it is alarming to see that today, opiates and heroine abuse is once again on the rise. it is in fact at epidemic levels every community throughout our country including my state of california which the cdc software thousand 521 drug overdose deaths in 2014 alone. recently in my district in pasadena, i met ryan hampton who for in five heroine users began by using prescription drugs. it was once an ambitious white house intern who was succeeding at college but then broke his knee while hiking and was put on scription opiates for pain area ryan like so many other young people became a pendant

on prescription drugs and started running out of his prescriptions too fast. he was then labeled a drug seeker and discharged from medical care. without any other option he turned to heroine area the fall into heroin addiction was quick and within months he was living on the streets. brian sought treatment after overdose and was told his life depended on it but there was a month long waiting list for accessing publicly available treatment options. thankfully, one of his family members was able to send him to a self paid treatment program but most are not that lucky. he told me that if he had to wait 30 days to access care he would have been one of the tragic overdoses statistics that we are talking about today. that is why passing a comprehensive policy package with the necessary funding is so critical and i cannot support this package without a funding commitment from congress.

we cannot deliver the promises of thisbill without it . so let's increase prevention programs and access to treatment andrecovery . let's fund these programs so that we can they live. >> the old lady you expect, chair recognizes the gentle lady from connecticut for an opening statement. >> thank you mister chairman. as a state legislator in 2009, i began working to prevent the destruction of prescription drug addiction and now has a member of congress i received calls virtually every day in my office from families struggling with the destruction of heroine or drug addiction and it is a public health emergency. congress needs to treat it like one so i am pleased that we are coming together here today more than 120 americans will die today from drug addiction. and by the time we conclude this meeting, another 12

american lives will be lost. the policies and proposals in this bill and they will help but without adequate funding we are not doing our job. it is very easy to stand up and cheer for good policies, to tell our constituents to tell the service providers to tell the heroin addiction counselors that we are with them, we support them but unless we provide them the funding the states are in crisis, our communities are in crisis, our providers are in crisis and to do that we need to do our jobs and provide them the resources to do their jobs and save lives. i hope we can continue to work together and not only support the important policies but give them the resources so that the folks on the street in the clinic, in our communities, our law enforcement can do their jobs and help these families, thank you very much and without ideal back the gentle lady kneels back. the chair recognizes mister

carter's for an opening statement. >> thank you chairman upton. ladies and gentlemen, the crisis of opioid abuse and addiction clearly requires our immediate attention. in my state of michigan for example, there were 1745 drug overdose deaths in 2014 and more than half of those overdose deaths were caused by opioids and heroine. each day 78 americans die for an opioid overdose, fortunately we now have better ways of adjusting issues of addition and we know that incarceration is not the answer. we know that there are effective ways to get annexed to treatment and to provide them with needed services to

address their addiction and prevent recidivism. we know also that evidence-based treatment and alternatives to incarceration work. title ii of this bill reflects much of this approach in the grant program as reported by the judiciary committee and passed by the house. while i've supported this effort, i also support alternative approaches area which provide separate grant programs for many of these were the purposes but regardless of which approach this conference committee adopts, we must do more and simply authorize funding, we must provide real dollars and i urgently needed by those fighting this. to emphasize this, i ask unanimous consent to enter into the record a letter that police chiefs participating in the police assisted

addiction and recovery initiative sent to us urging that we provide $1.1 million in increased funding to address this issue. >> without objection. >> thank you. that will be the true measure of success of this legislative effort and i think the chair and yield back the balance of my time. >> the gentleman yields back, the chair recognizes the gentle lady from texas, ms. sheila jackson. >> mister chairman, thank you very much and i am pleased in this significant moment of history to join my colleagues who have come together with a similar and very important purpose and that is to save lives. the ranking member on the judiciary committee dealing with crime, we see the aftermath over the years of a

wrong policy. let me simply add to the record some very startling facts. on an average day in the united states more than 650,000 opioid prescriptions are dispensed. 3900 people initiate nonmedical use of prescription opioids area 580 people initiate heroin use area 78 people die from it opioid -related death. $55 billion in health and social costs related to the prescription opioid abuse each year and $20 billion in emergency department and inpatient care from opioid poisonings. this conference committeeis on the right direction . there are worthy bills. the problem is huge. between 2020 14, almost a half 1 million people died from drug overdose based on the statistics i just read. our goal must be not just

legislation but to fulfill our obligation for full funding and i'm glad to have been a cosponsor of the contribution of the judiciary committee, hr 5446 comprehensive overdose reduction act, i'm glad to work with my ranking member and chairman and chairman of the subcommittee, the crime subcommittee. it is largely incorporated into the draft congress report provided to us that would establish a grant program to be administered by the department of justice to state and local governments, particularly by helping criminal justice agencies will be opioid problem from a variety of angles. i would encourage the alternatives to incarceration that provide treatment as a solution to the underlying motivation for criminal behavior or conduct associated with mental disorders. breaking news: there are no mandatory minimums in this legislation.combined with other treatment programs and

proposed to be included in the congress report, the approach congress is taking to the crisis of heroine and other opioids is thoughtful and comprehensive.the national association of counties in the united states has as one of their suggestions for elements provide for greater use of max alone. we have done that. we are training police officers. i hope it signals a departure from some of the failed appropriate concerning other preferences in the past. for instance, many of you know our responses surging crack cocaine in the 1980s was to enact enormous amounts of draconian mandatory minimum penalties and reduce treatment for particle cocaine. at that time congress took action that we are still trying to rectify so in conclusionafter chairman , let me make one final point. we know that in that instance many of those who were incarcerated were african-american. today, we have an opportunity to turn the page on heroine

as i hope we will turn the page going forward dealing with these traffic and terrible acts that impact society and cause great death with yield back. >> the gentle lady time is expired,chair recognizes the gentle lady from new hampshire . for an opening statement. >> thank you mister chair and thank you to all the bipartisan congressmen taking part in this historic conference today. many of the people in this room from both chambers and from both parties have been working long time to address challenges of addiction as the opioid and heroine epidemic has swept across our country. in my home state of new hampshire, the epidemic continues to grow. in 2015 the total number of drug overdoses in the state surpassed 400 and 35 and our population is only 1.3 million people. far exceeding the record set just one year before at 325 and well over double the

