander Nevsky Church, with its pale blue onion dome, is the only Russian Orthodox Church in Maine.

From the Fire and Ice Festival in winter, to Richmond Days in summer, townspeople love to get together to celebrate their heritage. The last Saturday in June is observed statewide as R.B. Hall Day in honor of Maine's world-renowned composer of marches and band music, and the day has special significance for Richmond. Born in neighboring Bowdoinham in 1858, Robert Browne Hall lived in Richmond, began his career as soloist and leader of the Richmond Cornet Band, and is buried in the town's Evergreen Cemetery.

Today, visitors and residents alike enjoy Richmond's smalltown charm, beautiful historic buildings, and exciting outdoor recreation opportunities. The energy that so many have devoted to this year's exciting bicentennial celebration is but one example of the spirit that has guided the town from its founding to today. For two centuries, the people of Richmond, ME, have worked together, cared for one another, and built a great community.

Madam President, I ask unanimous consent to speak for up to 15 minutes prior to the scheduled roll call vote.

Madam President, I come to the floor to urge action on the fiscal year 2024 appropriations bills that fund critical programs, programs that are so important to America and to American families, programs ranging from biomedical research to our national defense.

On November 1, the Senate passed its first package of three appropriations bills: the military construction and veterans affairs legislation, the Agriculture and FDA bill, and the Transportation and Housing bill. And due to the extraordinary work of the members of the Appropriations Committee, they passed by overwhelming bipartisan vote of 82 to 15.

Despite the Appropriations Committee working hard to report all 12 of the funding bills by the end of July, additional full-year appropriations bills have not been brought to the Senate floor. Instead, the Federal Government has been operating under short-term funding patches known as continuing resolutions since the start of the fiscal year on October 1. These temporary funding patches lead to harmful uncertainties, needless inefficiencies, and wasted taxpayer dollars.

One of the bills that I hope will be brought to the floor soon is the Department of Defense appropriations bill. This bill would provide critical resources for our military at a time when we are facing many complex threats from around the globe, including those posed by an imperialistic Russia, a hegemonic China, and an increasingly belligerent Iran and its proxies.

Earlier this summer, the Senate Appropriations Committee approved its version of the defense funding bill by a strong bipartisan vote of 27 to 1. This bill contains funding for key national security priorities, including providing our troops and their families with the pay and benefits that they deserve, expanding our naval fleet, and modernizing the nuclear triad, strengthening deterrence against China--our pacing threat--rebuilding our munitions stockpiles, and addressing military readiness and capability gaps.

Each day that the Department of Defense operates under a temporary funding measure rather than its full-year appropriations bill, important national security investments remain on hold. For example, the Department has identified more than 330 new programs or production increases that cannot proceed. This includes more than a dozen high- priority initiatives identified by the Air Force, 6 billion in Army transformation efforts, and multiyear procurement authority for the Virginia class submarines.

In a letter that was sent to the Appropriations Committee just today, Chairman C.Q. Brown, the chairman of the Joint Chiefs of Staff writes that ``We cannot outpace our pacing challenge while under continuing resolution.''

In other words, continuing resolutions give China the upper hand.

I ask unanimous consent that the text of General Brown's letter be printed in the Record following my remarks.

Recently, some have called for simply passing a year-long continuing resolution for fiscal year 2024, essentially locking in last year's priorities, continuing to fund programs that should not be funded or should be reduced, and preventing the funding of new programs. I would like to take just a few moments to describe just how harmful that would be to our national defense. A year-long continuing resolution would simply fail to provide the resources needed to protect our Nation. For fiscal year 2024, it would reduce defense spending by 26.6 billion relative to the President's budget request and the Fiscal Responsibility Act and by 34.6 billion compared to the funding levels approved by the Appropriations Committee by that wide bipartisan vote.

So you can see the big difference that having a year-long CR would lock in completely inadequate funding levels, given the threats that we face. Many of the key national security priorities funded in the Defense bill would suffer under a year-long continuing resolution.

Let me give some specific examples. To respond to military recruitment challenges, the Senate committee-approved bill would invest in our men and women in uniform. It includes funding for the 5.2 percent military pay raise. As General Brown points out, a year-long CR would create a $5.8 billion shortfall in military personnel funding and exacerbate recruiting and retention challenges.

To offset the cost of the pay raise for the military, DOD would be forced to slow recruiting--the last thing we want to see happen--delay servicemembers' moves, and take other detrimental actions.

So this chart compares our committee bill versus a year-long CR. And as you can see, there are tremendous differences in quality-of-life issues for our servicemembers and the actual funding for the pay raise which will go into effect, but the Department would have to take money out of other personnel accounts.

Other quality-of-life initiatives in the bill, such as expanding prekindergarten for more than 4,000 children of servicemembers and improving living conditions for sailors serving aboard ships would not be able to proceed during a year-long CR. Our committee-passed bill also invests in the overdue modernization of all three legs of the nuclear triad. These efforts would be delayed under the yearlong CR because of a nearly $3.4 billion funding shortfall.

