Senate Health Committee Holds An Executive Session To Consider Pending Legislation

2 months ago

On Wednesday, the Senate Health Committee held an executive session to consider pending legislation.

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Transcript

00:00will come to order. This morning we will be considering three bipartisan bills.

00:06We're going to debate each bill and then stack all votes at the end. And let me

00:12start off by thanking each of the bill's sponsors for working on these important

00:17policies and to all the staff for working together to prepare these bills

00:22for our mock-up today. The first bill that we will consider is S. 4776

00:29legislation to reauthorize, expand, and improve the Older Americans Act, which I have introduced

00:36with Ranking Member Cassidy and is co-sponsored by Senators Casey, Collins, Kane, Mullen, and Markey.

00:43This legislation has been endorsed by the AARP, Meals on Wheels America, the Elder Justice

00:51Coalition, and the National Association of Nutrition and Aging Services Programs, among many

00:58other groups. And I would ask unanimous consent to include all of these support letters in the record

01:05without objection. This legislation begins to pay attention to the urgent unmet needs of millions

01:12of seniors in our country and what we should do as a society to reduce the senior poverty rate,

01:19to reduce senior hunger, and to improve the health and well-being of some of the most

01:26vulnerable people in our nation. Specifically, this legislation would authorize an increase

01:33in Older Americans Act funding from $2.3 billion this year to $2.76 billion in fiscal year 2025,

01:43a 20 percent increase in funding compared to last year, $450 million more in funding.

01:51Over the next five years, this legislation would authorize the Appropriations Committee

01:56to spend 44 percent more on the Older Americans Act than it currently does,

02:03taking funding levels from $2.3 billion in 2024 to $3.3 billion in 2029 for a total of $15 billion.

02:12When we talk about the unmet needs of our nation's seniors, this is what we are talking about.

02:20In America today, 12 million seniors are dealing with food insecurity and are worried about not

02:25having enough food to eat. Nearly a quarter of our nation's seniors are considered to be socially

02:32isolated and more than one out of every four seniors suffer from tragic falls, the leading

02:39cause of death from injury among our elderly population. Nearly 95 percent of adults over

02:45the age of 60 have a chronic health condition and 80 percent have two or more chronic conditions

02:51like high blood pressure, arthritis, or diabetes. Seniors throughout our country,

02:57particularly in rural areas, lack the transportation they need to get to a doctor's office,

03:03the grocery store, or the dentist. That should not be happening in the United States,

03:09the richest country in the history of the world.

03:12Now, here is the good news. We have a very effective piece of legislation on our books

03:19to address these needs, and that is the Older Americans Act. As we all know, since 1965,

03:26the Older Americans Act has provided federal funding for many essential services for our

03:32nation's seniors, including helping them live at home, preventing loneliness and isolation,

03:38preventing disease, supporting job training, protecting against elder abuse, and providing

03:43rides to the doctor's office and grocery store. Perhaps most importantly, about 45 percent of

03:50funding from this legislation is used to provide meals to millions of frail and isolated seniors

03:58through Meals on Wheels and congregate meal programs at senior centers. The good news is

04:04that over two million seniors receive nutrition services each year under the Older Americans Act.

04:11The bad news is that due to a lack of funding, roughly four out of five seniors who need a home

04:18delivered or congregate meal do not receive one, and many are put on waiting lists that can last

04:26for several months. That is something this legislation begins to address. And let's be

04:32clear, not only does the Older Americans Act save lives and ease human suffering, it also saves money.

04:40In fact, it costs less to feed a senior for an entire year through the Older Americans Act

04:47than it does for a senior to spend one night in a hospital. Providing adequate nutrition services

04:55for seniors also reduces the need for nursing home care. In America today, the median cost of a

05:00private room and nursing home is over a hundred thousand dollars. Unfortunately, funding for the

05:06Older Americans Act has gone down by nearly 20 percent after adjusting for inflation and population

05:12growth since 2016, even though the demand for its services have gone up. This legislation we are

05:18marking up today would begin to reverse that trend. This legislation also strengthens our nation's

05:25senior centers, makes it easier for seniors to receive routine health screenings to detect

05:30and prevent chronic health conditions, provides more resources to our nation's home health care

05:35workers, takes important steps to prevent social isolation and loneliness, expands access to

05:41nutritious meals for our seniors, and begins to address the serious mental health needs of many

05:46of the elderly. Well, I believe there is much more that we must do to reduce the senior poverty rate

05:53in America and to make sure that every senior in the country has access to the services they need.

05:58This bipartisan legislation is a very good and important step forward, and I want to thank

06:05all of our colleagues who have come together in a bipartisan way to make this happen. Senator Cassidy.