amount we had in 2013. this rapid rise in overdose rates reflects a deadly combination in new hampshire. we have one of the nation's highest addiction rates but ranked second to last in treatment capacity. the bill before us today and the programs included within it will provide crucial tools to help us begin to address this epidemic from allowing nurse practitioners to prescribe epinephrine under the supervision of a doctor to treatment alternatives to incarceration to building communities of recovery and improving prevention and education efforts. however, this legislation still falls short of where we need to be with 129 americans dying each and every day from overdose, action is needed now. the lack of funding included in this proposal represents a hole in this package and will hamper our ability to provide

education, treatment and recovery services in our communities across the country. with amendments still to be considered later today, i urge my colleagues on both sides of the aisle, please support representative pallone's amendment and ensure emergency funding for this legislation. by doing so, we can deliver help to those in need before it is too late. thank you mister chairman, i yield back. >> the young lady yields back, she wouldrecognize the gentleman from georgia , mister collins. >> thank you mr. chairman. and i appreciate the opportunity to be part of this and all the work that went into it. as we can hear by the opening statements, the magnitude of what we are dealing with and i think that is affected as well in the state of georgia where the bureau of investigation heroin overdoses are by over 300 percent this year. my shares say it has become again a rehash of one of the longest times where they see

it more regularly now than they see any other confiscation in many other areas. i am appreciative of the context of this addiction recovery act and take many important provisions but i want to focus on one very quickly and that is section 502. this is close to my heart. it's a section that deals with a grant process to expand veterans treatment. as a member of the air force and the chaplain who has served overseas it is startling the statistics that why introduce the mental health act to expand veterans treatment courses and most of the language reflected in the report shows the opioid and epidemic affects veterans. quickly, the va says one in three veterans seeking treatment for substance abuse also has ptsd. one in six veterans of operation enduring freedom or iraqi freedom supper since abuse. and should not cast them aside. i've seen the pain this causes not only our military?

every day. i'm pleased with the report so far and i look forward to the increasing efforts to bring forward help in this crisis and without you back. >> the chair recognizes mister court for an opening statement thank you mr. chairman. in 2000 for the center for disease control, and 7000 americans lost their lives to heroine opioid overdoses. fast-forward to 2014, last year they have full statistics, that number grew four times, 28,000 americans lost her life to heroine and opioid overdoses. we know 25 to 15 because of statewide numbers is going to be a and 2016 is off to a horrendous art as well. if there was an infectious disease causing this part of harm to our country, if it was a natural disaster that was causing this kind of have to our country, this congress would be on fire in terms of getting emergency funding into the country to deal with this devastation. this bill contains many good provisions in terms of policy changes, authorizing languages but the absence of any real resources to help

families who right now as we are sitting in this room are scrambling to try to find a detox bed for a long-term treatment bad, a police department where they have an addict in lockup they are trying to get out and into a treatment program, and emergency room where a doctor has brought someone afterlife with narcan is watching that patiently with no treatment options available. we need to get much more serious about dealing with the overwhelming avalanche of harm and need that exists in this country. the amendment which will be offered later offers a fully paid for amount of resources that deals with prevention, it deals with treatment and also gives resources in terms of education and law enforcement. this is the approach that ultimately is going to make a difference to those families were looking to us desperately for help so they can help their loved ones get the treatment we know works

and again, we have that power. we have an opportunity. we should do this like we would any natural disaster. we should do this like any other type of infectious disease epidemic that again, over and over again we as a great nation have stood up and responded to with real resources to get help to the people we represent and i yield back. >> the gentleman yields back, the gentleman recognizes the gentleman from indiana. >> i'm pleased to support the report for us today specifically section 303 which is language based on my legislation the opioid modernization act and the treat act as passed by the senate health committee. i will submit them the remainder of my remarks on the record and i yield back. >> thank you. the gentleman yields back, the chair recognizes the gentleman from virginia mister scott thank you mr. chairman. this chairman is the original sponsor of the house version of the comprehensive bill. we have an opportunity to make a real difference in

people's lives. we are losing far too many people to opioid addiction and research tells us we must address this crisis is a public health issue, not a criminal justice issue. there are any number of evidence illusions that can effectively address that epidemic and many of them are found in this bill that are focused on prevention, early intervention and rehabilitation. we also know the states localities need more resources to respond to this crisis and while this conference report takes a positive step in the right direction, by authorizing several new programs to combat opioid addiction we need to take the next set by authorizing funding levels necessary to ensure these programs make the impact they are designed tomake we have a choice , we can shortchange these intervention programs and say more later in criminal justice expenses or put up the money now and save lives, keep families together and save money. mister chairman, this is a good bill as far as it goes but in addition to the funding issue , there is another issue and that is

that the bowl bill should include support for correctional education initiatives. this provision was included in the senate passed legislation and in the house bill that our colleague from wisconsin mister simpson introduced which i was proud to be a cosponsor. that bill has over 100 cosponsors and including over 40 republicans so because of the need of the programs to assist those already in the justice system and the broad bipartisan support, such an initiative has received i will be introducing an amendment which will include retinal education activities as an allowable use for state block grant to address opioid addiction. mister chairman i thank you for your leadership and i yield back the balance of my time. >> gentleman yields back, the chair recognizes the gentleman from the great state of michigan, mister trott for two minutes. >> as so many of my colleagues have mentioned, the opioid epidemic has no

boundaries and reaches every one of our districts. a few minutes ago my colleague mister conyers from detroit indicated that 1700 people passed away in 2014 from lloyd abuse. unfortunately my district had a disproportionate number of those deaths in 2014. 449 people passed away from heroine and painkiller abuse in wayne county. this legislation we are considering containing important solutions to fight this problem. first the bill we pass on the judiciary provide for a comprehensive grant program to ensure law enforcement first responders and criminal investigations in drug courts have resources necessary to fight this problem. second, it provides for transparency and accountability to ensure that our solution is actually making a difference in reducing the number of deaths because of opioid abuse and finally, ask the root of the problem, allowing treasury to have the resources to designate in the international drug traffickers asking him in order to prevent them from accessing our financial system and for their illicit

purposes and also keeps such designation confidential. i applaud the house and senate for tackling this important issue for coming together today to respond responsibly and thoroughly to address this epidemic and i yield back. >> the chair recognizes the gentleman for an opening statement. >> thank you mr. chairman. today we come together to address one of our nations most pressing crises, opioid addiction and abuse. i would like that house and state senate leadership for their work on this confidence report and particularly i would like to thank ranking member pallone for his tireless leadership on this issue and for being an important guiding voice on the energy and commerce committee. as my colleagues before me have noted, millions of americans each year face the devastating impact of drug abuse and addiction. as an emergency management physician, i have seen far too many patients who have fallen victim to this horrible cycle of addiction. i remember when a young man blue with purple lips was dropped out of a moving car