At a time when China's Navy is already at least 80 ships larger than our own, the committee-approved bill includes record investments--more than $33 billion--in Navy shipbuilding. It includes funding for two destroyers and advance procurement for a much needed third.

In recent days, the capabilities of these ships and the professionalism and expertise of the sailors who serve aboard them have been on full display as they have downed numerous drones and missiles headed toward them and aimed also at Israel.

Two of these ships, I am proud to say, the USS Carney and the USS Thomas Hudner, were built at Bath Iron Works in my State.

Since October 7, Iranian-backed proxies have launched at least 73 attacks on U.S. servicemembers and bases. Our fleet is essential to protect those servicemembers and bases as well as Israel.

The Senate committee-approved bill also includes funding for two Virginia-class submarines, two frigates, and a downpayment on an amphibious ship, which is the Marine Corps' top unfunded priority. In addition to contributing to cost increases and delays in the delivery of ships to the Navy, a yearlong CR would result in only one Virginia- class submarine, one frigate, and potentially no funding for the amphibious ship or the third destroyer.

General Brown points out in his letter that 30 percent of the funding in the Navy shipbuilding request could not be spent.

The Defense bill also includes more than $65 billion for capabilities or requirements related to the Indo-Pacific, including $857 million to meet the highest priorities of the most senior U.S. military commander in the region and an additional $981 million for other unfunded requirements listed as priorities by our military services focused on deterring China.

Our bill would authorize multiyear procurements for seven munitions critical to the region, such as long-range precision missiles, Patriot air defense missiles, and anti-ship missiles. Multiyear procurements provide stability and predictability to our defense industrial base and save taxpayer dollars. Neither the additional funding nor the authority to award these contracts would be possible under a yearlong CR.

Our committee-passed bill would ramp up investments in the U.S. defense industrial base. It would increase munitions procurement funding by 31 percent compared to the last fiscal year and includes $1.8 billion to modernize 23 Army depots, arsenals, and ammo plants across 17 States. Under a yearlong CR, both of those initiatives would be blocked or delayed.

Our committee-passed bill also includes readiness investments that would be put at risk under a yearlong CR. Up to 75 Navy ship repair availabilities would be delayed or canceled, which would degrade the Navy's ability to deploy its fleet for operations, even as the Navy is maintaining a greater presence and projecting power in the Middle East since Hamas's terrorist attack against Israel.

There was just yesterday a news story talking about the Department of Defense ordering an additional aircraft carrier strike group, air defenses, fighter jets, and hundreds of troops to the Middle East since the surprise terrorist attacks on Israel in an effort to prevent that conflict from spiraling into a regional war. But the problem is that the military, because it has not received its regular appropriations bill, is having to scramble to find the funding for this. Because these Middle East troop movements weren't planned, the Pentagon has had to pull money from existing operations and maintenance accounts. That means less money for training exercises and deployments that the military had already planned for this year.

Our Nation's security and our service men and women deserve better than a yearlong continuing resolution. In the letter sent today, General Brown writes that besides passing a supplemental, ``the single greatest thing that Congress can do to enable the Department to execute our strategy is to enact a full-year appropriation.''

Let's get our work done and pass the full-year funding bills. I urge my colleagues to work together. Let's meet the challenges our Nation faces.

Madam President, I rise to introduce the Supporting Seniors with Opioid Use Disorder Act with my colleague from Maryland, Senator Cardin. I very much appreciate his leadership on this issue. The United States is experiencing an opioid overdose and addiction crisis with devastating effects on communities across the country. The opioid epidemic is claiming the lives of far too many people, with a record 716 Mainers and nearly 110,000 Americans lost in 2022. While many perceive the face of opioid addiction as young, the epidemic harms older adults as well. In Maine, approximately 12 percent of drug overdose deaths last year were among residents age 60 and older.

Each and every opioid death is preventable, and more can be done to ensure that the unique needs of older Americans struggling with addiction are not forgotten. In December 2021, the Department of Health and Human Services Office of the Inspector General, OIG, identified an urgent need to increase the number of Medicare beneficiaries receiving treatment for opioid use disorder. The legislation we are introducing today would help improve seniors' awareness of, and access to, opioid use disorder, OUD, treatment covered by the Medicare Program.

The challenges of the pandemic, combined with the increased prevalence of fentanyl entering our country, have aggravated this national crisis. Even before COVID-19, however, the number of people age 55 or older treated in emergency rooms for nonfatal opioid overdoses was increasing, with a shocking 32 percent jump in ER visits from 2016 to 2017. In 2018, when I served as chairman of the Senate Special Committee on Aging, I chaired a hearing on this topic to shed light on the unique challenges faced by this often-overlooked population. One expert witness told the Aging Committee, ``Medicare beneficiaries are the fastest growing population of diagnosed opioid use disorders.'' Dr. Charles Pattavina, an emergency medicine physician in Bangor, ME, also explained how increased incidences of acute illnesses and injuries among older Americans make them more susceptible to opioid misuse.

