May 10 sees Congressional Record publish “STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTION” in the Senate section

By Great Lakes Wire

May 10, 2021

Volume 167, No. 80, covering the 1st Session of the 117th Congress (2021 - 2022), was published by the Congressional Record.

The Congressional Record is a unique source of public documentation. It started in 1873, documenting nearly all the major and minor policies being discussed and debated.

“STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTION” mentioning Gary C. Peters was published in the Senate section on pages S2414-S2421 on May 10.

Of the 100 senators in 117th Congress, 24 percent were women, and 76 percent were men, according to the Biographical Directory of the United States Congress.

Senators' salaries are historically higher than the median US income.

The publication is reproduced in full below:

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTION

By Mr. SCHUMER (for himself and Mrs. Gillibrand):

S. 1529. A bill to establish safety standards for certain limousines, and for other purposes; to the Committee on Commerce, Science, and Transportation.

Mr. SCHUMER. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

There being no objection, the text of the bill was ordered to be printed in the Record, as follows:

S. 1529

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Safety, Accountability, and Federal Enforcement of Limos Act of 2021'' or the ``SAFE Limos Act''.

SEC. 2. LIMOUSINE COMPLIANCE WITH FEDERAL SAFETY STANDARDS.

(a) Limousine Standards.--

(1) Safety belt and seating system standards for limousines.--Not later than 2 years after the date of the enactment of this Act, the Secretary shall prescribe a final rule--

(A) that amends Federal Motor Vehicle Safety Standard Numbers 208, 209, and 210 to require to be installed in limousines at each designated seating position, including on side-facing seats--

(i) an occupant restraint system consisting of integrated lap shoulder belts; or

(ii) an occupant restraint system consisting of a lap belt if the occupant restraint system described in clause (i) does not meet the need for motor vehicle safety; and

(B) that amends Federal Motor Vehicle Safety Standard Number 207 to require limousines to meet standards for seats

(including side-facing seats), seat attachment assemblies, and seat installation to minimize the possibility of their failure by forces acting on them as a result of vehicle impact.

(2) Report on retrofit assessment for limousines.--Not later than 2 years after the date of the enactment of this Act, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Commerce, Science, and Transportation of the Senate a report that assesses the feasibility, benefits, and costs with respect to the application of any requirement established under paragraph (1) to a limousine introduced into interstate commerce before the date on which the requirement takes effect.

(b) Safety Regulation of Limousines.--

(1) In general.--Section 30102(a)(6) of title 49, United States Code, is amended--

(A) in subparagraph (A), by striking ``or'' at the end;

(B) in subparagraph (B), by striking the period and inserting ``; or''; and

``(C) modifying a passenger motor vehicle (as such term is defined in section 32101) that has already been purchased by the first purchaser (as such term is defined in subsection

(b)) by increasing the wheelbase of the vehicle so that the vehicle has increased seating capacity.''.

(2) Effective date.--The amendments made by paragraph (1) shall apply beginning on the date that is 1 year after the date of the enactment of this Act.

(1) In general.--Chapter 301 of title 49, United States Code, is amended by inserting after section 30128 the following:

``Sec. 30129. Limousine compliance with Federal safety standards

``(a) Requirement.--Beginning on the date that is 1 year after the date of the enactment of this section, a limousine remodeler may not offer for sale, lease, or rent, introduce or deliver for introduction into interstate commerce, or import into the United States a new limousine unless the limousine remodeler has submitted to the Secretary a vehicle remodeler plan (or an updated vehicle remodeler plan required by subsection (b), as applicable) that describes how the remodeler is mitigating risks to motor vehicle safety posed by the limousines of the remodeler. A vehicle remodeler plan shall include the following:

``(1) Verification and validation of compliance with applicable motor vehicle safety standards.

``(2) Design, quality control, manufacturing, and training practices adopted by the limousine remodeler.

``(3) Customer support guidelines, including instructions for limousine occupants to wear seatbelts and limousine operators to notify occupants of the date and results of the most recent inspection of the limousine.

``(b) Updates.--Each limousine remodeler shall submit an updated vehicle remodeler plan to the Secretary each year.

``(c) Publicly Available.--The Secretary shall make any vehicle remodeler plan submitted under subsection (a) or (b) publicly available not later than 60 days after the date on which the plan is received, except the Secretary may not make publicly available any information relating to a trade secret or other confidential business information (as such terms are defined in section 512.3 of title 49, Code of Federal Regulations (or any successor regulation)).

``(d) Review.--The Secretary may inspect any vehicle remodeler plan submitted by a limousine remodeler under subsection (a) or (b) to enable the Secretary to determine whether the limousine remodeler has complied, or is complying, with this chapter or a regulation prescribed or order issued pursuant to this chapter.

``(e) Rule of Construction.--Nothing in this section may be construed to affect discovery, a subpoena or other court order, or any other judicial process otherwise allowed under applicable Federal or State law.

``(f) Definitions.--In this section, the following definitions apply:

``(1) Certified passenger motor vehicle.--The term

`certified passenger motor vehicle' means a passenger motor vehicle that has been certified in accordance with section 30115 to meet all applicable motor vehicle safety standards.

``(2) Incomplete vehicle.--The term `incomplete vehicle' has the meaning given such term in section 567.3 of title 49, Code of Federal Regulations (or any successor regulation).

``(3) Limousine.--The term `limousine' means a motor vehicle--

``(A) that has a seating capacity of 9 or more persons

(including the driver);

``(B) with a gross vehicle weight rating greater than 10,000 pounds but not greater than 26,000 pounds; and

``(C) that the Secretary has determined by regulation has physical characteristics resembling--

``(i) a passenger car;

``(ii) a multipurpose passenger vehicle; or

``(iii) a truck with a gross vehicle weight rating of 10,000 pounds or less.

``(4) Limousine operator.--The term `limousine operator' means a person who owns or leases, and uses, a limousine to transport passengers for compensation.

``(5) Limousine remodeler.--The term `limousine remodeler' means a person who alters or modifies by addition, substitution, or removal of components (other than readily attachable components) an incomplete vehicle, a vehicle manufactured in two or more stages, or a certified passenger motor vehicle before or after the first purchase of the vehicle to manufacture a limousine.