06:12Thank you, Chair Sanders. Today, the committee considers reauthorizing multiple programs

06:16providing health and social services to Americans. This includes reauthorizing the Older Americans

06:22Act or the OAA, legislation which empowers an American senior to live a healthy and independent

06:30life in the setting that they choose. First enacted in 1965, the OAA provides funding to support

06:36essential services to aging Americans through things such as nutrition assistance, caregiver

06:41support, and elder abuse prevention. Now, this program has traditionally been reauthorized in a

06:48bipartisan manner, and it strengthens its support for seniors every time. Now, it is our

06:54responsibility as a committee to examine and evaluate the efficacy of the existing program,

06:59to see where we can improve it, to make sure that taxpayer dollars are used effectively.

07:04It is good that this committee is fulfilling this responsibility today. I want to particularly

07:11thank the members of the working group who were so effective at working through those thorny

07:18issues to make this a bipartisan product, and I will call out Chair Sanders, Senators Colin, Braun,

07:26Mullen, Casey, Cain, and Markey again for their work to improve the OAA in a responsible bipartisan

07:33fashion. I also want to highlight the work of other committee members and senators who

07:37contributed policies, specifically Murkowski, Marshall, Romney, Budd, and Rubio. Our bill

07:43reauthorizes crucial nutrition programs providing meals to seniors and also disease prevention and

07:51health promotion programs. Additionally, the bill strengthens the aging network by improving program

07:56integrity, transparency, supporting the development of state and local capabilities,

08:02and encouraging innovation and flexibility within the OAA programs. In addition to OAA,

08:09the committee is considering the Autism Cares Act of 2024 led by Senators Collins and Lujan. I smiled

08:17because there's a woman, a doctor friend of mine, who's been texting me about this. I can tell her,

08:22don't worry, Elizabeth, we've addressed the issue. The legislation authorizes research and public

08:27health programs to better understand and address autism and other developmental disabilities. It

08:34also supports provider training and the development of diagnostic tools and evidence-based

08:39interventions. The committee is also considering legislation to reauthorize traumatic brain injury

08:44or TBI programs. This is led by Senators Mullen and Casey. Specifically, the bill identifies and

08:51addresses gaps in TBI data that highlights populations with higher risk of TBI. It also

08:57reauthorizes the Administration for Community Living grants to states for TBI rehabilitation

09:04and other supportive services. I specifically highlight and thank Senator Mullen for his

09:10dedication and work on this issue so close to Senator Mullen and his family. Again, I thank

09:17Chair Sanders for today's markup and to my colleagues for your collaboration. I yield.

09:22Thank you, Senator Cassidy. And as Senator Cassidy mentioned, after we finish with the Older

09:28Americans Act, we can go to the Autism Cares Act led by Senators Lujan and Collins. Then we go to

09:35S. 4755, the Traumatic Brain Injury Program Reauthorization Act led by Senators Mullen and

09:42Casey. Let's now begin consideration of these three bipartisan bills. I would appreciate if

09:48my colleagues could limit their remarks to two minutes. We will now consider S. 4776,

09:55the Older Americans Act Reauthorization Act of 2024, and we have a Manager's Amendment. I move

10:02to adopt the Manager's Amendment in the nature of a substitute and have it be considered original

10:07text for the purpose of further amendment. All those in favor, please say aye. Aye. Those opposed,

10:13no. The ayes have it and the motion is agreed to. Are there any members who wish to speak on

10:21or offer amendments to S. 4776? Mr. Chairman. Yes, Senator Casey. Mr. Chairman, thanks very

10:29much. I want to thank you and Ranking Member Cassidy and others in the working group for

10:33working so collaboratively to reauthorize the Older Americans Act, or OAA as we refer to it.

10:40As Chairman of the Senate Aging Committee, I'm proud to have been part of the working group

10:44and pleased that this bill was negotiated on a bipartisan basis. The bill includes important

10:50supports for the Long-Term Care Ombudsman Program, a critical program that advocates for

10:55the interests of long-term care residents. The bill also provides critical support and guidance

11:00for grandparents raising grandchildren and enhances flexibility for nutrition providers,

11:07allowing innovations that were developed during the COVID-19 pandemic like grab-and-go meals

11:13and other innovations to continue to operate. These are important steps to improve the lives

11:19of the nation's seniors and their families, but our work is not done. Today's bill provides

11:25increased funding over the next five years, but the number of older adults across the country is

11:30increasing very rapidly, and we need to do more to serve them. Without robust funding,

11:35we cannot expect the aging network to continue to provide for older Americans as they have

11:41historically done. Additionally, I'm concerned that some of the changes to nutrition programs

11:47might undermine the dedicated work of local service providers. But in the spirit of the

11:53bipartisan agreement, I'm not offering any amendments today. I'm hopeful that as this

11:57bill moves forward, we'll continue to have conversations around increased funding and

12:02bolstering the nutrition programs to ensure we are comprehensively meeting the needs of our

12:08nation's older adults. I look forward to continue to work with my colleagues to ensure we're passing

12:13the strongest version of this reauthorization as soon as possible. Thank you, Mr. Chairman.