In 2021, the Office of the Inspector General investigated the extent to which Medicare beneficiaries diagnosed with opioid use disorder received medication and behavioral therapy through Medicare. The report found that more than 1 million Medicare beneficiaries were diagnosed with OUD in 2020, yet fewer than 16 percent of those patients received medication to treat their OUD. The report also concluded that older beneficiaries were three times less likely to receive medication to treat their OUD than younger beneficiaries. Even fewer beneficiaries received both medication and behavioral therapy. The conclusion was clear: Medicare beneficiaries are not receiving the OUD treatment they need.

A followup OIG report from September 2022 revealed that the situation has largely failed to improve over time. About 50,400 Part D beneficiaries experienced an opioid overdose--from prescription opioids, illicit opioids, or both--during 2021. While the overall proportion of beneficiaries with opioid use disorder receiving medication increased slightly from 16 percent in 2020 to 18 percent in 2021, still fewer than one in five Medicare beneficiaries received the medication they need. This report echoed the call to implement the 2021 OIG recommendations.

The Supporting Seniors with Opioid Use Disorder Act would put into law the recommendations made by the HHS OIG regarding how to improve beneficiaries' awareness of Medicare coverage for OUD treatment and how to identify gaps and opportunities to better meet the needs of this unique population. Specifically, our legislation would require CMS to conduct additional outreach to beneficiaries to increase awareness about Medicare coverage for the treatment of OUD, such as by revising enrollment materials, making State and national contact information for healthcare providers publicly available and easily accessible, and developing or improving continuing education programs about opioid medications and substance use disorder treatment programs. Our bill would also improve data sharing within Agencies at HHS with the goal of obtaining a better understanding of current treatment gaps.

Finally, the bill would require HHS to convene a stakeholder meeting to share best practices on the use of behavioral therapy among beneficiaries receiving medication to treat opioid use disorder. Emerging research points to evidence that patients receiving medication to treat opioid use disorder may also benefit from behavioral therapy, so this opportunity for collaboration on strategies to support better treatment engagement and continuity could be beneficial to both patients and healthcare professionals.

The drug crisis continues to ravage our country, and it is critical that people who are suffering from opioid use disorder have access to the treatment they need to survive and thrive--including our seniors. Challenges in treatment and recovery will persist, but we can begin by better supporting older Americans' access to opioid use disorder services and by strengthening our understanding of potential disparities in treatment. I urge my colleagues to support this important legislation.

Madam President, I rise to introduce the Supporting Seniors with Opioid Use Disorder Act with my colleague from Maryland, Senator Cardin. I very much appreciate his leadership on this issue. The United States is experiencing an opioid overdose and addiction crisis with devastating effects on communities across the country. The opioid epidemic is claiming the lives of far too many people, with a record 716 Mainers and nearly 110,000 Americans lost in 2022. While many perceive the face of opioid addiction as young, the epidemic harms older adults as well. In Maine, approximately 12 percent of drug overdose deaths last year were among residents age 60 and older.

Each and every opioid death is preventable, and more can be done to ensure that the unique needs of older Americans struggling with addiction are not forgotten. In December 2021, the Department of Health and Human Services Office of the Inspector General, OIG, identified an urgent need to increase the number of Medicare beneficiaries receiving treatment for opioid use disorder. The legislation we are introducing today would help improve seniors' awareness of, and access to, opioid use disorder, OUD, treatment covered by the Medicare Program.

The challenges of the pandemic, combined with the increased prevalence of fentanyl entering our country, have aggravated this national crisis. Even before COVID-19, however, the number of people age 55 or older treated in emergency rooms for nonfatal opioid overdoses was increasing, with a shocking 32 percent jump in ER visits from 2016 to 2017. In 2018, when I served as chairman of the Senate Special Committee on Aging, I chaired a hearing on this topic to shed light on the unique challenges faced by this often-overlooked population. One expert witness told the Aging Committee, ``Medicare beneficiaries are the fastest growing population of diagnosed opioid use disorders.'' Dr. Charles Pattavina, an emergency medicine physician in Bangor, ME, also explained how increased incidences of acute illnesses and injuries among older Americans make them more susceptible to opioid misuse.

In 2021, the Office of the Inspector General investigated the extent to which Medicare beneficiaries diagnosed with opioid use disorder received medication and behavioral therapy through Medicare. The report found that more than 1 million Medicare beneficiaries were diagnosed with OUD in 2020, yet fewer than 16 percent of those patients received medication to treat their OUD. The report also concluded that older beneficiaries were three times less likely to receive medication to treat their OUD than younger beneficiaries. Even fewer beneficiaries received both medication and behavioral therapy. The conclusion was clear: Medicare beneficiaries are not receiving the OUD treatment they need.