``(6) Multipurpose passenger vehicle.--The term

`multipurpose passenger vehicle' has the meaning given such term in section 571.3 of title 49, Code of Federal Regulations (or any successor regulation).

``(7) Passenger car.--The term `passenger car' has the meaning given such term in section 571.3 of title 49, Code of Federal Regulations (or any successor regulation).

``(8) Passenger motor vehicle.--The term `passenger motor vehicle' has the meaning given such term in section 32101.

``(9) Truck.--The term `truck' has the meaning given such term in section 571.3 of title 49, Code of Federal Regulations (or any successor regulation).''.

(2) Enforcement.--Section 30165(a)(1) of title 49, United States Code, is amended by inserting ``30129,'' after

``30127,''.

(3) Clerical amendment.--The table of sections for subchapter II of chapter 301 of title 49, United States Code, is amended by inserting after the item relating to section 30128 the following:

``30129. Limousine compliance with Federal safety standards.''.

(d) Limousine Crashworthiness.--

(1) Research.--Not later than 4 years after the date of the enactment of this Act, the Secretary shall complete research into the development of motor vehicle safety standards for side impact protection, roof crush resistance, and air bag systems for the protection of occupants for limousines with alternative seating positions, including perimeter seating arrangements.

(2) Rulemaking or report.--

(A) Crashworthiness standards.--

(i) In general.--Not later than 2 years after the completion of the research required under paragraph (1), except as provided in clause (ii), the Secretary shall prescribe a final motor vehicle safety standard, for the protection of occupants in limousines with alternative seating positions, for each of the following:

(I) Side impact protection.

(II) Roof crush resistance.

(III) Air bag systems.

(ii) Requirements and considerations.--The Secretary may only prescribe a motor vehicle safety standard described in clause (i) if the Secretary determines that such standard meets the requirements and considerations set forth in subsections (a) and (b) of section 30111 of title 49, United States Code.

(B) Report.--If the Secretary determines that a standard described in subparagraph (A)(i) does not meet the requirements and considerations set forth in subsections (a) and (b) of section 30111 of title 49, United States Code, the Secretary shall publish in the Federal Register and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Commerce, Science, and Transportation of the Senate a report describing the reasons for not prescribing such standard.

(e) Limousine Evacuation.--

(1) Research.--Not later than 2 years after the date of the enactment of this Act, the Secretary shall complete research into safety features and standards that aid evacuation in the event that one exit in the passenger compartment of a limousine is blocked.

(2) Standards.--Not later than 3 years after the date of the enactment of this Act, the Secretary shall prescribe a final motor vehicle safety standard based on the results of the research under paragraph (1).

(f) Limousine Inspection Disclosure.--

(1) In general.--A limousine operator may not introduce a limousine into interstate commerce unless the limousine operator has prominently disclosed in a clear and conspicuous notice, including on the website of the operator if the operator has a website, the following:

(A) The date of the most recent inspection of the limousine required under State or Federal law.

(B) The results of the inspection.

(2) Federal trade commission enforcement.--The Federal Trade Commission shall enforce this subsection in the same manner, by the same means, and with the same jurisdiction, powers, and duties as though all applicable terms and provisions of the Federal Trade Commission Act (15 U.S.C. 41 et seq.) were incorporated into and made a part of this subsection. Any person who violates this subsection shall be subject to the penalties and entitled to the privileges and immunities provided in the Federal Trade Commission Act (15 U.S.C. 41 et seq.).

(3) Savings provision.--Nothing in this subsection shall be construed to limit the authority of the Federal Trade Commission under any other provision of law.

(4) Effective date.--This subsection shall take effect 180 days after the date of the enactment of this Act.

(g) Event Data Recorders for Limousines.--

(1) In general.--Not later than 2 years after the date of the enactment of this Act, the Secretary shall prescribe a final motor vehicle safety standard requiring the use of event data recorders for limousines.

(2) Privacy protections.--Any standard prescribed under paragraph (1) pertaining to event data recorder information shall be consistent with the collection and sharing requirements under the FAST Act (Public Law 114-94) and any other applicable law.

(h) Definitions.--In this section, the following definitions apply:

(1) Event data recorder.--The term ``event data recorder'' has the meaning given such term in section 563.5 of title 49, Code of Federal Regulations (or any successor regulation).

(2) Limousine.--The term ``limousine'' has the meaning given such term in section 30129 of title 49, United States Code, as added by this section.

(3) Limousine operator.--The term ``limousine operator'' has the meaning given such term in section 30129 of title 49, United States Code, as added by this section.

(4) Limousine remodeler.--The term ``limousine remodeler'' has the meaning given such term in section 30129 of title 49, United States Code, as added by this section.

(5) Motor vehicle.--The term ``motor vehicle'' has the meaning given such term in section 30102(a) of title 49, United States Code.

(6) Motor vehicle safety standard.--The term ``motor vehicle safety standard'' has the meaning given such term in section 30102(a) of title 49, United States Code.

(7) Secretary.--The term ``Secretary'' means the Secretary of Transportation.

(8) State.--The term ``State'' has the meaning given such term in section 30102(a) of title 49, United States Code.

______

By Mr. SCHUMER (for himself and Mrs. Gillibrand):

S. 1531. A bill to amend title 49, United States Code, to require the Secretary of Transportation to award grants to States that have enacted and are enforcing certain laws with respect to stretch limousines, and for other purposes; to the Committee on Commerce, Science, and Transportation.

Mr. SCHUMER. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

There being no objection, the text of the bill was ordered to be printed in the Record, as follows:

S. 1531

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Take Unsafe Limos Off the Road Act''.

SEC. 2. GRANT PROGRAM FOR SAFETY OF STRETCH LIMOUSINES.

(a) In General.--Subchapter IV of chapter 311 of title 49, United States Code, is amended by adding at the end the following:

``Sec. 31162. Grant program for safety of stretch limousines

``(a) Definitions.--In this section:

``(1) Eligible defect.--The term `eligible defect' means a defect that would cause a motor vehicle to fail a commercial motor vehicle safety inspection.

``(2) Passenger motor vehicle.--The term `passenger motor vehicle' has the meaning given the term in section 32101.

``(3) Secretary.--The term `Secretary' means the Secretary of Transportation.