not breathing. he was rushed into my emergency room and i admitted him, gave him naloxone and other supportive care, save his life but ialways wondered if he had the appropriate resources once he left the emergency department to turn his life around , to get treatment and to live that better life that we all strive for. so i've seen this working physical and emotional impact on medication abuse on individuals and their families today we had an incredible opportunity to enact meaningful legislation to combat the epidemic of opioid abuse and help save millions of lives. in 2014 more than 28,000 americans died because of an opioid abuse. they suffered, their families and loved ones suffered, their communities suffered. today, more americans die from drug overdoses than car crashes. in fact, opioid abuse and addiction have become a leading cause of injury and death in the united states.

our constituents are calling on us to act. now is the time to ensure we provide meaningful resources and support so millions suffering from this disorder can move on the path to recovery. sentiments, plans and ideas are important but they must include the resources that will allow local state and federal officials to implement these ideas and fully address what is truly a public health crisis, that is why i join my colleagues in demanding that our actions reflect the seriousness of this health crisis by including the necessary funding as part of the conference report. we need funding so law enforcement and other first responders are able to reverse the effects of an overdose and save more lives, we need funding so that patients, their families and the public are educated on the symptoms and treatment of opioid abuse and more importantly how to prevent opioid abuse. we need funding so programs we and supporting states

around the country are sustainable and make lasting measurable improvement. we cannot let our words become merely empty promises and in conclusion it is critical that we ensure americans who are suffering received resources, treatment and support they need to overcome addiction so that opioid abuse patients and their families leave the emergency department have a meaningful chance to heal and turn their lives around, i yield back my time>> gentleman signs expired, the chair recognizes the gentle lady from indiana area . >> thank you mister chairman. as my colleagues have talked about, the public health crisis that the heroine opioid devastation creates, many may not realize there was a crisis in my home state of indiana. in scott county, rural county in southern indiana, the hiv aids rates exploded a little over a year ago as a result of iv drug use. and while the spotlight was on got county for a period of time, we know this public health crisis happens all across our country .

with headlines more sadly obituaries in our papers day in and day out. we see rising rates of child welfare cases due largely to the neglect of children of drug addicted parents, large numbers of instant being born addicted to opioids and cycles of recovery, relapse and addiction but the epidemic didn't happen overnight. medical providers and healthcare workers say much of the crisis began with the overprotection of opioids. certainly there is a medical need for pain medication and opioids but in this country we develop a culture of over prescription that is built on patient expectations and providers lack of awareness and failure to address this over prescription of these types of medications which is a major part of the epidemic , what i would say the root from the outset perpetuates the cycle of addiction in our communities so i urge my colleagues to support this legislation which includes

beginning with section 101 the task force on pain management which establishes this comprehensive task force comprised of representatives from the relevant federal agencies as well as expert physicians, recovery specialists, hospitals, dentists, pharmacists, all sorts of groups. because we must get to the root of this problem. i believe this bill does this and is going to take all of us working together and i urge my colleagues to support and move over and give families some hope. thank you and i yield back to the chairrecognizes the gentleman from washington state, mister mcdermott area . >> thank you mr. chairman. i ask unanimous consent that to enter into the record a letter to the chairman 53 senators and 12 members of the house. >> without objection. >> dated five july. the issue here is whether you're going to put the resources, you heard it over and over and over again area we are preparing today on the floor of the house to adopt a mental health bill that has

no money attached to it. you are not going to fix the problems we are talking about here today with good legislation perfectly designed policies, policies are wonderful but you have to have money to implement them. and that's clearly what is the problem with this particular piece that we are working on today. you would have a unanimous nature list at the end of this conference if there were some money. but if there is no money in it, it becomes, it's like building a house. you say we got a housing problem so let's build a house. then you build a nice shell but you don't connect the electricity. you don't connect the water. you don't connect the sewer system. that is not a functioning house and that's what you are doing here. this is a public health house we are building but we're not connecting the utilities that will make it work and that's really why i think that we

must consider mister pallone's amendment in a positive way if we are serious about this. everybody, i've heard it about 33 times how many people died and all that stuff. i'm tired of that. it's time to do something and that means you put some money where your mouth is, i yield back . >> the gentleman yield back, the chair recognizes the gentleman from the great state of michigan for two minutes. >> thank you mr.chairman. i appreciate the opportunity to serve on this conference committee . there are so many statistics that have been cited so far by my colleagues, too many to mention and too many to review again but suffice to say that my community is not the only one that's seen this epidemic, too many have suffered as a result of opioids and opioid addiction . this is a ticking time bomb and everybody's district,

everybody's community and i am therefore proud that congress has decided to act. the statistics speak for themselves and as a father of three school-age children, i know full well that an unacceptable percentage of those younger people find it very easy to obtain opioids in every possible form. they're available in every school and every neighborhood and the abuse continues to proliferate. this is a crisis that demands urgent attention and urgent action and while this bill and this conference report does not represent a panacea and a silver bullet i believe it's a great step in the right direction that one of the things it does that i'm very grateful to have as a part of this is that it encourages treatment alternatives and divergent programs and as a former prosecutor, i saw drug court

in action and know that they are very effective in what they do in addressing this issue. committee base divergent programs, addiction problems need interdiction and treatment and i believe the drug courts are very effective at doing that. i'm also grateful for the fact that this report entitled to include my amendment to develop and implement technology that would prevent or deter individuals , in particular our children from getting access to opioid medications which have been lawfully prescribed. i want to thank the conference committee, my time is concluded and thank you for your effort today, i yield back. >> gentleman yield back, the chair recognizes the gentleman from florida, mister carter. >> i'm delighted to be here today to make it major step in finalizing this

legislation. mister chairman, i've been a member of this august body for 18 months and i can think of very few times when i have been any more proud of any legislation we have passed then what we working on right now. this is definitely a problem in our country and i'm very proud of this body or recognizing this and for addressing this area i believe there are numerous challenges that our community healthcare providers and community leaders face and this bill will help them address many of those challenges. as a lifelong healthcare professional i believe the key to filling any successful prescription is education. this bill does that. it makes improvements to current prevention and education programs to ensure americans stay well-informed about their medications. i also believe that once key component that has lacked in the past to address opioid addiction has been a real concentration on improving treatment and treatment facilities. this bill does that. whether it's evidence-based prescription treatment, improving treatment for pregnant and postpartum women or training the first responder, this report provides treatment for all americans who need it.