A followup OIG report from September 2022 revealed that the situation has largely failed to improve over time. About 50,400 Part D beneficiaries experienced an opioid overdose--from prescription opioids, illicit opioids, or both--during 2021. While the overall proportion of beneficiaries with opioid use disorder receiving medication increased slightly from 16 percent in 2020 to 18 percent in 2021, still fewer than one in five Medicare beneficiaries received the medication they need. This report echoed the call to implement the 2021 OIG recommendations.

The Supporting Seniors with Opioid Use Disorder Act would put into law the recommendations made by the HHS OIG regarding how to improve beneficiaries' awareness of Medicare coverage for OUD treatment and how to identify gaps and opportunities to better meet the needs of this unique population. Specifically, our legislation would require CMS to conduct additional outreach to beneficiaries to increase awareness about Medicare coverage for the treatment of OUD, such as by revising enrollment materials, making State and national contact information for healthcare providers publicly available and easily accessible, and developing or improving continuing education programs about opioid medications and substance use disorder treatment programs. Our bill would also improve data sharing within Agencies at HHS with the goal of obtaining a better understanding of current treatment gaps.

Finally, the bill would require HHS to convene a stakeholder meeting to share best practices on the use of behavioral therapy among beneficiaries receiving medication to treat opioid use disorder. Emerging research points to evidence that patients receiving medication to treat opioid use disorder may also benefit from behavioral therapy, so this opportunity for collaboration on strategies to support better treatment engagement and continuity could be beneficial to both patients and healthcare professionals.

The drug crisis continues to ravage our country, and it is critical that people who are suffering from opioid use disorder have access to the treatment they need to survive and thrive--including our seniors. Challenges in treatment and recovery will persist, but we can begin by better supporting older Americans' access to opioid use disorder services and by strengthening our understanding of potential disparities in treatment. I urge my colleagues to support this important legislation.

Madam President, I rise today to introduce the Medical Nutrition Therapy Act of 2023, along with my colleague from Michigan, Senator Peters. Our bill would expand Medicare beneficiaries' access to medical nutrition therapy, or MNT, which is a cost-effective component of treatment for obesity, diabetes, hypertension, dyslipidemia, and other chronic conditions.

At a time when the increased prevalence of diet-related chronic conditions is contributing to poor health outcomes and growing healthcare expenditures, increasing access to MNT should be part of the strategy to improve disease management and prevention for America's seniors. The Medical Nutrition Therapy Act would make two important changes to support patients, improve health outcomes, and reduce unnecessary healthcare costs.

First, it would expand Medicare Part B coverage of outpatient medical nutrition therapy services to a number of currently uncovered diseases or conditions--including prediabetes, obesity, high blood pressure, high cholesterol, malnutrition, eating disorders, cancer, HIV/AIDS, gastrointestinal diseases including celiac disease, and cardiovascular disease. Currently, Medicare Part B only covers outpatient MNT for diabetes, renal disease, and post-kidney transplant.

Second, the bill would allow more types of providers--including nurse practitioners, physician assistants, clinical nurse specialists, and psychologists--to refer patients to MNT. This is especially critical for a rural State like Maine, where a NP or PA may be one's trusted primary care provider.

MNT counseling is provided by registered dietician nutritionists, RDNs, as part of a collaborative healthcare team. It is evidenced-based and proven to positively affect weight, blood pressure, blood lipids, and blood sugar control. Nutritional counseling by RDNs is recommended by the National Lipid Association to promote long-term adherence to an individualized, heart-healthy diet. Through MNT, individuals benefit from in-depth, individualized nutrition assessments. Follow up visits help reinforce important behavior and lifestyle changes and increase compliance.

Older Americans deserve improved access to this cost-effective medical treatment, but many older adults are missing out under the current Medicare policy. Marcy Kyle, a RDN from Rockport, ME, has seen many patients denied access to medically necessary MNT. One of her patients with prediabetes was referred by his primary care physician for MNT at age 64. At that time, his private insurance covered the service, and he booked the first available appointment the following week. That same week, this patient turned 65 and transitioned onto Medicare. You can imagine his surprise upon arriving for his appointment and learning that MNT would not be covered.

Another unfortunate example from Maine was a patient with a new celiac disease diagnosis complicated by severe weight loss. His private insurance covered MNT as celiac disease is a controllable disease with proper nutrition. But when transitioning from private insurance to Medicare, this patient, too, lost his access to MNT. The saddest situation this RDN has confronted is when an older cancer patient experiences such side effects from cancer treatment as severe weight loss or nausea, which could be prevented with MNT. As with prediabetes and celiac disease, however, Medicare does not cover MNT for cancer patients. This truly is a lost opportunity since we know early treatment with MNT can prevent future and more serious health complications and chronic conditions in older adults. These conditions should be covered.