``(4) Stretch limousine.--The term `stretch limousine' means a new or used passenger motor vehicle that--

``(A) has been modified, altered, or extended in a manner that increases the overall wheelbase of the vehicle--

``(i) beyond the wheelbase dimension of the original equipment manufacturer for the base model and year of the vehicle; and

``(ii) to a length sufficient to accommodate additional passengers; and

``(B) after being altered as described in subparagraph (A), has a seating capacity of not fewer than 9 passengers, including the driver.

``(b) Grant Program.--Each fiscal year, the Secretary shall make a grant, in accordance with this section, to each State that is eligible for a grant under subsection (c).

``(c) Eligibility.--A State is eligible for a grant under this section for a fiscal year if, on October 1 of that fiscal year, the State--

``(1) has enacted a law that requires the impoundment or immobilization of a stretch limousine that is found to have an eligible defect on inspection; and

``(2) is enforcing the law described in paragraph (1), as determined by the Secretary.

``(d) Grant Amounts.--

``(1) In general.--Beginning on October 1 of the first fiscal year beginning after the date of enactment of this section, the Secretary shall apportion the amounts appropriated to carry out this section to each State that is eligible to receive a grant under subsection (c) in an amount that is equal to the quotient obtained by dividing--

``(A) the difference between--

``(i) $5,000,000; and

``(ii) the total amount provided to States under paragraph

(2); and

``(B) the number of States eligible for a grant under subsection (c) for the fiscal year.

``(2) Increase of grant amounts.--Beginning on October 1 of the first fiscal year beginning after the date of enactment of this section, a State that is eligible for a grant under subsection (c) may receive an additional $50,000 in grant funds if, on October 1 of that fiscal year, the State has enacted and is enforcing a law or regulation that requires--

``(A) any safety inspection of a stretch limousine to be conducted at a designated site controlled by the State; and

``(B) the inspection described in subparagraph (A) to be conducted by employees trained in the inspection of stretch limousines.

``(e) Use of Funds.--A State receiving a grant under this section may use grant amounts--

``(1) for the impoundment or immobilization of a stretch limousine;

``(2) for the establishment and operating expenses of designated stretch limousine safety inspection sites; or

``(3) to train employees in the inspection of stretch limousines.

``(f) Authorization of Appropriations.--There is authorized to be appropriated to the Secretary to carry out this section

$5,000,000 for each of fiscal years 2021 through 2024.''.

(b) Clerical Amendment.--The analysis for subchapter IV of chapter 311 of title 49 is amended by inserting after the item relating to section 31161 the following:

``31162. Grant program for safety of stretch limousines.''.

______

By Mr. KAINE (for himself, Mr. Boozman, and Mr. Tillis):

S. 1532. A bill to provide a work opportunity tax credit for military spouses and to provide for flexible spending arrangements for childcare services for uniformed services families; to the Committee on Finance.

Mr. KAINE. Mr. President, today I am introducing the Jobs and Childcare for Military Families Act, with my colleagues Senators Boozman and Tillis. By incentivizing private businesses to hire military spouses and allowing military families to use pre-tax dollars to pay for childcare, we can alleviate some of the unique hardships military families face and put them on firmer financial footing. This effort has only become more critical as the nation recovers from the coronavirus pandemic that has increased the number of unemployed and emphasized some longstanding issues in securing childcare for young families.

The families of America's servicemembers make sacrifices that are not as recognized in the public eye. Military spouses face routine moves every few years that require packing up a stable home in order to move to a new area and start over. This is compounded by the complex system of state licensing and certification requirements, which can limit these spouses from taking jobs that utilize their expertise and experience. Because of this, military spouses have unemployment rates substantially higher than the national average, and are often underemployed when they do have jobs. Adding to the financial struggle that frequent periods of unemployment and underemployment cause, the rising cost of childcare puts a substantial burden on many military families.

The Jobs and Childcare for Military Families Act would help these families in two ways. First, the bill makes military spouses an eligible population for the Work Opportunity Tax Credit. This tax credit has been proven effective in improving the employment prospects for other groups, and extending it to military spouses would help them find employment easier after moving a new area. Second, the bill instructs the administration to implement dependent care flexible spending accounts for all servicemembers. These accounts which are widely available in the private sector would allow military families to contribute pre-tax dollars to accounts that they can then use to pay for childcare services, helping ease the financial burden of childcare.

I hope my colleagues will support this bill to help families who have made an incredible sacrifice for our nation.

______

By Mr. DURBIN (for himself, Mr. Blumenthal, Mr. Booker, Mr.

Leahy, Mr. Merkley, Mrs. Murray, and Mr. Menendez):

S. 1535. A bill to designate as wilderness certain Federal portions of the red rock canyons of the Colorado Plateau and the Great Basin Deserts in the State of Utah for the benefit of present and future generations of people in the United States; to the Committee on Energy and Natural Resources.

Mr. DURBIN. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

There being no objection, the text of the bill was ordered to be printed in the Record, as follows:

S. 1535

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``America's Red Rock Wilderness Act''.

(b) Table of Contents.--The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Definitions.

Sec. 3. Findings.

Sec. 4. Purposes.

TITLE I--DESIGNATION OF WILDERNESS AREAS

Sec. 101. Great Basin Wilderness Areas.

Sec. 102. Grand Staircase-Escalante Wilderness Areas.

Sec. 103. Moab-La Sal Canyons Wilderness Areas.

Sec. 104. Henry Mountains Wilderness Areas.

Sec. 105. Glen Canyon Wilderness Areas.

Sec. 106. San Juan-Anasazi Wilderness Areas.

Sec. 107. Canyonlands Basin Wilderness Areas.

Sec. 108. San Rafael Swell Wilderness Areas.

Sec. 109. Book Cliffs and Uinta Basin Wilderness Areas.

TITLE II--ADMINISTRATIVE PROVISIONS

Sec. 201. General provisions.

Sec. 202. Administration.

Sec. 203. State school trust land within wilderness areas.

Sec. 204. Water.

Sec. 205. Roads.

Sec. 206. Livestock.

Sec. 207. Fish and wildlife.

Sec. 208. Protection of Tribal rights.

Sec. 209. Management of newly acquired land.

Sec. 210. Withdrawal.