12:20Mr. Chairman, I was going to introduce a few amendments, but I decided not to. But I do want

12:27to make a brief statement about the bill itself. As a ranking member of the Senate Aging Committee,

12:34we put a lot of work in on this issue. In the bill itself, we'll have up to seven provisions that

12:42make this a great bill. A lot coming from that committee. My staff worked diligently on this,

12:49and I want to give them credit for fleshing out most of this. This was done in a bipartisan way.

12:58These provisions that we put in there are aimed at improving services for seniors by increasing

13:05flexibility, efficiency, and transparency. It empowers area agencies on aging to engage in

13:13business contracts, codify nutrition innovation, and allow health promotion programs to be

13:21evidenced and form helping rural seniors. It also includes proposals to support older Americans by

13:29increasing long-term care transparency. It's so important in anything protecting seniors facing

13:36guardianship and expanding access to broadband. Finally, work to increase transparency of the

13:43functions, funding, and performance of OAA's resource centers. This bill has got a lot in it.

13:51Many have contributed to it, and it's one of the things that makes this job a pleasure to

13:55see something like this go across the finish line. Thank you, Senator Bruin. Further discussion?

14:02Senator Murray. Thank you very much, Chair Sanders. Sixty years ago, the Older Americans

14:08Act enshrined into law our responsibility for helping seniors live healthy, full, and independent

14:13lives. With this year's reauthorization, we have a bipartisan opportunity to recommit to that mission

14:19and strengthen this critical bill, which serves so many people. I'm very proud to say this

14:24reauthorization includes many steps to help make that happen, and it supports not just older adults,

14:30but also people with disabilities and their families. I worked hard to make sure this bill

14:35would increase access to assistive technology, things like wheelchairs, screen readers, hearing

14:41aids, and many other things that help our friends and neighbors and loved ones with disabilities

14:46live their lives and be meaningfully included in their communities, workplaces, and classrooms.

14:51I also secured language to require that each state's plan on aging include the Centers for

14:57Independent Living and Disability Networks. We have seven of these centers in my home state

15:02of Washington, and consulting with them is a commonsense way to connect more people to the care

15:07and support they need. Also, this bill strengthens support for the 13 area agencies on aging that

15:13serve Washington State, allowing them to expand services to more adults, older adults. And I'm

15:19especially pleased we were able to make important strides supporting family caregivers and improving

15:24services for elders in our Native American communities. These are longstanding priorities

15:30for me and pivotal for folks in Washington State. My dad had MS when I was growing up, so I saw

15:36firsthand how hard that was on him, and now things only got more difficult as he and my mom got older

15:42and how that affected actually our entire family. So it's very personal to me that we make sure

15:48everyone in America has the support they need to age with dignity. I want to thank all of the

15:54colleagues who worked on this in a really collaborative and bipartisan way, and I hope

15:58everyone will join us today in voting to advance the Older Americans Reauthorization Act. Thank you.

16:04Thank you, Senator Murray. Senator Collins. Mr. Chairman, let me begin by thanking you and the

16:11Ranking Member Cassidy and all of the senators who served on the Older Americans Working Group

16:20for their dedication in reauthorizing this important legislation.

16:26Having co-authored the prior reauthorization of the Older American Acts with Senator Casey,

16:33I appreciated being a member of the Working Group, and I recognize how important it is

16:42to update OAA programs and services, which are truly a lifeline for millions of seniors. Maine

16:51has the oldest population in the nation, and our population of those age 65 and older only

17:00continues to grow. The OAA helps Maine seniors access services ranging from nutrition to

17:09caregiver support, that Senator Murray just mentioned, to transportation assistance. I

17:16especially appreciate that this reauthorization includes an extension to the RAISE Family

17:22Caregivers Act, which I co-authored with Senator Baldwin. Forty million family caregivers in the

17:29United States provide an estimated $470 billion in uncompensated long-term care. It is important

17:40that we not only recognize but also support these family caregivers. The bill also includes

17:46important changes that will help our essential area agencies on aging better serve those living

17:55with Alzheimer's. Finally, I'd like to highlight the Grandparents Raising Grandchildren Council,

18:03first created by a law authored by Senator Casey and I in 2018, which is also extended

18:12in this bill. Approximately 2.6 million children are being raised by their grandparents or other

18:19relatives, and it's important to address the unique needs of this population. This Older

18:26Americans Reauthorization Act represents a great bipartisan effort to better serve older Americans,

18:35and I congratulate all of you who have been involved in the effort. Thank you, Senator Collins.