In addition to leading to confusion and potential delays in care for patients seeking needed healthcare services, we must also consider the staggering economic impact of chronic diseases. According to the U.S. Centers for Disease Control and Prevention, 90 percent of the $3.8 trillion that the United States spends annually on healthcare goes to the treatment of people with chronic diseases and mental health conditions. Preventing chronic diseases or managing symptoms when prevention is not possible is one way to reduce these costs. This is particularly important for the Medicare Program, as more than two- thirds of seniors on Medicare live with multiple chronic conditions. As one registered dietitian nutritionist in Maine told me, ``We all know a dollar spent on prevention saves many health care dollars in the long run and is the right thing to do for our seniors at a time when they have limited budgets.''

MNT can help prevent chronic disease, such as type 2 diabetes. It can better control celiac and other gastrointestinal ailments. It can improve outcomes and the quality of life for those with cancer and other devastating diagnoses. The current Medicare restrictions on medical nutrtition therapy coverage can be detrimental for older adults at a critical juncture in their journey to better health and should be changed.

The Medical Nutrition Therapy Act of 2023 is supported by more than 40 expert national organizations, including the Academy of Nutrition and Dietetics, the American Diabetes Association, the Endocrine Society, and UsAgainstAlzheimer's.

I urge my colleagues to support this important legislation to improve access to cost-effective medical treatment for Medicare patients with chronic diseases.

Madam President, I rise today to introduce the Medical Nutrition Therapy Act of 2023, along with my colleague from Michigan, Senator Peters. Our bill would expand Medicare beneficiaries' access to medical nutrition therapy, or MNT, which is a cost-effective component of treatment for obesity, diabetes, hypertension, dyslipidemia, and other chronic conditions.

At a time when the increased prevalence of diet-related chronic conditions is contributing to poor health outcomes and growing healthcare expenditures, increasing access to MNT should be part of the strategy to improve disease management and prevention for America's seniors. The Medical Nutrition Therapy Act would make two important changes to support patients, improve health outcomes, and reduce unnecessary healthcare costs.

First, it would expand Medicare Part B coverage of outpatient medical nutrition therapy services to a number of currently uncovered diseases or conditions--including prediabetes, obesity, high blood pressure, high cholesterol, malnutrition, eating disorders, cancer, HIV/AIDS, gastrointestinal diseases including celiac disease, and cardiovascular disease. Currently, Medicare Part B only covers outpatient MNT for diabetes, renal disease, and post-kidney transplant.

Second, the bill would allow more types of providers--including nurse practitioners, physician assistants, clinical nurse specialists, and psychologists--to refer patients to MNT. This is especially critical for a rural State like Maine, where a NP or PA may be one's trusted primary care provider.

MNT counseling is provided by registered dietician nutritionists, RDNs, as part of a collaborative healthcare team. It is evidenced-based and proven to positively affect weight, blood pressure, blood lipids, and blood sugar control. Nutritional counseling by RDNs is recommended by the National Lipid Association to promote long-term adherence to an individualized, heart-healthy diet. Through MNT, individuals benefit from in-depth, individualized nutrition assessments. Follow up visits help reinforce important behavior and lifestyle changes and increase compliance.

Older Americans deserve improved access to this cost-effective medical treatment, but many older adults are missing out under the current Medicare policy. Marcy Kyle, a RDN from Rockport, ME, has seen many patients denied access to medically necessary MNT. One of her patients with prediabetes was referred by his primary care physician for MNT at age 64. At that time, his private insurance covered the service, and he booked the first available appointment the following week. That same week, this patient turned 65 and transitioned onto Medicare. You can imagine his surprise upon arriving for his appointment and learning that MNT would not be covered.

Another unfortunate example from Maine was a patient with a new celiac disease diagnosis complicated by severe weight loss. His private insurance covered MNT as celiac disease is a controllable disease with proper nutrition. But when transitioning from private insurance to Medicare, this patient, too, lost his access to MNT. The saddest situation this RDN has confronted is when an older cancer patient experiences such side effects from cancer treatment as severe weight loss or nausea, which could be prevented with MNT. As with prediabetes and celiac disease, however, Medicare does not cover MNT for cancer patients. This truly is a lost opportunity since we know early treatment with MNT can prevent future and more serious health complications and chronic conditions in older adults. These conditions should be covered.

In addition to leading to confusion and potential delays in care for patients seeking needed healthcare services, we must also consider the staggering economic impact of chronic diseases. According to the U.S. Centers for Disease Control and Prevention, 90 percent of the $3.8 trillion that the United States spends annually on healthcare goes to the treatment of people with chronic diseases and mental health conditions. Preventing chronic diseases or managing symptoms when prevention is not possible is one way to reduce these costs. This is particularly important for the Medicare Program, as more than two- thirds of seniors on Medicare live with multiple chronic conditions. As one registered dietitian nutritionist in Maine told me, ``We all know a dollar spent on prevention saves many health care dollars in the long run and is the right thing to do for our seniors at a time when they have limited budgets.''

MNT can help prevent chronic disease, such as type 2 diabetes. It can better control celiac and other gastrointestinal ailments. It can improve outcomes and the quality of life for those with cancer and other devastating diagnoses. The current Medicare restrictions on medical nutrtition therapy coverage can be detrimental for older adults at a critical juncture in their journey to better health and should be changed.