SEC. 2. DEFINITIONS.

In this Act:

(1) Secretary.--The term ``Secretary'' means the Secretary of the Interior, acting through the Bureau of Land Management.

(2) State.--The term ``State'' means the State of Utah.

SEC. 3. FINDINGS.

Congress finds that--

(1) the land designated as wilderness by this Act is 1 of the largest remaining expanses of unprotected, wild public land in the continental United States;

(2) the designation of wilderness by this Act would--

(A) increase landscape connectivity in the Colorado Plateau; and

(B) help to mitigate the impacts of climate change by--

(i) providing critical refugia;

(ii) reducing surface disturbances that exacerbate the impacts of climate change;

(iii) reducing greenhouse gas emissions related to the extraction and use of fossil fuels; and

(iv) contributing to the goal of protecting 30 percent of global land and waters by 2030;

(3) the land designated as wilderness by this Act is--

(A) a living cultural landscape;

(B) a place of refuge for wild nature; and

(4) Indian Tribes have been present on the land designated as wilderness by this Act since time immemorial, using the plant, animal, landform, and spiritual values for sustenance and cultural, medicinal, and ceremonial activities, purposes for which Indigenous people continue to use the land; and

(5) the designation of wilderness by this Act--

(A) is vital to the continuation and revitalization of Indigenous cultures; and

(B) serves to protect places of Indigenous use and sanctuary.

SEC. 4. PURPOSES.

The purposes of this Act are--

(1) to designate as wilderness certain Federal portions of the red rock canyons of the Colorado Plateau and the Great Basin Deserts in the State of Utah for the benefit of present and future generations of people in the United States;

(2) to protect the cultural, ecological, and scenic values of land designated as wilderness by this Act for the benefit, use, and enjoyment of present and future generations of people in the United States; and

(3) to protect the ability of Indigenous and non-Indigenous people to use the land designated as wilderness by this Act for traditional activities, including hunting, fishing, hiking, horsepacking, camping, and spirituality as people have used the land for generations.

TITLE I--DESIGNATION OF WILDERNESS AREAS

SEC. 101. GREAT BASIN WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) the Great Basin region of western Utah is comprised of starkly beautiful mountain ranges that rise as islands from the desert floor;

(2) the Wah Wah Mountains in the Great Basin region are arid and austere, with massive cliff faces and leathery slopes speckled with pinon and juniper;

(3) the Pilot Range and Stansbury Mountains in the Great Basin region are high enough to draw moisture from passing clouds and support ecosystems found nowhere else on earth;

(4) from bristlecone pine, the world's oldest living organism, to newly flowered mountain meadows, mountains of the Great Basin region are islands of nature that--

(A) support remarkable biological diversity; and

(B) provide opportunities to experience the colossal silence of the Great Basin; and

(5) the Great Basin region of western Utah should be protected and managed to ensure the preservation of the natural conditions of the region.

(b) Designation.--In accordance with the Wilderness Act (16 U.S.C. 1131 et seq.), the following areas in the State are designated as wilderness areas and as components of the National Wilderness Preservation System:

(1) Antelope Range (approximately 17,000 acres).

(2) Barn Hills (approximately 21,000 acres).

(3) Black Hills (approximately 8,700 acres).

(4) Bullgrass Knoll (approximately 16,000 acres).

(5) Burbank Hills/Tunnel Spring (approximately 94,000 acres).

(6) Conger Mountain (approximately 31,000 acres).

(7) Crater and Silver Island Mountains (approximately 121,000 acres).

(8) Crater Bench (approximately 35,000 acres).

(9) Cricket Mountains (approximately 56,000 acres).

(10) Deep Creek Mountains (approximately 128,000 acres).

(11) Drum Mountains (approximately 40,500 acres).

(12) Dugway Mountains (approximately 24,500 acres).

(13) Fish Springs Range (approximately 64,500 acres).

(14) Granite Peak (approximately 19,500 acres).

(15) Grassy Mountains (approximately 24,000 acres).

(16) Grouse Creek Mountains (approximately 15,000 acres).

(17) House Range (approximately 202,000 acres).

(18) Keg Mountain (approximately 38,500 acres).

(19) Kern Mountains (approximately 15,000 acres).

(20) King Top (approximately 111,000 acres).

(21) Little Goose Creek (approximately 1,300 acres).

(22) Middle/Granite Mountain (approximately 81,000 acres).

(23) Mount Escalante (approximately 17,500 acres).

(24) Mountain Home Range (approximately 90,000 acres).

(25) Newfoundland Mountains (approximately 23,000 acres).

(26) Ochre Mountain (approximately 13,500 acres).

(27) Oquirrh Mountains (approximately 8,900 acres).

(28) Painted Rock (approximately 26,500 acres).

(29) Paradise/Steamboat Mountains (approximately 136,000 acres).

(30) Pilot Range (approximately 44,000 acres).

(31) Red Tops (approximately 28,000 acres).

(32) Rockwell-Little Sahara (approximately 19,000 acres).

(33) San Francisco Mountains (approximately 40,000 acres).

(34) Sand Ridge (approximately 73,000 acres).

(35) Sevier Plateau (approximately 30,000 acres).

(36) Simpson Mountains (approximately 43,000 acres).

(37) Snake Valley (approximately 103,000 acres).

(38) Spring Creek Canyon (approximately 5,200 acres).

(39) Stansbury Island (approximately 9,900 acres).

(40) Stansbury Mountains (approximately 25,000 acres).

(41) Thomas Range (approximately 41,000 acres).

(42) Tule Valley (approximately 159,000 acres).

(43) Wah Wah Mountains (approximately 177,000 acres).

(44) White Rock Range (approximately 5,500 acres).

SEC. 102. GRAND STAIRCASE-ESCALANTE WILDERNESS AREAS.