finally, as a lifelong pharmacist i'm glad to see this bill recognizes the need for greater involvement when it comes to prescription drug monitoring programs. as the author of george's pd and p i believe these programs will continue to play an important role in our fight against opioid addiction. i believe pdm keys with the coordination between prescribers and pharmacists can and will be a cornerstone in our fight against the american opioid abuse epidemic area i believe this bill does many bright things but i have real concerns with provisions that include the definition of one pharmacy as a multiple location pharmacy that works on their own real-time database area over the past few years, pharmacy benefit managers have used their money and power to purchase drugstores and force americans away from their community pharmacists. i hope i can work with chairman upton and my colleagues to address this issue and issues related to pharmacy market manipulation to ensure that everything is being done to help grow small business pharmacies in this country.

again, i want to thank the leadership and commend them in both chambers on this bill and i look forward to sending something to the president's desk soon so we can better fight this epidemic. thank you mister chairman and i yield back >> the chair recognizes the gentleman from mister florida . >> thank you mr. chairman. i want to thank you mister chairman and all members of the staff for their tireless efforts and hard work in bringing these workable solutions together in a bipartisan manner. we all have been touched one way or another knowing someone that has been affected by opioids whether it's family, friends or heartbreaking stories from constituents back home. included in this report, the underlying bill, the positions i've been advocating for on behalf of our true american heroes, our veterans and military that have sacrificed so much. my bill and the contract will ultimately provide the quality healthcare our veterans have heard and

deserve. specifically the thomas act will update the guidelines used to treat our servicemembers for pain management and the cover act will provide a pathway forward to implement complementary and integrative health alternatives within the va. additionally, the pilot program offered was included that will provide veterans access to treatments provided in our communities that have shown positive results with those experiencing mental health or chronic pain. i urge all my colleagues to support the conference report and the underlying bill. in doing so we uphold our promise to those we represent and send a clear message to our military that we have them covered. i yield back, thank you mr. chairman. >> the chair recognizes the gentle lady from indiana, miss mirsky for an opening statement. >> as a member of the veterans affairs committee

community i am concerned over opioid prescription and i'm honored to support this report. veterans face higher rates of poly trauma and morbidity, particularly t ptsd and traumatic brain injury. veterans are more vulnerable to addiction and i've seen the problem for stand with veterans coming into my office often carrying a large bag or box of random pills. this is escalated so quickly the dea has rated and it is investigating several va facilities including one in my home state of indiana. the medical center in marion raise adea suspicion after it purchased more prescription drugs than any other va facility in the entire northern district of indiana. for too long va relied too heavily on the prescription of opioids. there needs to be more oversight at va facilities and the va needs to explore more effective treatment. with that said i want to

highlight two important provisions of this legislation i've advocated for years. the first requires the va to report to state prescription drug monitoring programs read these databases have proven to be an important and effective tool for tracking prescription practices . yet the va is not required to report to them as other healthcare providers are. this will open a window into prescribing practices that will help law enforcement identify practices that warrant investigation. the second provision allows the va to consider forms of treatment such as fda approved medical devices for patients with chronic pain . an apartment more options than strictly prescribing opioids. i want to thank you for the opportunity to be part of this community and work side-by-side on this important issue facing our veterans and i yield back the gentle lady yield back, the chair recognizes mister means from pennsylvania for an opening statement. >> thank you mr. chairman. i knew john thomas dekker. he was a scholar, a leader, an outstanding athlete. he's not a statistic. unfortunately, he has sports related injury that led to opioid abuse and ultimately heroin addiction and his death.

and in so many ways, it's the name that's important because we're not talking about statistics. were talking about real lives and families have been struggling with addiction first and ultimately the loss of a loved one. we have so much opportunity with this bill to do meaningful things now . as we are hearing the statistics of over 120 people a day who are dying, we must do something now. this is an ongoing process and the commitment we must make to continue but we have so much such as a sports related intervention that can be done in high schools in the name of john decker. the court i worked on as a prosecutor that i have seen make a difference in the lives of those who have been struggling. prescription monitoring that can ensure that we identify those who are abusing the opioids in a safe care, so many pieces which are going to make a difference in the lives of those struggling families. i urge my colleagues on both sides of the aisle to stay

focused on these real people. and make sure that we do something meaningful today. i yield back. >> the gentleman yield back, the chair recognizes the data from from illinois, mister dold for a statement. >> thank you mr. chairman. and it's an honor to be able to work with you on my colleagues on this conference committee. you've heard the statistics and frankly i don't agree with my colleague mister mean, this isn't about statistics, this is about families across our country. from buffalo grove, a high school student had his life in front of him. agood student, a good athlete and lots of friends . when he went off to college he actually ended up dying from a heroin overdose. we have an epidemic on our hands in our country and this legislation we are working on today is really talking about hopefully having a second chance at recovery for literally millions of people

across our nation. every single community is at rest .so as someone that serves as the cochair of the suburban heroin task force i've seen firsthand what this is doing to families right back at home. no mother should have to walk into a child's bedroom to find them overdosed from heroine. and prescription drugs and so there is very meaningful pieces of legislation. mister chair, i'm going to submit the rest rest of my remarks for the record but i do think this is an incredibly important piece of legislation that requires our attention and requires we step up and meaningfully attack what's going on across our country. i yield back. >> the chairman yield back. i would now ask unanimous consent that all statements be made part of the record without objection, so ordered. i believe that all members that are here have given an opening statement or submitted them to the record. so i now call up the

conference draft and asked the court to report conference draft of the conference of addiction and recovery act of 2016. >> the conference draft will be considered as read. i want to remind members of our amendment process. for the countries of the sponsor's house will first discuss the amendment for five minutes. each for the majority and then for the minority. then that house will vote on the amendment. if the amendment is agreed to, the process will repeat for the countries of the other body. the chair now recognizes himself to offer an amendment and the clerk will report that amendment. >> amendments to the conference report on s524 authored by chairman upton. >> the amendment will be considered as read, the staff will distribute the amendment and the chair will recognize himself briefly in support of the amendment. this amendment provides

technical edits to the conference report. specifically, the edits insure the grants authorized in the bill are carried out by the secretary of hhs , the authorization of appropriations is included in that section. the amendment also makes minor classifications to section 303, the opioid use disorder treatment expansion and modernization. and i would k my colleagues to support the amendment, are there members in the majority side that would with wish to speak in support of the amendment? seeing none i will yield back the balance of my time, are there members in the minority that would like to speak for or against the amendment? seeing none, the vote occurs on the upton amendment, those in favor will say aye. those opposed say no. the aye's at it, the amendment is agreed to so at this point i yield to mister grassley. to see if the senate will accept a house amendment.