The Medical Nutrition Therapy Act of 2023 is supported by more than 40 expert national organizations, including the Academy of Nutrition and Dietetics, the American Diabetes Association, the Endocrine Society, and UsAgainstAlzheimer's.

I urge my colleagues to support this important legislation to improve access to cost-effective medical treatment for Medicare patients with chronic diseases.

Madam President, today I rise to introduce the Peer Support Services Center of Excellence Act, a bipartisan bill that I have authored to help combat the vast and growing opioid epidemic. I want to acknowledge and thank Senator Shaheen for her leadership on this effort, and I look forward to continuing to work with her and others on this important legislation.

Last year in Maine, 716 people died from a drug overdose--a record number. Tragically, this was the third consecutive year that Maine set a record for fatal overdoses. Nationwide, nearly 110,000 Americans were lost in 2022 to overdoses. It is clear that we need to take an all-of- the-above approach to tackle this crisis. This includes support for education and prevention, treatment, law enforcement, and border security. No single focus will be enough on its own.

One ongoing challenge to reducing the number of overdose deaths is that far too often individuals suffer an addiction relapse. Indeed, a nonfatal overdose is a leading predictor for a future fatal overdose. We must do more to address this reality. Between 40 and 60 percent of individuals in treatment for substance use disorders relapse, and this rate is often much higher for those struggling with opioid addiction. Relapse rates are high, but that does not mean relapse is inevitable.

One way that individuals struggling with addiction are finding support is through peer recovery groups. In 2018, Senator Shaheen and I introduced the Opioid Peer Support Networks Act, much of which was enacted as part of the SUPPORT for Patients and Communities Act that year. Our bill fostered the expansion of peer support networks through the creation of a National Peer-Run Training and Technical Assistance Center for Addiction Recovery Support. This center provides no-cost training and assistance to recovery community organizations, or RCOs, and peer support networks to integrate peer support workers into nontraditional settings, build and strengthen the capacity of RCOs, enhance the professionalism of peers through workforce development, as well as provide evidence-based and practice-based tool kits and resource information to stakeholders.

This national center has enhanced the field of peer recovery support services. Through the center's work, in fiscal year 2022, nearly 2,000 individuals were trained in how to support RCOs and peer support networks, and nearly 200 individuals were trained to provide specialized technical assistance, evaluate and improve the effectiveness of services provided by RCOs, and offer translation and interpretation services, data collection support, and capacity building expertise. This training is improving the services that are offered by organizations across our country, and the center has provided a platform for experts and recovery centers to learn from each other's experiences.

In peer support networks, individuals and families battling addiction help one another stay firm on the road to recovery by assisting with employment, education, housing, health and overall well-being. I have visited the Bangor Area Recovery Network, or BARN, in Brewer, ME, which is a volunteer-led organization that provides support to individuals recovering from addiction. BARN is a model for peer-led counseling and brings hope, recovery support, and healing to those struggling with substance abuse. Individuals who are themselves in recovery can make that critical connection to others facing addiction, which, in turn, can make the recovery process sustainable and reduce the stigma of addiction and treatment.

In recent years, in response to growing need and community efforts to expand recovery programming, Maine has seen the presence of RCOs like BARN grow across our State. As of January 2023, there were 19 recovery centers--from Sanford to Caribou--operated by people in recovery who are serving their local communities by offering peer-based support services, among other activities.

After touring BARN and other similar organizations, I believe the emergence of peer-based and other recovery support services is one of the most significant trends in the addiction field. Peer-based recovery support services are unique in that they cover a wide range of activities not generally offered by treatment providers. This includes recovery coaching, support groups, sober social activities, as well as housing, transportation, and employment services. In offering services beyond treatment, this model provides the strong support system that is essential to recovery. As one of BARN's core beliefs tells us, ``A supportive community is vital to a successful recovery.''

The Opioid Peer Support Networks Act brought critical training and assistance to these on-the-ground peer-to-peer networks and helped build up these important recovery support systems. Our new bill reauthorizes the National Peer-Run Training and Technical Assistance Center for Addiction Recovery Support that is set to expire, and it expands upon the work made possible by our bill that was enacted 5 years ago. In addition to reauthorizing the center, our bill would create a pilot program for a regional center of excellence that could assist the national center and tailor its work to the needs of a particular region.

We believe that the development of regional assistance programs, along with the continuation of a national center, will promote coordination and effectiveness of technical assistance delivery. According to the Substance Abuse and Mental Health Services Administration, utilizing a regional model to grow the national center's reach may be an effective way to triage and distribute technical assistance requests and ensure that all entry points are coordinated centrally by retaining the National Center.

Tackling the opioid epidemic, both its causes and consequences, requires a multi-pronged approach. The bipartisan bill I have introduced continues and builds upon one proven way to respond to this growing problem--supporting individuals in recovery through proven support systems.

I urge my colleagues to support this important bill.