(a) Grand Staircase Area.--

(1) Findings.--Congress finds that--

(A) the area known as the Grand Staircase rises more than 6,000 feet in a series of great cliffs and plateaus from the depths of the Grand Canyon to the forested rim of Bryce Canyon;

(B) the Grand Staircase--

(i) spans 6 major life zones, from the lower Sonoran Desert to the alpine forest; and

(ii) encompasses geologic formations that display 3,000,000,000 years of Earth's history;

(C) land managed by the Secretary lines the intricate canyon system of the Paria River and forms a vital natural corridor connection to the deserts and forests of those national parks;

(D) land described in paragraph (2) (other than East of Bryce, the majority of Upper Kanab Creek, Moquith Mountain, Bunting Point, Canaan Mountain, Orderville Canyon, Parunuweap Canyon, and Vermillion Cliffs) is located within the Grand Staircase-Escalante National Monument, as established in 1996; and

(E) the Grand Staircase in Utah should be protected and managed as a wilderness area.

(2) Designation.--In accordance with the Wilderness Act (16 U.S.C. 1131 et seq.), the following areas in the State are designated as wilderness areas and as components of the National Wilderness Preservation System:

(A) Bryce Boot (approximately 2,800 acres).

(B) Bryce View (approximately 850 acres).

(D) Canaan Mountain (approximately 15,000 acres).

(E) East of Bryce (approximately 850 acres).

(F) Glass Eye Canyon (approximately 25,000 acres).

(G) Ladder Canyon (approximately 14,000 acres).

(H) Moquith Mountain (approximately 15,500 acres).

(I) Nephi Point (approximately 15,000 acres).

(J) Orderville Canyon (approximately 8,100 acres).

(K) Paria-Hackberry (approximately 196,000 acres).

(L) Paria Wilderness Expansion (approximately 4,000 acres).

(M) Parunuweap Canyon (approximately 44,500 acres).

(N) Pine Hollow (approximately 11,000 acres).

(O) Slopes of Bryce (approximately 3,700 acres).

(P) Timber Mountain (approximately 52,500 acres).

(Q) Upper Kanab Creek (approximately 51,000 acres).

(R) Vermillion Cliffs (approximately 26,000 acres).

(S) Willis Creek (approximately 21,000 acres).

(b) Kaiparowits Plateau.--

(1) Findings.--Congress finds that--

(A) the Kaiparowits Plateau east of the Paria River is one of the most rugged and isolated wilderness regions in the United States;

(B) the Kaiparowits Plateau, a windswept land of harsh beauty, contains distant vistas and a remarkable variety of plant and animal species;

(C) ancient forests, an abundance of big game animals, and 22 species of raptors thrive undisturbed on the grassland mesa tops of the Kaiparowits Plateau;

(D) each of the areas described in paragraph (2) (other than Heaps Canyon, Little Valley, and Wide Hollow) is located within the Grand Staircase-Escalante National Monument, as established in 1996; and

(E) the Kaiparowits Plateau should be protected and managed as a wilderness area.

(A) Andalex Not (approximately 18,000 acres).

(B) Box Canyon (approximately 3,000 acres).

(D) Canaan Peak Slopes (approximately 2,500 acres).

(E) Carcass Canyon (approximately 85,000 acres).

(F) Fiftymile Bench (approximately 13,000 acres).

(G) Fiftymile Mountain (approximately 207,000 acres).

(H) Heaps Canyon (approximately 4,000 acres).

(I) Horse Spring Canyon (approximately 32,000 acres).

(J) Kodachrome Headlands (approximately 8,500 acres).

(K) Little Valley Canyon (approximately 4,000 acres).

(L) Mud Spring Canyon (approximately 66,000 acres).

(M) Nipple Bench (approximately 32,000 acres).

(N) Paradise Canyon-Wahweap (approximately 266,000 acres).

(O) Rock Cove (approximately 17,000 acres).

(P) The Blues (approximately 22,000 acres).

(Q) The Cockscomb (approximately 12,000 acres).

(R) Warm Creek (approximately 24,000 acres).

(S) Wide Hollow (approximately 7,700 acres).

(1) Findings.--Congress finds that--

(A) glens and coves carved in massive sandstone cliffs, spring-watered hanging gardens, and the silence of ancient Anasazi ruins are examples of the unique features that entice hikers, campers, and sightseers from around the world to Escalante Canyon;

(B) Escalante Canyon links the spruce fir forests of the 11,000-foot Aquarius Plateau with winding slickrock canyons that flow into Glen Canyon;

(C) Escalante Canyon, one of Utah's most popular natural areas, contains critical habitat for deer, elk, and wild bighorn sheep that also enhances the scenic integrity of the area;

(D) each of the areas described in paragraph (2) is located within the Grand Staircase-Escalante National Monument, as established in 1996; and

(E) Escalante Canyon should be protected and managed as a wilderness area.

(A) Colt Mesa (approximately 28,000 acres).

(B) Death Hollow (approximately 50,000 acres).

(D) Lampstand (approximately 11,500 acres).

(E) Muley Twist Flank (approximately 3,700 acres).

(F) North Escalante Canyons (approximately 182,000 acres).

(G) Pioneer Mesa (approximately 11,000 acres).

(H) Scorpion (approximately 61,000 acres).

(I) Sooner Bench (approximately 500 acres).

(J) Steep Creek (approximately 36,000 acres).

(K) Studhorse Peaks (approximately 24,000 acres).

SEC. 103. MOAB-LA SAL CANYONS WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) the canyons surrounding the La Sal Mountains and the town of Moab offer a variety of extraordinary landscapes;

(2) outstanding examples of natural formations and landscapes in the Moab-La Sal area include the huge sandstone fins of Behind the Rocks, the mysterious Fisher Towers, and the whitewater rapids of Westwater Canyon; and

(3) the Moab-La Sal area should be protected and managed as a wilderness area.

(1) Arches Adjacent (approximately 4,100 acres).

(2) Beaver Creek (approximately 45,000 acres).

(3) Behind the Rocks (approximately 19,500 acres).

(4) Big Triangle (approximately 21,500 acres).

(5) Coyote Wash (approximately 27,000 acres).

(6) Dome Plateau (approximately 36,500 acres).

(7) Fisher Towers (approximately 18,000 acres).

(8) Goldbar Canyon (approximately 9,500 acres).

(9) Granite Creek (approximately 5,000 acres).

(10) Hunter Canyon (approximately 5,500 acres).

(11) Mary Jane Canyon (approximately 27,500 acres).

(12) Mill Creek (approximately 17,000 acres).

(13) Morning Glory (approximately 11,000 acres).

(14) Porcupine Rim (approximately 10,000 acres).