>> i support the managers amendment. it seems i can take a moment to thank senator upton and members. >> you said senator upton. >> i apologize. >> you can still call me sir. >> i support chairman upton and thank him for this opportunity. we ought to thank also members of the staff of both chambers on both sides of the aisle for their work finalizing the report and preparation for today. it was truly bipartisan, bicameral team effort. if there's anybody on the senate minority wants to speak then i will yield back my time. those in favor shall signify by saying aye. all posed, no. the aye's have it, the

amendment is agreed to, the senate has accepted the house offer on the upton amendment and the amendment is adopted. >> with that, the conference accepts the on the upton amendment. the lady amendment was next in line,he will be back shortly so when he returns we will take his amendment up . at this point, the gentleman from new jersey has an amendment at the desk area. >> thank you mr. chairman. i do have an amendment at the desk. >> clerk will report, the title of the amendment. >> discussion draft amendment to the conference report for s5 24 offered by mister pallone. >> the amendment will be considered as read, the staff will attribute the amendment and the gentleman from new jersey is recognized for five minutes in support of the amendment. >> thank you mr. chairman. this amendment would provide critical funding for opioid and heroine treatment that is fully paid for with vetted partisan offsets. as we've all made clear we are here today because we are in the midst of an unprecedented opioid and

heroine crisis. daily, 2014 said the highest number of drug overdose deaths than any other year on record. our treatment systems have not kept pace with the epidemic. those struggling with heroin or opioid addiction suffers from critical shortages in treatment access. only one in 10 individuals offering from substance abuse disorders received any form of treatment. given the tremendous gap between supply and demand for substance abuse treatment, it's a force to believe we can mount a forceful response this epidemic without providing additional resources to our community and public health systems. that's why i'm offering this amendment which provides $920 million in immediate funding to provide critical tools to attack the opioid endemic head on and expands the type of providers to treat opioid dependency. the funding would go directly to the states to enable them to increase treatment capacity through cooperative

treatments to expand assistance treatment for opioid use disorders. this proposal provides for a targeted response where funding is allocated to the areas hit the hardest by this epidemic. it will empower state to adopt innovative solutions to increase treatment capacity as well as make treatment more affordable for those seeking services. the amendment is fully offset with bipartisan offsets that we've all agreed to in the past including and i will list them, one, rolling back the start date on a policy that is currently enacted to ensure we are applicable, medicare payments that are no more than what we pay for the same items for medicare. two, changing the way medicare pays for part b dme infusion drugs to asp +6 percent methodology which would result in the payment amount that is reflected in the actual transaction prices. three, reducing payments made

to fraudulent providers in our federal health programs with the requirements of the state report any provider that is terminated from one state graham to a uniform and central database accessible to all state and forth, better protecting our medicare and medicaid program integrity algorithms and last, ensuring the savings from an opioid policy we've all agreed to allowing for the creation of prescription drug management programs for at-risk medicare beneficiaries in the part b program and that it goes towards the opioid crisis in this country. mister chan i would urge my colleagues to support this man. these are all policies we've voted on before in funding is needed to address this crisis. make no mistake, if we do not bring resources to the table in our fight against the opioid epidemic we will fail. anything less than a robust response to address this crisis will result in increased deaths and place tremendous emotional and financial burden on our

families and communities and the need for action is now. we can't wait until the normal appropriation cycle to provide funding necessary to respond to this crisis. additionally, if congress doesn't take a proactive approach in providing this necessary resources to combat this crisis we will pay for it later through the collateral consequences of this epidemic such as to our emergency department and through the criminal justice system meaning that we aid money today at the expense of lives lost and increase spending later so mister chairman it's time for congress to step up and provide safe communities and family with funding they need to fight this epidemic. i urge my colleagues to support this critical amendment and i yield back. >> the gentleman yields back. i will claim the time in opposition. i want to say that i think all the members on this conference committee believed the resources to fight the

open opioid epidemic are an important component in our strategy to help communities that in the and families are suffering . i would note that just this morning the house probation committee announced they will be providing some $581 million to address opioid and heroine abuse. that's $525 million increase above the 2016 and acted level and some $490 million above the president's budget request so this conference report includes many bipartisan priorities addressing the prevention, education, and recovery of opioid use disorders aimed at strengthening our nation's response to this horrendous epidemic. just one example is an important provision in the bill to provide pregnant and postpartum women with proper treatment for substance abuse disorders. however, the amendment before us and it's not a bipartisan temp at finding resources for opioid programs, in fact at no point was this amendment

discussed during the months of negotiations in the house and senate. instead, the ideas included in the amendment were included in a letter that the democratic conference released yesterday afternoon. so i would agree with our appropriators that we have to devote significant resources to combat this epidemic which is what they've done, they've announced this morning but this amendment is not the right way to do it. we would note that s5 24 passed the senate with 94 senators voting in support, the house package of opioid past 402 five. yesterday over 100 groups voice their support for the legislation . i think we have to allow this bill, we must not allow the bill to be weighed down with last-minute objections to major bipartisan priority so i would urge my companies in

the house tooppose the amendment and would ask if any members of the majority side would also like to speak against it . if not, i would yield back the balance of my time, roll call is being requested. we did five minutes on each side so the clerk will call the rolei would note that on this amendment , the conferees from energy and commerce, the general conferees, judiciary and ways and means members will be voting and the clerk will call the role. >> mister pitts. mister pitts votes no. [roll call vote]

>>. [roll call vote] [roll call vote] [roll call vote]

>>. [roll call vote] >> we have proxies for all these members so how ismister simpson reported? >> he is not reported. >> he votes no by proxy . >> mister simpson book burner votes no. >> how is mister moreno recorded? >> he is not reported. >> i have a proxy, he votes no. >> how is mister mccarthy? >> mister mccarthy is not reported. >> i have a proxy, he votes no. >> and i wouldask , ... >> richard chairman?