Madam President, today I rise to introduce the Peer Support Services Center of Excellence Act, a bipartisan bill that I have authored to help combat the vast and growing opioid epidemic. I want to acknowledge and thank Senator Shaheen for her leadership on this effort, and I look forward to continuing to work with her and others on this important legislation.

Last year in Maine, 716 people died from a drug overdose--a record number. Tragically, this was the third consecutive year that Maine set a record for fatal overdoses. Nationwide, nearly 110,000 Americans were lost in 2022 to overdoses. It is clear that we need to take an all-of- the-above approach to tackle this crisis. This includes support for education and prevention, treatment, law enforcement, and border security. No single focus will be enough on its own.

One ongoing challenge to reducing the number of overdose deaths is that far too often individuals suffer an addiction relapse. Indeed, a nonfatal overdose is a leading predictor for a future fatal overdose. We must do more to address this reality. Between 40 and 60 percent of individuals in treatment for substance use disorders relapse, and this rate is often much higher for those struggling with opioid addiction. Relapse rates are high, but that does not mean relapse is inevitable.

One way that individuals struggling with addiction are finding support is through peer recovery groups. In 2018, Senator Shaheen and I introduced the Opioid Peer Support Networks Act, much of which was enacted as part of the SUPPORT for Patients and Communities Act that year. Our bill fostered the expansion of peer support networks through the creation of a National Peer-Run Training and Technical Assistance Center for Addiction Recovery Support. This center provides no-cost training and assistance to recovery community organizations, or RCOs, and peer support networks to integrate peer support workers into nontraditional settings, build and strengthen the capacity of RCOs, enhance the professionalism of peers through workforce development, as well as provide evidence-based and practice-based tool kits and resource information to stakeholders.

This national center has enhanced the field of peer recovery support services. Through the center's work, in fiscal year 2022, nearly 2,000 individuals were trained in how to support RCOs and peer support networks, and nearly 200 individuals were trained to provide specialized technical assistance, evaluate and improve the effectiveness of services provided by RCOs, and offer translation and interpretation services, data collection support, and capacity building expertise. This training is improving the services that are offered by organizations across our country, and the center has provided a platform for experts and recovery centers to learn from each other's experiences.

In peer support networks, individuals and families battling addiction help one another stay firm on the road to recovery by assisting with employment, education, housing, health and overall well-being. I have visited the Bangor Area Recovery Network, or BARN, in Brewer, ME, which is a volunteer-led organization that provides support to individuals recovering from addiction. BARN is a model for peer-led counseling and brings hope, recovery support, and healing to those struggling with substance abuse. Individuals who are themselves in recovery can make that critical connection to others facing addiction, which, in turn, can make the recovery process sustainable and reduce the stigma of addiction and treatment.

In recent years, in response to growing need and community efforts to expand recovery programming, Maine has seen the presence of RCOs like BARN grow across our State. As of January 2023, there were 19 recovery centers--from Sanford to Caribou--operated by people in recovery who are serving their local communities by offering peer-based support services, among other activities.

After touring BARN and other similar organizations, I believe the emergence of peer-based and other recovery support services is one of the most significant trends in the addiction field. Peer-based recovery support services are unique in that they cover a wide range of activities not generally offered by treatment providers. This includes recovery coaching, support groups, sober social activities, as well as housing, transportation, and employment services. In offering services beyond treatment, this model provides the strong support system that is essential to recovery. As one of BARN's core beliefs tells us, ``A supportive community is vital to a successful recovery.''

The Opioid Peer Support Networks Act brought critical training and assistance to these on-the-ground peer-to-peer networks and helped build up these important recovery support systems. Our new bill reauthorizes the National Peer-Run Training and Technical Assistance Center for Addiction Recovery Support that is set to expire, and it expands upon the work made possible by our bill that was enacted 5 years ago. In addition to reauthorizing the center, our bill would create a pilot program for a regional center of excellence that could assist the national center and tailor its work to the needs of a particular region.

We believe that the development of regional assistance programs, along with the continuation of a national center, will promote coordination and effectiveness of technical assistance delivery. According to the Substance Abuse and Mental Health Services Administration, utilizing a regional model to grow the national center's reach may be an effective way to triage and distribute technical assistance requests and ensure that all entry points are coordinated centrally by retaining the National Center.

Tackling the opioid epidemic, both its causes and consequences, requires a multi-pronged approach. The bipartisan bill I have introduced continues and builds upon one proven way to respond to this growing problem--supporting individuals in recovery through proven support systems.

I urge my colleagues to support this important bill.

Madam President, the Senate is about to cast its vote--a key vote--on passage of the first package of fiscal year 2024 appropriations bills. They include the Military Construction-VA bill, the Agriculture and FDA legislation, and the Transportation and Housing and Urban Development appropriations.

I want to thank everyone involved for their cooperation for getting us to the point of passing this significant package.

First, let me thank Chair Murray for her strong, persistent, and dedicated leadership.