(15) Renegade Point (approximately 6,200 acres).

(16) Westwater Canyon (approximately 39,000 acres).

(17) Yellow Bird (approximately 4,600 acres).

SEC. 104. HENRY MOUNTAINS WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) the Henry Mountain Range, the last mountain range to be discovered and named by early explorers in the contiguous United States, still retains a wild and undiscovered quality;

(2) fluted badlands that surround the flanks of 11,000-foot Mounts Ellen and Pennell contain areas of critical habitat for mule deer and for the largest herd of free-roaming buffalo in the United States;

(3) despite their relative accessibility, the Henry Mountain Range remains one of the wildest, least-known ranges in the United States; and

(4) the Henry Mountain range should be protected and managed to ensure the preservation of the range as a wilderness area.

(1) Bull Mountain (approximately 16,000 acres).

(2) Bullfrog Creek (approximately 42,000 acres).

(3) Dogwater Creek (approximately 3,400 acres).

(4) Fremont Gorge (approximately 22,000 acres).

(5) Long Canyon (approximately 16,500 acres).

(6) Mount Ellen-Blue Hills (approximately 145,000 acres).

(7) Mount Hillers (approximately 20,000 acres).

(8) Mount Pennell (approximately 155,000 acres).

(9) Notom Bench (approximately 7,300 acres).

(10) Oak Creek (approximately 1,500 acres).

(11) Ragged Mountain (approximately 29,000 acres).

SEC. 105. GLEN CANYON WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) the side canyons of Glen Canyon, including the Dirty Devil River and the Red, White and Blue Canyons, contain some of the most remote and outstanding landscapes in southern Utah;

(2) the Dirty Devil River, once the fortress hideout of outlaw Butch Cassidy's Wild Bunch, has sculpted a maze of slickrock canyons through an imposing landscape of monoliths and inaccessible mesas;

(3) the Red and Blue Canyons contain colorful Chinle/Moenkopi badlands found nowhere else in the region; and

(4) the canyons of Glen Canyon in the State should be protected and managed as wilderness areas.

(1) Cane Spring Desert (approximately 18,000 acres).

(2) Dark Canyon (approximately 138,000 acres).

(3) Dirty Devil (approximately 245,000 acres).

(4) Fiddler Butte (approximately 93,000 acres).

(5) Flat Tops (approximately 30,000 acres).

(6) Little Rockies (approximately 64,000 acres).

(7) Red Rock Plateau (approximately 210,000 acres).

(8) The Needle (approximately 11,000 acres).

(9) White Canyon (approximately 115,500 acres).

SEC. 106. SAN JUAN-ANASAZI WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) more than 1,000 years ago, the Anasazi Indian culture flourished in the slickrock canyons and on the pinon-covered mesas of southeastern Utah;

(2) evidence of the ancient presence of the Anasazi pervades the Cedar Mesa area of the San Juan-Anasazi area where cliff dwellings, rock art, and ceremonial kivas embellish sandstone overhangs and isolated benchlands;

(3) the Cedar Mesa area is in need of protection from the vandalism and theft of its unique cultural resources;

(4) the Cedar Mesa wilderness areas should be created to protect both the archaeological heritage and the extraordinary wilderness, scenic, and ecological values of the United States; and

(5) the San Juan-Anasazi area should be protected and managed as a wilderness area to ensure the preservation of the unique and valuable resources of that area.

(1) Allen Canyon (approximately 6,400 acres).

(2) Arch Canyon (approximately 30,500 acres).

(3) Comb Ridge (approximately 16,000 acres).

(4) Cross Canyon (approximately 2,400 acres).

(5) East Montezuma (approximately 46,500 acres).

(6) Fish and Owl Creek Canyon (approximately 74,000 acres).

(7) Grand Gulch (approximately 161,000 acres).

(8) Hammond Canyon (approximately 4,700 acres).

(9) Monument Canyon (approximately 18,000 acres).

(10) Nokai Dome (approximately 94,000 acres).

(11) Road Canyon (approximately 64,000 acres).

(12) San Juan River (approximately 15,000 acres).

(13) The Tabernacle (approximately 7,400 acres).

(14) Tin Cup Mesa (approximately 26,000 acres).

(15) Valley of the Gods (approximately 20,000 acres).

SEC. 107. CANYONLANDS BASIN WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) Canyonlands National Park safeguards only a small portion of the extraordinary red-hued, cliff-walled canyonland region of the Colorado Plateau;

(2) areas near Canyonlands National Park contain canyons with rushing perennial streams, natural arches, bridges, and towers;

(3) the gorges of the Green and Colorado Rivers lie on adjacent land managed by the Secretary;

(4) popular overlooks in Canyonlands National Park and Dead Horse Point State Park have views directly into adjacent areas, including Lockhart Basin and Indian Creek; and

(5) designation of those areas as wilderness would ensure the protection of this erosional masterpiece of nature and of the rich pockets of wildlife found within its expanded boundaries.

(1) Bridger Jack Mesa (approximately 33,500 acres).

(2) Butler Wash (approximately 27,000 acres).

(3) Dead Horse Cliffs (approximately 5,300 acres).

(4) Demon's Playground (approximately 3,600 acres).

(5) Duma Point (approximately 14,500 acres).

(6) Gooseneck (approximately 9,400 acres).

(7) Hatch Point Canyons/Lockhart Basin (approximately 150,500 acres).

(8) Horseshoe Canyon (approximately 83,500 acres).

(9) Horsethief Point (approximately 15,500 acres).

(10) Indian Creek (approximately 28,500 acres).

(11) Labyrinth Canyon (approximately 83,000 acres).

(12) San Rafael River (approximately 117,000 acres).

(13) Shay Mountain (approximately 15,500 acres).

(14) Sweetwater Reef (approximately 69,500 acres).

SEC. 108. SAN RAFAEL SWELL WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) the San Rafael Swell towers above the desert like a castle, ringed by 1,000-foot ramparts of Navajo Sandstone;

(2) the highlands of the San Rafael Swell have been fractured by uplift and rendered hollow by erosion over countless millennia, leaving a tremendous basin punctuated by mesas, buttes, and canyons and traversed by sediment-laden desert streams;

(3) among other places, the San Rafael wilderness offers exceptional back country opportunities in the colorful Wild Horse Badlands, the monoliths of North Caineville Mesa, the rock towers of Cliff Wash, and colorful cliffs of Humbug Canyon;

(4) the mountains within these areas are among Utah's most valuable habitat for desert bighorn sheep; and

(5) the San Rafael Swell area should be protected and managed to ensure its preservation as a wilderness area.