18:40Further discussion? Senator Murphy. Thank you very much, Mr. Chairman. I want to speak for a minute

18:47on an amendment that I have that I won't be calling. For the record, count me as somebody who

18:53wished we were having some debate on amendments. I understand the difficult nature of the compromise,

18:59but I think it's often pretty healthy for us to sit and contemplate changes and amendments to

19:05these very big, important bills. But I wanted to at least speak to an amendment that I was

19:11prepared to offer that touches, I think, a very troubling development in our national meal

19:19delivery service. I know Senator Sanders is concerned with this and other members of the

19:25committee are concerned with this prioritization of profit and the cult of inefficiency in our

19:32health care and social care systems today. Sometimes when profit is the only thing that matters,

19:38consumers benefit, but often not so when it comes to our health care system.

19:44The Meals on Wheels program works not just because it gets food to seniors, but because

19:50it connects a neighbor, a community member, with that senior at home. The food keeps the senior

19:57alive, but it is often that socialization, that check-in, that daily conversation that actually

20:04has the biggest health impact on that senior citizen. But under our noses, what has happened

20:11to the rest of our health care and social care delivery system is happening in Meals on Wheels.

20:16Big, for-profit national companies are coming in and gobbling up more of the market. These

20:23companies don't send somebody to deliver the meal. They just send the meal in the mail. Now,

20:29technically, that's cheaper. Technically, that's more efficient. But it robs that shut-in senior

20:37of a really important personal connection. And I think it speaks to this broader trend in our

20:44health care and social care delivery system in which all we care about is whiteboard efficiency.

20:50So I had an amendment that would give priority to local community groups who run much of our Meals

20:58on Wheels system but are losing share to national companies. National companies that are unashamedly

21:05in this business to make money. The biggest national for-profit Meals on Wheels provider is

21:11run by a former private equity CEO who makes no bones about the fact that he is running that

21:17company in order to make money, as much money as possible. So I think this committee should

21:25take steps to have this important conversation. I'll just share one last story. My kid doesn't

21:32have a pediatrician because we go to a pediatric practice in which whiteboard efficiency tells them

21:42that it's more efficient for us to just see whoever's available on that day. So we get quicker

21:49appointments. They make more money. The system is technically more efficient. But we don't have

21:56a doctor, a pediatrician that we can build a relationship with, that we can trust an important

22:03part of being a parent. So I checked as I was getting ready for this markup the other week.

22:08My kid's pediatric practice is owned by Golden Sacks. And so it makes sense that in order to

22:17make money, they're going to build as technically efficient a system as possible. Maybe we can't

22:23unwind Wall Street from pediatric practices, but we could have made a decision today to stop the

22:29beginning of a trend in Meals on Wheels from becoming the norm. I think Meals on Wheels works

22:34because we prioritize socialization, not just the efficiency of the delivery of the meal. And I hope

22:41it's something this committee can talk about in the future. Thank you very much, Senator Murphy.

22:48Other discussion? Senator Kaine. I want to thank the chair and ranking for prioritizing

22:55this markup. And I was very pleased to work with a bipartisan group to make sure we got here today.

23:00And I just want to mention four priorities that are really important to Virginians,

23:04but that I think are good advances in this authorization that I worked on in particular.

23:10Senator Brown and I worked on a piece that focused on an emerging trait with our AAAs,

23:16which is as public funding has not kept pace with the need, many of our AAAs have gotten pretty

23:21entrepreneurial and they're bringing in contract revenue in to help them supplement the services

23:27they provide. It's just that the statutory language about what AAAs can do did not make

23:33that an easy fit. And we want to encourage that entrepreneurial spirit and additional revenue,

23:38but we want to make sure that we're warding off conflicts of interest and things like that. So

23:42Senator Brown and I had a piece that sort of, again, encourages this trend, but put some

23:47guidelines in place to make sure that the underlying integrity of the AAAs and the

23:52services they provide are maintained. Senator Casey mentioned the work that we've done together

23:57to improve the long care ombudsman program. That's really important. Third, we have language to

24:04reauthorize the direct care workforce strategies center at the administration

24:09for community living that really focuses upon innovative strategies to try to bring more

24:15people into this direct care workforce. That's important. And then the last thing that I worked

24:19on in particular with Senators Kelly and Murkowski, and I want to thank them both,

24:24language requiring the GAO to review the supply affordability and accessibility of housing for

24:30seniors, which, you know, I think we're all dealing with housing shortages in all of our

24:34communities and it is impacting seniors in a significant way. And this bill will direct the

24:40GAO to give us some data so that we might be able to more appropriately tackle that need.