>> how is mister smith recorded? >> mister smith is not recorded. >> i believe the only proxies i have is mister conyers. >> how is mister conyers recorded? >> i vote aye. >> mister conyers boat aye. >> how is mister lujan recorded? >> is not reported. mister lujan boat aye. >> how is mister green recorded? >> mister green isnot reported. >> i do not have a proxy for mister green . >> are there other members that are not recorded? yes, you may. [inaudible conversation] it's

my understanding that the conference allows, conferences allow for proxy voting and we told all members that earlier at a point, proxies would be included. are there members that were called who have not voted, that wish to vote or change their vote?if not the clerk will report the tally. you know, i might ask how is congressman lamar smith recorded? >> he is not reported. >> i have a proxy for him and sohe votes no . >> mister smith to know. >> now the clerk will record the vote. >> mister chairman on that boat there were 17 aye, there were 11 aye's and 17 nays. >> the amendment is not

agreed to. next amendment. next amendment, gentle lady from washington state . ms. murray. >> i call up my minute. >> the clerk will report the title of the amendment. >> the amendment to the conference report of theft by 24 offered by ms. murray. >> the amendment will be considered as red, staff will distribute the amendment and the gentle lady is recognized for five minutes. >> as i said in my opening statement i am glad we've been able to reach some important bipartisan agreement on this issue but our state need more to tackle the opioid crisis head on. they need new investments. this investment will provide $920 million in funding for states to extend access to prevention and treatments services, especially for those who cannot afford it. there is no reason we can't all support this amendment.

we all agree the funding is needed to help our communities stop the wave of overdose deaths and to properly treat addiction to prescription opioids and heroine and specifically we know that without more funding to extend access to medication assisted treatments, states will not have the resources they need to put people on the path to recovery and save lives area we are debating a bill to address the opioid epidemic that should include the funding necessary to actually fight that epidemic so this amendment would provide funding to states for medicaid assisted treatment, allow nurse practitioners and physician assistants to prescribe the drug to help their patients cope with and recover from addiction and importantly, the bill empowers these providers to treat patients while deferring to state practice laws. this is critical for many of our rural communities that have been hit hard this epidemic. the amendment is also fully paid for by a set of offsets

that both parties have supported in previous boats and would not add a single dollar to the deficit. the bottom line is when someone is ready for treatment, we need to make sure our healthcare system is ready to treat them and i'm very concerned that if we pass a bill that changes our nations opioid policies but completely ignores the funding that would enable cities and states to put those policies into practice, that funding might never come. for far too many families there is no later. there is no next time. this is the opioid bill this yearand frankly, people across the country are running out of time . so let's make the tough choices. let's vote for this amendment and that's make sure this bill takes an absolute necessary step forward in expanding access to the life-saving treatments that

families across the country need. mister chairman, i yield my additional time to senator roy. >> do i have two minutes? >> 2:28. >> i will be very brief. colleagues, i strongly support the murray amendment. this is what i meant when i said we were talking about writing infernos with a thimbleful of water. very briefly, according to research published in 2015 in the journal of the american medical association, 80 percent of people are dependent on heroin or painkillers are not getting treatment. now, i don't want to tell families at home in oregon and across the country that they ought to wait around for the appropriations process. my staff did research, apparently it's been years since there's been a labor health and human services budget so the question is, are we going to be able to tell families now that we are serious about securing the money when 80 percent of those who need treatment

according to research done by one of the most reputable groups in the country say they are waiting and i don't think they ought to be waiting around for the appropriations process and the amendment to the amendment to the amendment that never really seem to get there when these families are in crisis. i urge my colleagues to support the murray amendment. >> the gentle lady still has a minute left, the sealed back?>> mister chairman. >> the gentleman from tennessee is recognized for five minutes. >> thank you mister chairman. i think the senator from washington and senator from oregon for their comments. i would not want the american people to get the wrong impression, we have bipartisan support here for the policy we are talking about today . 94 to 1 in the senate, 400 to 5 in the house. we have bipartisan support for funding the opioid abuse,

it's much more than a symbol. it may not be a firehose but over the last two years if you follow what the senate appropriations committee has recommended, we've increased funding for opioid abuse by a factor of seven times, seven times more money than two years ago. and if we do what the house appropriations committee announced today, it would be 14 times. so seven times more than two years ago, 14 times more than two years ago. that's an opportunity for bipartisan support. that's the way we always do it in the senate, we operate on two tracks. the senate from washington and i worked together on fixing no child left behind with members of the house of representatives, the president called it a christmas miracle didn't stand on penny because it reformed programs. we pass defense bill every year, that doesn't spend one penny.we do that in the

appropriations process. we pass an energy bill doesn't spend one penny. the bills are good and so is the appropriations bill so we are spending money on opioids and we are doing it in the right way. so we should go ahead and finish our work today on reforming the programs and then we should finish our work on funding, on funding opioid which as i said the appropriations committee in the senate wants to do seven times the rate of two years ago and thehouse said today it wants to do at a rate of 14 times . that's a substantial improvement and i think it would have bipartisan support. there's a second reason why i would oppose the amendment by

>> >> that will get treatments and discoveries through the process of the medicine cabinet faster progress it is different than the heather legislation but it is related and the money to pay for it with 344 votes is the save money we cannot spend that save money twice. let's recognize read to have bipartisan support and spending money, i cannot think of other provisions of the budget where we spend seven times or 14 times that we did two years ago and we're still talking about additional funding in the senate in a bipartisan way

and the house for kosher lee take the money we would use and try to spend the money twice i've opposed to the amendment i am in favor of the policy but this isn't the way to do it we can do it another way some. >> those in favor? those opposed? a recorded vote is asked for on the senate side and the clerk will call the roll.