(1) Cedar Mountain (approximately 15,000 acres).

(2) Devils Canyon (approximately 14,000 acres).

(3) Eagle Canyon (approximately 38,500 acres).

(4) Factory Butte (approximately 22,000 acres).

(5) Hondu Country (approximately 2,600 acres).

(6) Jones Bench (approximately 3,400 acres).

(7) Limestone Cliffs (approximately 25,500 acres).

(8) Lost Spring Wash (approximately 36,500 acres).

(9) Mexican Mountain (approximately 25,000 acres).

(10) Molen Reef (approximately 32,500 acres).

(11) Muddy Creek (approximately 92,000 acres).

(12) Mussentuchit Badlands (approximately 24,500 acres).

(13) Price River-Humbug (approximately 122,000 acres).

(14) Red Desert (approximately 36,500 acres).

(15) Rock Canyon (approximately 17,500 acres).

(16) San Rafael Knob (approximately 15,000 acres).

(17) San Rafael Reef (approximately 53,000 acres).

(18) Sids Mountain (approximately 36,500 acres).

(19) Upper Muddy Creek (approximately 18,500 acres).

(20) Wild Horse Mesa (approximately 63,000 acres).

SEC. 109. BOOK CLIFFS AND UINTA BASIN WILDERNESS AREAS.

(a) Findings.--Congress finds that--

(1) the Book Cliffs and Uinta Basin wilderness areas offer--

(A) unique big game hunting opportunities in verdant high-plateau forests;

(B) the opportunity for float trips of several days duration down the Green River in Desolation Canyon; and

(2) the long rampart of the Book Cliffs bounds the area on the south, while seldom-visited uplands, dissected by the rivers and streams, slope away to the north into the Uinta Basin;

(3) bears, Bighorn sheep, cougars, elk, and mule deer flourish in the back country of the Book Cliffs; and

(4) the Book Cliffs and Uinta Basin areas should be protected and managed to ensure the protection of the areas as wilderness.

(1) Bad Land Cliffs (approximately 13,000 acres).

(2) Bourdette Draw (approximately 15,500 acres).

(3) Bull Canyon (approximately 3,100 acres).

(4) Dead Horse Pass (approximately 8,400 acres).

(5) Desbrough Canyon (approximately 14,000 acres).

(6) Desolation Canyon (approximately 32,000 acres).

(7) Diamond Breaks (approximately 8,600 acres).

(8) Diamond Canyon (approximately 168,000 acres).

(9) Diamond Mountain (approximately 31,000 acres).

(10) Dinosaur Adjacent (approximately 7,900 acres).

(11) Goslin Mountain (approximately 3,800 acres).

(12) Hideout Canyon (approximately 12,500 acres).

(13) Lower Flaming Gorge (approximately 21,000 acres).

(14) Mexico Point (approximately 1,500 acres).

(15) Moonshine Draw (approximately 10,500 acres).

(16) Mountain Home (approximately 7,800 acres).

(17) O-Wi-Yu-Kuts (approximately 14,000 acres).

(18) Red Creek Badlands (approximately 4,600 acres).

(19) Survey Point (approximately 8,600 acres).

(20) Turtle Canyon (approximately 9,700 acres).

TITLE II--ADMINISTRATIVE PROVISIONS

SEC. 201. GENERAL PROVISIONS.

(a) Names of Wilderness Areas.--Each wilderness area named in title I shall--

(1) consist of the quantity of land referenced with respect to that named area, as generally depicted on the map entitled

``Utah BLM Wilderness Proposed by H.R. 1630, 113th Congress''; and

(2) be known by the name given to it in title I.

(b) Map and Description.--

(1) In general.--As soon as practicable after the date of enactment of this Act, the Secretary shall file a map and a legal description of each wilderness area designated by this Act with--

(A) the Committee on Natural Resources of the House of Representatives; and

(B) the Committee on Energy and Natural Resources of the Senate.

(2) Force of law.--A map and legal description filed under paragraph (1) shall have the same force and effect as if included in this Act, except that the Secretary may correct clerical and typographical errors in the map and legal description.

(3) Public availability.--Each map and legal description filed under paragraph (1) shall be filed and made available for public inspection in the Office of the Director of the Bureau of Land Management.

SEC. 202. ADMINISTRATION.

Subject to valid rights in existence on the date of enactment of this Act, each wilderness area designated under this Act shall be administered by the Secretary in accordance with--

(1) the Federal Land Policy and Management Act of 1976 (43 U.S.C. 1701 et seq.); and

(2) the Wilderness Act (16 U.S.C. 1131 et seq.).

SEC. 203. STATE SCHOOL TRUST LAND WITHIN WILDERNESS AREAS.

(a) In General.--Subject to subsection (b), if State-owned land is included in an area designated by this Act as a wilderness area, the Secretary shall offer to exchange land owned by the United States in the State of approximately equal value in accordance with section 603(c) of the Federal Land Policy and Management Act of 1976 (43 U.S.C. 1782(c)) and section 5(a) of the Wilderness Act (16 U.S.C. 1134(a)).

(b) Mineral Interests.--The Secretary shall not transfer any mineral interests under subsection (a) unless the State transfers to the Secretary any mineral interests in land designated by this Act as a wilderness area.

SEC. 204. WATER.

(a) Reservation.--

(1) Water for wilderness areas.--

(A) In general.--With respect to each wilderness area designated by this Act, Congress reserves a quantity of water determined by the Secretary to be sufficient for the wilderness area.

(B) Priority date.--The priority date of a right reserved under subparagraph (A) shall be the date of enactment of this Act.

(2) Protection of rights.--The Secretary and other officers and employees of the United States shall take any steps necessary to protect the rights reserved by paragraph (1)(A), including the filing of a claim for the quantification of the rights in any present or future appropriate stream adjudication in the courts of the State--

(A) in which the United States is or may be joined; and

(B) that is conducted in accordance with section 208 of the Department of Justice Appropriation Act, 1953 (66 Stat. 560, chapter 651).