The support of Leaders McConnell and Thune and Leader Schumer were also absolutely essential.

I want to express my thanks to our hard-working staff, led by Betsy McDonnell and Evan Schatz.

We have a great Republican team on the Appropriations Committee. And I want to thank all of them for working with their Democratic counterparts to bring about truly bipartisan bills. Particularly, I want to thank on the Agriculture Subcommittee, the chairman, Senator Heinrich, and the ranking member, Senator Hoeven.

I want to thank my Military Construction and Veterans Affairs Committee, Senator Murray, for playing a double role there, as well as Senator Boozman.

And on the Transportation-HUD Subcommittee--a subcommittee I chaired for many years and was ranking member on--I want to thank Senator Schatz and Senator Hyde-Smith. They all worked incredibly hard.

After working for weeks with our colleagues, we considered 40 amendments to these three bills. All three of these bills passed the Appropriations Committee unanimously this past summer. And I appreciate the hard work of every single one of our members.

Giving Senators a voice in funding decisions through a robust committee and floor process was an early goal that Chair Murray and I established. It guided our process as the committee approved all 12 of the appropriations bills by the end of July for the first time in 5 years. It also has guided our process on the Senate floor. Well, it was certainly not easy and certainly took far longer than either the chair or I would have liked. The amendment process allowed for Senators of both parties to fully debate these bills and be heard.

I look forward to working with Chair Murray and her colleagues to build on this progress by continuing to process our committee-approved appropriations bills on the Senate floor.

I urge my colleagues to join me in voting for this important legislative package that honors and serves our Nation's veterans, supports our farmers, ranchers, and rural communities, and improves transportation infrastructure and housing opportunities all across our great country.

I urge a yea vote on the bill.

Madam President, I rise today to introduce the Working Waterfront Preservation Act, legislation to help preserve access by our Nation's fishermen and maritime workers to the waterfronts in coastal communities. I would like to thank my friend Senator Jack Reed from Rhode Island, who joins me in introducing this legislation.

According to the most recent data from the National Oceanic and Atmospheric Administration, commerical and recreational fisheries are responsible for more than 1.7 million jobs in the

United States, $253 billion in sales, and $117 billion in value-added impacts. In Maine, our fisheries are one of our State's most important resources and are vital to our economy. A report of Maine's seafood sector as a whole, which included downstream contributors, found that in 2019, the sector contributed more than $3.2 billion to Maine's economy. Although the fishing industry is a significant economic contributor both nationwide and in Maine, it is losing access to the working waterfronts that are vital to the industry's survival.

A working waterfront is defined as land that is used for or that supports commercial fishing, aquaculture, boatbuilding, or the for-hire recreational fishing industries. That may be a technical definition, but these areas represent much more to coastal communities. A recent study conducted by the Maine Coast Fishermen's Association sums it up perfectly: ``Working waterfronts are more than just a place of business for commercial fishermen; they are a hub of information, a collection of salty characters, a safe haven, a meeting room, a space for support, and they are well-deserving of both a place in Maine's history and its future.'' The importance of these areas cannot be overstated.

In Maine our fishermen and women are losing access to waterfront property up and down the coast. In some coastal Maine communities, once thriving working waterfronts no longer exist. Recent interviews conducted by the Island Institute in Maine uncover that ``for all practical purposes, working waterfront access [in these towns] is essentially gone.'' The reasons for this are complex. In some cases, burdensome fishing regulations have led to a decrease in landings, hindering the profitability of shoreside infrastructure. In other cases, soaring land values and rising taxes have made the current use of commercial land unprofitable. Property is being sold and quickly converted into private spaces, which means that they are no longer available to support our fisheries.

While this trend has been happening for decades--in 2006, Maine's working waterfront only took up 20 miles of Maine's nearly 3,500 miles of coastline--the recent demand for coastal properties has intensified this problem in Maine. We can help preserve these areas for the next generation of fishermen, boatbuilders, and maritime workers with dedicated investments. Currently, the primary mechanism for preserving Maine's waterfronts is through a State-run program called the Working Waterfront Access Protection Program. Since 2008, that program has helped preserve 34 waterfront properties. The legislation I am introducing today would help scale up that model program so that more communities can be assisted.

There is currently no targeted, Federal assistance program to help the commercial fishing industry and other maritime sectors gain or preserve access to working waterfront areas. The Working Waterfront Preservation Act would create a $20 million program to help municipal and State governments, nonprofit organizations, and participants in maritime industries improve working waterfront property in our coastal States. Grants would be administered by the Economic Development Administration, and successful applicants would need to be endorsed by State fisheries agencies, which have the local expertise to understand the needs of each coastal State. In order to be eligible for a grant, recipients would be required to permanently protect an area as working waterfront, to ensure that it can be used for commercial purposes for decades to come, and to invest in the cost themselves.

This legislation is crucial for the continued prosperity of coastal communities across the country. I urge my colleagues to join Senator Reed and me in supporting this important legislation.