[roll call] >> read there those wishing to change their vote? >> there was three aye and for no. it's been recommended to the conference report. >> it will be considered as

read and the gentleman from vermont is recognized. >> i help to put together the amendment that is correct. >> i hope to create the heroine task force program provider from law-enforcement people all over the country they have to have additional funds to combat the traffickers this nattily a fax vermont the states like tennessee your wisconsin manage those because they have critical support every move direct

task it would really plays the task force programming times and allow that to be another issues. we really wanted this the way it was a and senator grassley i agree with him and an end i am happy to know the tennessee bureau of investigation highroad to a letter on behalf of the investigative agencies there is no easy way out of all of this in favor of large cities or small areas this is a set up so if like every

state you have role areas you can get help with the big cities to the also the smaller areas. they tell us it works in think we should keep something that works i yield back my time. >> the gentleman from iowa. >> separate standalone authorizations the amendment authorizes these task forces in the current appropriations bill the conference report provides resources for heroin

investigations as the allowable use under the grant program that does not authorize a methamphetamine taskforce and in particular the methamphetamine taskforce given house stranger those resources are at the state level to have these funded through the proper authorization i urge my colleagues to support the amendment or any videos of the majority side. i yield back. >> [inaudible] >> they're wrong amendment was distributed on the house side. it will come back we will

get you the right one. i apologize. sorry about that. the senator yield back the balance of time the vote that occurred on the amendment those in favor? the amendment is agreed to now it comes on the house side is passed to the senate and the gentleman from virginia will control the first five minutes. >> verizon opposition to this amendment because of a comprehensive opioid reduction act is to be a

grant program that is specifically included to provide for grants for eliciting activities related to the unlawful distribution of opioid that tracks is section that would single out a task force resulting in a disjointed rather than in comprehensive dot grant program. the amendment attempts to elevate the pet programs that has only benefited a small number of selects states and has never been supported in a house appropriations bill. that chooses to eliminate these programs this gives the taskforce preferential treatment over the court programs and prescription drug monitoring programs and

all the other extremely important efforts supported by the comprehensive opioid abuse reduction act. this amendment gives the task force's exclusive authorization for appropriation that is not even fully offset for the purposes of the comprehensive opioid reduction act falling short by $10 billion. this would negate that effort is a ready analogous than provided for and is fully offset under the protocol. the comprehensive opioid abuse reduction act goes above and beyond to have new funding for the

authorization of carefully developed as a result of a thorough consideration of the house amendments language with the need to focus on appeal way addiction at this time. the leaky grassley amendment introduces an unnecessary duplication into the comprehensive opioid abuse reduction act attempts to shift the of funding from the entire mobile radars to methamphetamines prepare those circumstances this is a poor fit for the bill. i will reject this amendment is not of'' for illicit activities but simply in favor of a comprehensive approach that supports law-enforcement efforts one purpose of which is to authorize grants for the purpose of investigating illicit activities and

therefore i urge my colleagues to reject this amendment. >> i reserve the balance of my time. >> are those looking to speak again opposition? >> cry there other members wishing to speak? >> other members of the house side willing to speak? >> those in favor? those opposed? the no have it is not agreed to. >> the next amendment is the

gentlelady from washington state has an amendment at the desk. >> the clerk will report the title. >> be amended to the conference report. >> at will be considered as read and you're recognized for five minutes. >> local v.a. medical centers have veterans seeking care to help them get the care that they need. overseeing the page said advocate system to intervene where needed to major veterans get the high quality care that they have burned.

these failures lead to a tragedy when no one would listen and when they raise concerns about how all the medications he was given at the v.a. medical center were making him feel and act reported to the chief of staff who was ultimately responsible for prescribing the deadly mix of medications that led to his staff. to prevent that from happening again this amendment would establish a central and independent office to help patient advocates effectively meet their obligations. his office will give advocates national level support at the medical center to ensure patient advocates report to the independent office rather

than the medical center for a dedicated office will ensure the program remains accountable to the needs of veterans and families to prevent any undue pressure from a local medical facility it is widely supported by the veterans' service organization and agreed to buy both sides and is included in the first act i appreciate my colleagues for their vital legislation this provision is a key component in should be included as the veterans committee has. >> the edge gentleman from tennessee? >> i support her amendment as the veterans affairs committee.

>> for reasons beyond i think we ought to support it because the wingback through august 2014 we pass legislation we thought would dramatically change the direction of the virginia and it has accomplished very little the new secretary has accomplished very little we're not doing enough for our veterans in this is a step in the direction of congress to weigh in to make the necessary changes so the of the day gets the answers -- the a gets assistance. >> i totally agree it is easy to get a parade to talk about veterans but it is the things that we actually need that should be included and i think the senator from

washington state. >> the amendment offered from the gentlelady of washington state. those in favor? those opposed? the aye is agreed to it comes to the house side, the chairman will recon lot -- recognize himself for five minutes. >> we need to support that and i urge my colleagues to vote in favor. other members wishing to speak? those in favor? the amendment is agreed to as part of the conference. >> is that amendment ready yet? >> we are ready enough we have the copies. >> maybe not quite that copy is coming to the desk.

>> we would like to go ahead while we go with the jackson lee amendment. >> thank you for your courtesy members. >> amendment to the conference report offered by ms. jackson lee. >> she offers by unanimous consent to the changes know we cannot do it in the house to the senate yet this is still the house side it will come to you if a passes. with fats her amendment to she has five minutes to

offer for amendment. >> i offer that it is accepted as amended. >> without objection. >> dishy have five minutes and support of her amendment. >> my apologies we have been engaged with legislative compromise is the sense of decades of experience and research have demonstrated the pope uaw's epidemic have demonstrated a fiscally responsible approach to addressing deal pureed abuse epidemic and other substance abuse epidemics require treating such as a public health emergency for treatment in and recovery. thank you for working with me on this as i ask my colleagues to support this as i started off i indicated

this is a significant moment in history to move forward to assure as many colleagues have said that we have resources but also want to use this as a model. many of you need not be reminded of the crack cocaine epidemic that resulted in almost 2 million people being incarcerated in the nation's prisons local state and federal and at this point we found a model that deals with those that are addicted and not criminally involved and are literally sick and it is important to treat this epidemic as a public health emergency emphasizing prevention and treatment and recovery the matter where ends up but i think it is safe to say the legislation to save and redeem lives of tens of thousands in many communities throughout

america we lost thousands of lives and families destroyed to the epidemic of crack cocaine and certainly others our health professionals were overwhelmed our emergency centers were overwhelmed and in particular to 80 percent of the defendants were african-american in spite of the fact that they were sick and addicted with broken lives and believe it is important as we move forward in this conference we reflect what the american public health association has indicated ending day criminalization of drugs after harm reduction strategy is to remove the barriers of treatment including some innovative ways to address the sickness and epidemic can certainly

we have experienced that in many inner-city communities for i cannot tell you the funerals i have gone to simply because people were addicted to crack and i am sure there are many other stories i've member of the opioid heroin caucus and i want to applaud them and the conferees as well with explicit recognition of a ground-based breaking work done to show that congress listens to the american people and his courage to learn from the past and is not afraid to embrace methods to address the critical problem addressing the nation want to commend the ranking members and i simply want to say we have buried too many people know what crack did we don't know what is next.