(b) Prior Rights Not Affected.--Nothing in this Act relinquishes or reduces any water rights reserved or appropriated by the United States in the State on or before the date of enactment of this Act.

(1) Specification of rights.--The Federal water rights reserved by this Act are specific to the wilderness areas designated by this Act.

(2) No precedent established.--Nothing in this Act related to reserved Federal water rights--

(A) shall establish a precedent with regard to any future designation of water rights; or

(B) shall affect the interpretation of any other Act or any designation made under any other Act.

SEC. 205. ROADS.

(a) Setbacks.--

(1) Measurement in general.--A setback under this section shall be measured from the center line of the road.

(2) Wilderness on 1 side of roads.--Except as provided in subsection (b), a setback for a road with wilderness on only 1 side shall be set at--

(A) 300 feet from a paved Federal or State highway;

(B) 100 feet from any other paved road or high standard dirt or gravel road; and

(3) Wilderness on both sides of roads.--Except as provided in subsection (b), a setback for a road with wilderness on both sides (including cherry-stems or roads separating 2 wilderness units) shall be set at--

(A) 200 feet from a paved Federal or State highway;

(B) 40 feet from any other paved road or high standard dirt or gravel road; and

(b) Setback Exceptions.--

(1) Well-defined topographical barriers.--If, between the road and the boundary of a setback area described in paragraph (2) or (3) of subsection (a), there is a well-defined cliff edge, stream bank, or other topographical barrier, the Secretary shall use the barrier as the wilderness boundary.

(2) Fences.--If, between the road and the boundary of a setback area specified in paragraph (2) or (3) of subsection

(a), there is a fence running parallel to a road, the Secretary shall use the fence as the wilderness boundary if, in the opinion of the Secretary, doing so would result in a more manageable boundary.

(3) Deviations from setback areas.--

(A) Exclusion of disturbances from wilderness boundaries.--In cases where there is an existing livestock development, dispersed camping area, borrow pit, or similar disturbance within 100 feet of a road that forms part of a wilderness boundary, the Secretary may delineate the boundary so as to exclude the disturbance from the wilderness area.

(B) Limitation on exclusion of disturbances.--The Secretary shall make a boundary adjustment under subparagraph (A) only if the Secretary determines that doing so is consistent with wilderness management goals.

(C) Deviations restricted to minimum necessary.--Any deviation under this paragraph from the setbacks required under in paragraph (2) or (3) of subsection (a) shall be the minimum necessary to exclude the disturbance.

(c) Delineation Within Setback Area.--The Secretary may delineate a wilderness boundary at a location within a setback under paragraph (2) or (3) of subsection (a) if, as determined by the Secretary, the delineation would enhance wilderness management goals.

SEC. 206. LIVESTOCK.

Within the wilderness areas designated under title I, the grazing of livestock authorized on the date of enactment of this Act shall be permitted to continue subject to such reasonable regulations and procedures as the Secretary considers necessary, as long as the regulations and procedures are consistent with--

(1) the Wilderness Act (16 U.S.C. 1131 et seq.); and

(2) section 101(f) of the Arizona Desert Wilderness Act of 1990 (Public Law 101-628; 104 Stat. 4469).

SEC. 207. FISH AND WILDLIFE.

Nothing in this Act affects the jurisdiction of the State with respect to wildlife and fish on the public land located in the State.

SEC. 208. PROTECTION OF TRIBAL RIGHTS.

Nothing in this Act affects or modifies--

(1) any right of any federally recognized Indian Tribe; or

(2) any obligation of the United States to any federally recognized Indian Tribe.

SEC. 209. MANAGEMENT OF NEWLY ACQUIRED LAND.

Any land within the boundaries of a wilderness area designated under this Act that is acquired by the Federal Government shall--

(1) become part of the wilderness area in which the land is located; and

(2) be managed in accordance with this Act and other laws applicable to wilderness areas.

SEC. 210. WITHDRAWAL.

Subject to valid rights existing on the date of enactment of this Act, the Federal land referred to in title I is withdrawn from all forms of--

(1) entry, appropriation, or disposal under public law;

(2) location, entry, and patent under mining law; and

(3) disposition under all laws pertaining to mineral and geothermal leasing or mineral materials.

______

By Ms. COLLINS (for herself and Mr. Peters):

S. 1536. A bill to amend title XVIII of the Social Security Act to expand the availability of medical nutrition therapy services under the Medicare program; to the Committee on Finance.

Ms. COLLINS. Mr. President, I rise today to introduce the Medical Nutrition Therapy Act of 2021, 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 we have seen many diet-related chronic conditions contribute to poor COVID-19 outcomes, 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 health care 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 Dietitian Nutritionists

(RDNs) as part of a collaborative health care 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.

Seniors 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, Maine, 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. Fortunately for that patient, the outpatient facility changed its process to prevent similar situations, but this example demonstrates how the current restrictions can be detrimental for older adults at a critical juncture in their journey to better health.

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. 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. Conditions such as prediabetes and Celiac Disease should be covered.

The health and financial crisis brought on by the COVID-19 pandemic makes access to MNT even more important. Seniors with diet-related conditions have suffered more than any other population in terms of experiencing the worst health outcomes, including death. According to Centers for Medicare & Medicaid Services (CMS) data, among those hospitalized with COVID-19, 84 percent of patients had hypertension, 68 percent had hyperlipidemia, 51 percent had diabetes, and 35 percent of patients were obese. Tragically, many of these patients were never able to leave the hospital because they passed away. In addition to the human cost, there is a financial one: the impact on the Medicare program.

This should not come as a surprise since the health and economic impact of chronic diseases is staggering. According to the U.S. Centers for Disease Control and Prevention, 90 percent of the $3.5 trillion that the United States spends annually on health care 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.''

The Medical Nutrition Therapy Act of 2021 is supported by nearly 50 national organizations, including the Academy of Nutrition and Dietetics, the American Diabetes Association, the Endocrine Society, the American Cancer Society Cancer Action Network, 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.

Thank you, Mr. President.

____________________

SOURCE: Congressional Record Vol. 167, No. 80

ORGANIZATIONS IN THIS STORY

State Of Michigan