24:44I want to thank all colleagues for getting us to this place. It's a very, very important bill.

24:50Thank you, Senator Cain. Further discussion, Senator Markey.

24:53Thank you, Mr. Chairman. I want to thank you. I want to thank Ranking Member Cassidy

24:58for your leadership. I want to thank the other members of the working group, Senators Casey and

25:04Cain and Braun and Collins and Mullen for their partnership and collaboration on this reauthorization.

25:12When President Johnson signed the Older Americans Act into law in 1965, he said that it was America's

25:19responsibility to ensure the well-being of older citizens for the benefit of the men and women

25:25who have done so much in this century to build an America which is just, decent, free, and a

25:33peaceful society. And we all remain committed with this bill to that sacred responsibility.

25:39And this reauthorization will help ensure the health, safety, and well-being of older adults.

25:45By passing this reauthorization, we will be taking a significant and bipartisan, importantly, step

25:53towards making sure seniors have access to healthy food, clean air, to breathe, homes that

25:58are safer in the face of climate change. This reauthorization will also support older Americans,

26:05family caregivers. Senator Collins and I were speaking yesterday on the floor about her

26:11father with Alzheimer's. My mother with Alzheimer's. There's 7 million people with

26:17Alzheimer's in America right now. There'll be 15 million by 2050. So this bill starts to

26:24deal with that issue and talk about the need for the caregivers to get the help they need

26:30because they're, the families are heroes, but they, families need help. And we're talking about that

26:36in this bill. And they serve on the front line of our health care system, often to the neglect of

26:42their own health and well-being. And by expanding access to respite care and peer support and

26:49improving caregiving assessments, we will be helping caregivers provide the often unseen,

26:56uncelebrated support that many older Americans rely upon. One hour a day, a visiting nurse came

27:04into my house to help my father keep my mother in the living room. And that one hour was the

27:12key for my father every day. So he did it at age 80, 82, 84, 86, 88, 90. My mother never left

27:19our living room, but it was that one little bit of support every single day that made the difference

27:25psychologically for him. So he could complete his mission that he would treat her with respect.

27:32So that's really what I love about this bill today. It kind of expands the vision, lifts our gaze to

27:37the constellation of possibilities for what we can do for all older Americans in our country. And I

27:43thank you, Mr. Chairman, and I thank the Ranking Member and all the members working on this.

27:46Thank you, Senator Markey. Further discussion? Seeing none, and once again, let me

27:53thank everybody. This has been a work of love on the part of many, many people who understand

27:59the importance of this legislation. So I thank everybody for their hard work on this.

28:03We're now going to move on to S.4762, the Autism Cares Act of 2024. And we have a manager's

28:10amendment. I move to adopt the manager's amendment in the nature of a substitute and have it be

28:16considered original text for the purpose of further amendment. All those in favor, please say aye.

28:21Aye. Those opposed say no. The ayes have it and the motion is agreed to. Are there any members

28:27who wish to speak on S.4762, the Autism Cares Act? Discussion? Yes, Mr. Lujan. Senator Lujan.

28:35Thank you, Mr. Chairman. Thank you to you and to our Ranking Member for holding this

28:40markup today. I think we all agree that it's critical that we reauthorize the Autism Cares

28:46Act. Now, this bill's legacy is built on the back of parents and loved ones who have fought for

28:53their children. Their hard work led us to invest in programs to support research, train practitioners,

29:03and provide services, development, and monitoring. Autism Cares 2024 builds on those successes.

29:11Autism rates are on the rise. One in 36 children in the United States have autism. Due to research,

29:19increased training, and awareness spurred by the Autism Cares Act, children are being diagnosed

29:24earlier and are receiving services from trained providers. Early intervention is key, but so are

29:30long-term supports and services. I've spoken to parents and caregivers, and this also hits close

29:38to home. One of my staff, Buddy Abeta and his spouse, Sarah, are the proud parents of a child

29:44with autism. Sophie was diagnosed at a young age, and her parents have fought for the resources that

29:51she needs. She's worked hard and thrived through it all, but as Sophie and other children with

29:58autism grow older, new challenges present themselves. Buddy has expressed a fear that

30:06so many parents of children with autism have. What happens to my child when I'm gone?

