Statements on Introduced Bills and Joint Resolution

Floor Speech

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Ms. COLLINS. Mr. President, I rise today, along with my colleagues Senator Cardin, Senator Marshall, and Senator Shaheen, to introduce the Home Health Emergency Access to Telehealth (HEAT) Act. This bipartisan bill would help ensure that seniors who rely on home health care have the choice to receive these critical services through telehealth during the COVID-19 pandemic and future public health emergencies.

COVID-19 is the greatest public health challenge since the flu pandemic of 1918 and has claimed the lives of more than 565,000 Americans. This public health emergency has underscored the need for older adults and other at-risk populations to have access to health care in the home setting. Home-based care is crucial to ensuring that this pandemic does not create devastating long-term health consequences due to delayed care. The highly skilled and compassionate care that home health agencies provide is an important component of this in-home care.

I have been a strong supporter of home care since my very first home visit, which took place in my hometown in Aroostook County early in my Senate service. This experience gave me the opportunity to meet and visit with home health patients, where I saw first-hand what a difference highly skilled and caring visiting nurses and other health care professionals make to the lives of patients and their families. I have been a passionate advocate for home care ever since.

Last year, my bipartisan home health legislation, the Home Health Care Planning Improvement Act, became law as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This law, which I championed for 13 years, will improve the access Medicare beneficiaries have to home health care by allowing physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives to order home health services. Far too often seniors experience unnecessary delays in accessing home health care. To avoid these needless delays, it is common sense that other medical professionals who are familiar with a patient's case should be able to order these services.

Home health professionals have continued to provide face-to-face services during the COVID-19 public health emergency, but this crisis has created additional challenges, including the need to maintain an adequate supply of personal protective equipment to protect themselves, their patients, and their patients' families. The use of telehealth and virtual visits can help address these challenges. Unlike other Medicare providers, however, home health agencies are not eligible to receive Medicare reimbursement for telehealth services during the COVID-19 emergency.

Last May, I chaired Congress' first hearing examining COVID-19's devastating impact on seniors. During the hearing, Dr. Steven Landers, President and CEO of the Visiting Nurse Association Health Group, testified that, despite this lack of Medicare reimbursement, his organization has found telehealth to be an essential part of providing high quality home health care during the COVID-19 public health emergency. He urged action to ensure that home health providers can continue offering these critical services remotely.

Maine home health care providers have also shared their stories about how telehealth is helping them to continue caring for their patients during COVID-19. Through a combination of video visits and care calls, one provider has been able to care for a woman with severe heart and lung disease and keep this patient out of the hospital. The nurse would speak with the woman by phone a couple of times per week to assess any symptoms that needed follow up. If the nurse identified an issue during the call, she would schedule a video visit and also work with the patient's physician to modify medications as needed.

The bill we are introducing today would authorize Medicare reimbursement for home health services provided through telehealth during an emergency period. The services would not be reimbursed unless the beneficiary consents to receiving the services via telehealth. To ensure that the Medicare home health benefit does not become a telehealth-only benefit, Medicare reimbursement would only be provided if the telehealth services constitute no more than half of the billable visits made during the 30-day payment period. The Secretary of Health and Human Services would be required to issue guidance on the authorization of and payment for home health services provided via telehealth.

Home health serves a vital role in helping our Nation's seniors avoid more costly hospital visits and nursing home stays. The COVID-19 emergencyhas further underscored the critical importance of home health services and highlighted how these agencies are able to use telehealth to provide skilled care to their patients. The Home Health Emergency Access to Telehealth (HEAT) Act would ensure that seniors in Maine and across the country retain access to remote home health services during the COVID-19 emergency and future public health emergencies.

Thank you, Mr. President.

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Ms. COLLINS. Mr. President, today is Earth Day, and there are many issues, environmental challenges, that each of us could be discussing here on the Senate floor.

I have chosen to speak on a bill that I am introducing today that is called the Comprehensive National Mercury Monitoring Act. I am pleased to be partnering, once again, with my colleague from Delaware, Senator Carper, who serves as the chairman of the Senate Environment and Public Works Committee. Our bipartisan bill would help ensure that we have accurate information about the extent of mercury pollution in our country.

Mercury is a potent neurotoxin. It poses significant ecological and public health concerns, especially for children and pregnant women. Mercury exposure has gone down as U.S. mercury emissions have declined. However, the levels remain unacceptably high.

It is estimated that nearly 200,000 children born in the United States have been exposed to levels of mercury in the womb that are high enough to impair their neurological development. This exposure can impose a lifelong disability.

In addition, the societal costs of neurocognitive deficits associated with mercury exposure are estimated to be approximately $4.8 billion per year.

In Maine, some of our lands and bodies of water face higher mercury pollution compared to the national average. Maine has been called the tailpipe of the Nation, as the winds carrying pollution, including mercury, from the West drift into the State of Maine

A system for collecting information, such as we have for acid rain and other forms of pollution, does not currently exist for mercury, which, ironically, is a more toxic pollutant. A comprehensive mercury monitoring network is needed to protect human health, safeguard our fisheries, and track the effect of emission reductions. This monitoring network would also help policymakers, scientists, and the public better understand the sources, consequences, and trends of mercury pollution in our country.

Specifically, our legislation would do the following:

First, it would direct the EPA, in conjunction with the Fish and Wildlife Service, the U.S. Geological Survey, the National Park Service, the National Oceanic and Atmospheric Association, and other Federal Agencies, to establish a national mercury monitoring program to measure and monitor mercury levels in the air and watersheds, water and soil chemistry, and in marine, freshwater, and terrestrial organisms at multiple sites across the Nation.

Second, it would establish a scientific advisory committee to advise on the establishment, site selection, measurement, recording protocols, and operations of this monitoring program.

Third, our bill would establish a centralized database for existing and newly collected environmental mercury data that can be freely accessed on the internet and that is compatible with similar international efforts.

Fourth, our bill would require a report to Congress every 2 years on the program, including trend data, and an assessment every 4 years of the reduction in mercury deposition rates that needs to be achieved in order to prevent adverse human and ecological effects on our environment.

Fifth, our bill would authorize $95 million over 3 years for these purposes.

We must establish a comprehensive, robust national mercury monitoring network. Otherwise, we will lack the data we need to help make informed decisions that can help protect the people of Maine and the Nation, particularly our children and pregnant women.

I urge my colleagues to join me in supporting this bipartisan bill, the Comprehensive National Mercury Monitoring Act.

Thank you

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