30:16This bill works to ease that fear. Not only does this bill emphasize communication and behavioral

30:22health needs, but it also expands research and development through services for the

30:32lifestyle of these children. Now, this bill directs our brightest minds to find new ways

30:39to support them through adolescence, midlife, and all the way through old age,

30:50so one day no parent will have to worry about their children after they're gone.

30:56Senator Collins, thank you for your partnership. I yield back.

31:01Thank you, Senator Lujan. Further discussion?

31:04Mr. Chairman.

31:05Senator Collins.

31:06Thank you, Mr. Chairman and Ranking Member Cassidy, for including this bipartisan Autism Cares Act

31:15on our agenda today. I've been very pleased to work with my friend and colleague, Senator Lujan,

31:23in introducing this reauthorization. Like many people, I have a personal story involving autism.

31:35My husband had a child who was diagnosed with severe autism at a very young age. His son was

31:45never verbal. He sadly passed away, but I know how difficult it was. This bill will continue the

31:57successful programming across HHS that helps us better understand the causes and the symptoms

32:06of the autism spectrum disorder and improve the lives of families affected by it. I also want to

32:15take just a moment to recognize our former colleague and friend, the late Senator Mike

32:21Enzi, a former chair of this committee. For his steadfast leadership on this law, he was a true

32:29champion for the autism community. The Autism Cares Act is the cornerstone of federal autism

32:37policy, but it's set to expire at the end of this fiscal year. Reauthorizing this important

32:45law is critical to expanding research at the NIH, supporting the CDC's effort to increase public

32:53awareness of ASD, and strengthening and expanding HRSA's workforce training to identify and support

33:03children and youth with autism as well as their families. The workforce training includes

33:09supporting leadership education in neurodevelopmental and related disability programs known as LEND

33:17at universities across the United States. The Maine-New Hampshire LEND program at the University

33:24of Maine and the Maine LEND program at the University of New England in Biddeford, Maine

33:30are doing such important work to serve individuals with ASD in Maine. So I want to thank Maine and

33:38Maine-New Hampshire LEND programs, the Autism Society of Maine, the Maine Developmental

33:45Disabilities Council, Disabilities Rights Maine, and Adopted Foster Families of Maine for their

33:53advocacy on the Autism Cares Bill, and I would urge all my colleagues to support the Lujan-Collins

34:01Bill. Thank you, Senator Collins. Further discussion? Mr. Chairman? Senator Casey.

34:07Just very briefly, I wanted to thank you and the ranking member as well as, of course,

34:12Senators Lujan and Collins for your work on this and for also including a provision on improving

34:19access to communication tools for people with autism and other developmental disabilities in

34:25the Autism Cares Act. I had legislation, the Augmentative and Alternative Communication

34:31Centers of Excellence and National Technical Assistance, or ACCENT Act, which would create

34:37a network of technical assistance centers to increase access to and highlight the need for

34:43augmentative and alternative communication. Access to augmentative and alternative communication

34:49devices and procedures is essential to thousands of people with autism, and this provision

34:55gets us one step closer to that goal. Thank you. Thank you, Senator Casey. Further discussion?

35:01Seeing none, we will now move on to S. 4755, the Traumatic Brain Injury Program Reauthorization

35:09Act of 2024, and we have a manager's amendment. I move to adopt the manager's amendment in the

35:15nature of a substitute and have it be considered original text for the purpose of further

35:19amendment. All those in favor, please say aye. Aye. All those opposed? The ayes have it, and the

35:24motion is agreed to. Are there any members who wish to speak on S. 4755? Chairman? Senator Mullen.

35:32And I'll try to be as brief as I can, but it's going to be a little longer because this is a

35:37personal story about my son. I'm very involved in traumatic brain injuries because of my son,

35:42Jim Mullen, who now wrestles at Oklahoma State at the age of 20, but at the age of 15,

35:49he had a dramatic brain injury which led him to not even be able to walk, not be able to touch his

35:54nose, not be able to read right, and at the time he was a high school and freshman, nationally

36:02ranked, had wrestled all over the world for the junior world team, and we knew something was wrong

36:08with Jim, and we had taken him every place. He'd been wrestling since he was a little kid and was

36:13absolutely amazing at the sport, but something just wasn't right, and we didn't know what it

36:20was. We'd sent him to several concussion specialists. We ended up getting referred to

36:25the Cleveland Clinic. He spent, and this is no backhand to the Cleveland Clinic, but the truth

36:29is if you speak to 12 neurologists, you'll get 12 different opinions, and we went to the Cleveland

36:36Clinic, spent two weeks at the Cleveland Clinic, and at the end of it, their conclusion was that

36:40it was in his head, not in his head like in his head, but mentally they said this is what the

36:45neurologist showed us, that this is his way of telling us he doesn't want to wrestle anymore.

36:49We never pushed Jim at wrestling. Jim loved wrestling from the day he first stepped on the

36:53mat at six years old, and he never stopped it. He was the kid that was always looking for practice,

36:58wanting to go to practice, walked out of practice, and all the other kids would be crying, and you'd

37:01ask Jim how he was doing, and he'd say, oh, dad, I loved it, and so we knew it wasn't right, but we said, well,

37:06okay, if it's nothing with neurology saying nothing's wrong with him,

37:12then we're going to go ahead and let him wrestle. Well, literally three months later, he's wrestling

37:16at Newton, Kansas. He gets hit in the head. I'm coaching, and he walks over to me, and he says,

37:29dad, I don't feel good, and he looked at me and collapsed, coated, had severe oxygen depletion.

37:38We, of course, rushed him to the Wesleyan Medical Center at Wichita, Kansas, and he's in the

37:47pediatric ICU there, and he woke up 26 hours later. He didn't know who he was, didn't know his name,

37:54didn't know who we were, knew we were somebody, but didn't know who we belonged to, didn't know

38:00what year it was. The only question he got right, and this is no political joke here, was who the

38:04president was. He said Trump, and, of course, President Trump found that hilarious, and

38:11then he started testing him, and they had him

38:17just do simple touches, and the issue was is that he couldn't touch his nose, and then they got him

38:23up to walk, and here's an elite athlete, and he was shuffling his feet and had to put a safety belt

38:27on him, and the neurologists at the Wesleyan Medical Center told us, we'll go home, and it'll

38:33eventually wear off. That's what we were told by the lead neurologist there.

38:39Fortunately, we got hold of the Center for Neural Skills in Bakersfield, California, and the founder

38:46of the place called Mark Ashley gave us a call while we were in the hospital, and he started

38:50asking for his medical records, and we started giving him all the medical records, and he

38:54said, has this happened, this happened, how long has this been going on? He started hitting all

38:58the points, and the first time as a as a parent, it was like we got somebody that actually got

39:02answers here. Well, what ended up happening was an 18-month journey for us being at the Center

39:06for Neural Skills and him learning every skill again. It's so hard to see your son can't even

39:14put together a kindergarten puzzle, and before this happened, he was taking advanced classes in

39:22school and not being able to hold a plank or be able to bring his feet up, and we couldn't,

39:30I mean, literally, doctor after doctor couldn't give us answers. They told us it was going to be

39:34three years of intense rehabilitation, and Jim's attitude was, he said, dad, I learned it once,

39:43I can learn it again, so he had a good attitude by it, right? I still have problems with it. I

39:49don't think I've ever quit crying over it. One of the hardest things that I've dealt with as a parent

39:53to see your kid go through this. They said he could never wrestle again, said he would never

39:56be able to play sports again. Of course, he's defeated odds. Like I said, he's at, he's wrestling

40:01at the University of, or the Oklahoma State University right now, but my point of all this,

40:05the reason why this is so personal, and Chairman, I appreciate you indulging me in so much extra time,

40:10is because there's so much more we need to know, and with this, with the reauthorization of the

40:16brain injury program, it gives families hope. It gives people the ability to have someplace to

40:24turn. It gives researchers, those that are trying to dive into this, some more answers, because it's

40:28not the doctor's fault. It's not the neurology fault. It's not the Wesleyan Medical Center. It's

40:32not the Cleveland Clinic. I don't blame them. They did the best they could. It's just they did the

40:38best they could, and there's so much more that can be done. There's so much more studies that

40:44need to happen. There's so many more answers that need to be, that need to be explained. Like,

40:49I didn't know a frontal lobe injury causes you to have, for adolescence, that it stunts your growth.

40:55We had no idea that until we're three months into it, and three months into it, his growth

41:01place is closed, so Jim's going to be five foot three the rest of his life, which is fine,

41:06but it's little things like that. If you had the information ahead of time, you can make better

41:12informed decisions, which we didn't have, so I appreciate this committee working in this manner.

41:19Senator Levin, I hate that you started it with an emotional, because you got me emotional before I

41:22even started, and I don't cry. I promise you. Actually, I do, but I do appreciate this committee

41:28working in a bipartisan manner, because this is something that's important to all of us. We've

41:31heard the stories around here, so thank you. Senator, Chairman, we don't always get along,

41:37but in this, I do appreciate your attention to it. Well, thank you, and thank you. I mean,

41:44this is what real legislation is about. It comes from personal experience, and we thank you very

41:48much, Senator Mullen, for sharing your own experience, and we wish you some of the very best.

41:54Further discussion on the Traumatic Brain Injury Program reauthorization. Mr. Chairman. Senator

42:00Casey. Mr. Chairman, I want to thank Senator Mullen. We're grateful to have worked with him

42:05and his team on this, and for his statement, and I'll submit a statement for the record. Thank you.

42:13Senator Cassidy. I also want to thank Senator Mullen and Senator Casey for their work on leading

42:18this, and I also thank Senators Cornyn and Ernst to work with the committee to make sure that the

42:22legislation addresses knowledge gaps for populations that have a high rate of TBI.

42:28It can happen to anyone. We see increasing evidence it can happen to young people with sports, as

42:33Senator Mullen spoke of. So the TBI Act reauthorizes these important programs,

42:39and I encourage my colleagues to support. Further discussion? Seeing none, all,

42:48I would note the presence of a quorum, and we will now move to votes.

42:54We're going to begin with the final passage of S. 4776. I move to favorably report S.

43:014776 as amended. The clerk will call the roll.

43:07Senator Murray. Aye. Senator Casey. Aye. Senator Baldwin. Aye. By proxy. Senator Murphy. Aye.

43:17Senator Cain. Aye. Senator Hassan. Aye. Senator Smith. Aye. Senator Lujan. Aye.

43:26Senator Hickenlooper. Aye. By proxy. Senator Markey. Aye. By proxy. Senator Cassidy. Aye.

43:36Senator Paul. No. By proxy. Senator Collins. Aye. Senator Murkowski. Aye. By proxy. Senator Braun.

43:47Aye. By proxy. Senator Marshall. Aye. By proxy. Senator Romney. Aye. By proxy.

43:54Senator Tarpaul. Aye. By proxy. Senator Mullen. Aye. Senator Budd. Aye. By proxy. Chairman Sanders.

44:02Aye. I have 20 ayes, one nay. The ayes have it. The bill is agreed to and will be favorably

44:11reported as amended. We're now going to final passage of S. 4762. I move to favorably report

44:22S. 4762 as amended. The clerk will call the roll. Senator Murray. Aye. Senator Casey. Aye.

44:33Senator Baldwin. Aye. By proxy. Senator Murphy. Aye. Senator Cain. Aye.

44:43Senator Hassan. Aye. Senator Smith. Aye. Senator Lujan. Aye.

44:52Senator Hickenlooper. Aye. By proxy. Senator Markey. Aye. By proxy. Senator Cassidy.

45:07Pardon me? Senator Mullen is there. Okay.

45:12Senator Cassidy. Aye. Senator Paul. No. By proxy. Senator Collins. Aye. Senator Murkowski.

45:28Aye. By proxy. Senator Braun. Aye. By proxy. Senator Marshall. Aye. By proxy. Senator Romney.

45:36Aye. By proxy. Senator Tuberville. Aye. By proxy. Senator Mullen. Aye. Senator Budd.

45:43Aye. By proxy. Chairman Sanders. Aye. I have 20 ayes, one nay. The ayes have it. The bill is

45:51agreed to and will be favorably reported as amended. I now move to authorize staff to make

45:56any required technical and performing changes. I'm sorry. The next vote is on final passage of S

46:054755 as amended. I move to favorably report S 4755 as amended. The clerk will call the roll.

46:15Senator Murray. Senator Casey. Senator Baldwin.

46:21Aye. By proxy. Senator Murphy. Aye. Senator Cain. Aye. Senator Hassan. Aye. Senator Smith. Aye.

46:34Senator Lujan. Aye. Senator Hickenlooper. Aye. By proxy. Senator Markey. Aye. By proxy.

46:43Senator Cassidy. Aye. Senator Paul. No. By proxy. Senator Collins. Aye. Senator Murkowski.

46:51Aye. By proxy. Senator Braun. Aye. By proxy. Senator Marshall. Aye. By proxy. Senator Romney.

46:58Aye. By proxy. Senator Tuberville. Aye. By proxy. Senator Mullen. Aye. Senator Budd. Aye. By proxy.

47:07Chairman Sanders. Aye. I have 20 ayes, one nay. The ayes have it. The bill is agreed to and will

47:13be favorably reported as amended. I now move to authorize staff to make any required technical

47:18and conforming changes when preparing S 4776, S 4762 and S 4755. All those in favor,

47:26please say aye. Aye. All those opposed, nay. The ayes have it and the motion is agreed to.

47:32And that's it. Okay. Committee stands is adjourned.

47:48you

Senate Health Committee Holds An Executive Session To Consider Pending Legislation

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