my city tried to do somethingabout the push users because of the train on the public health system we need to realize we can deal with this in a way that is more than how we looked before i ask my colleagues to support this amendment. >> 80 very much. i am speaking on behalf of the task force bipartisan congressional task force to combat the heroin epidemic and want to join your comments as they come from rural state, it is a new phenomenon for us but i urge bipartisan support we have 85 members in the task force because we recognize this is a public health emergency

justin one county they could implement treatment during incarceration with a yearlong program from the 80th percentile down at the 20th. something that we can all embrace to save tax dollars and people's lives i heard jazz strong bipartisan vote. >> i yield back some of them want to thank the gentleman from texas for offering this and i want to thank her especially for working with me and others on the committee to modify the language to make it bipartisan and i commend her for doing that program would be happy to yield. >> also thank you for sharing the image of

yesterday in working with a gentleman from virginia and to modify and i support it as well. >> all those in favor? those opposed? the amendment is agreed to now as modified goes to the senate the chair will recognize the gentleman from iowa. >> those in favor say aye? those opposed say no amendment is included the next amendment is offered to

have an amendment at the desk first amendment to the conference report cynical be considered as read in the gentleman is recognized for five minutes. >> in my opening statement the problems we have had with heroin and marijuana a young man i dated his mother we had a conversation a barrel of marijuana and he smoked it. he shouldn't but he did. he was young he said nobody my age believes it is bad because we have smoked and a dozen have the same effect as people say it does. he died from a heroin

overdose from a very prominent family from the fortune 500 world. i talked to a family in new york is now a prominent actor and musician and lasted about marijuana he said my friends all smoking it so they elsie up problem with other drugs. we have mismanaged the messaging of this for years. kids do drugs because they don't believe the government for when we tell them not to do heroin or crack or marijuana. it doesn't belong in that class this amendment would tell nih to see if it is an appropriate alternative to opioid. it maybe we have a further

amendment that we ask it is rescheduled at number two all the groups in favor i believe the best and do today is with the permission in of the committee i moved to withdraw the amendment and in the future better address the issue to the effects of heroin. >> he withdraws his amendment and the next amendment is offered by mr. wyden the clerk will report the title. >> it will be considered as

read the gentleman is is recognized. >> this is an amendment to make sure that when you have a task force the interagency task force he don't have the fox to guard the hen house there are members that are serving as part of the task force in what is important if there are clear rules to make sure there is not biased in the work there will be represented as their professional associations that often receive substantial amount of funding i have raised this

issue before with the secretary of the national academy of medicine and it seems if you have nonfederal participants you should have clear guidelines to make sure any financial interest the conference language has no safeguards to ensure that either occurs this does not micromanage but does require there should be rules that special interest don't hijack the work of the task force indeed hopi way area a whole my colleagues will support the amendment as a conflict of interest in

their urge them to support this in a bipartisan way i hope colleagues will support it and i yield back. >>. >> i am happy to yield back to my colleague. >> with my a reputation for transparency and transparency and i recommend they do as well. >> diamond favor of transparency but it provides that that the task force provide the public with at least 90 days with any recommendations made by the task force so if we have an

urgent situation to recommend for doctors and hospitals dealing with the abusive paid medication medication, unafraid having the secretary develop guidelines and procedures procedures, and that takes a long time to discourage from voluntary and their ideas for violate transparency and openness as a like the idea of those who know more about the subject tallis what the of best practices are i will vote no.

>>. >>. >>. >> the concern that i have is respect to the task force there are no standards in the bill we have had this problem before added time when there was concern for the task force's i produce much less dash thank you for your support. >> we need a roll call on this. >> the clerk will call role. >>.

>>. >> go. [roll call] >> gone that a vote there were four aye. >> it is agreed to that sense that to the house side does it have the language of the bill? that this was never raised

or during the floor consideration given the vague terminology of the unintended consequences to be considered to be qualified participants less willing to participate of the foremost experts it can also cast unwarranted doubt on the validity of the recommendations raised by participants including veteran so respectfully urge my colleagues on the house side to vote no on the amendment. >> and i would read disagree to support the why did

amendment it seems clear to me of greater transparency to address the conflict of interest in several urge my colleagues to vote in favor of the amendment and i would ask the chairman that we have a roll call. >> we would note to the clerk of the house side it is appropriate to vote on this amendment fast if passed by the senate and the clerk will call the roll. >>. >> devotes no by proxy. [roll call]

[roll call] [roll call]

teeeighteen. [roll call] members wishing to change your vote? spec mr. chairman hydrocodone aye and 15 no the amendment is not agreed to the chair will recognize

the gentleman from tennessee to offer amendments 109 and the title of the amendment? >> i think this may be beyond our call it a help in the future we will have a steady on marijuana i ask unanimous consent at this time the chair would recognize in this very for the amendment the amendments offered by ms. murray the staff will distribute the

amendment and we recognize for five minutes. >> this is a very simple amendment of the reductions due to the limitations at the virginia should not disproportionately affect lower wage employees and they should prioritize bonuses to those positions where they struggle it needed support reforms in many areas but the public can agreed that the rank-and-file employee should not be targeted first over top executives both the majority worked on this language in the help we can support this. >> i support this amendment i urge my colleagues to support that as well.

those in favor? the amendment is adopted on the senate side. >> and now comes to the house side of orders my colleagues to support in the field back by the adoptive now and amendment is agreed to and made part of the conference the chair will recognize mr. wyden fifth thoughts.

>>. >> i am not offering that amendment if you ask me to offer the medicaid windfall amendment. >>. >> amendment to the conference report. >> at will be considered as read what he is recognized for five minutes. >> there is a little confusion there is the amendment i have authored on the medicaid windfall not steadfast right. >> colleagues from the medicaid program drug

companies pay a rebate to state and federal governments to offer drugs to the 70 million americans on medicaid currently those paying less of full rebate there is the provision in this bill however to allow the companies to get special treatment with the reduced rebate if they sell opioids that are of use deterrence. this is a windfall to the company because they're already making their drugs in that manner and have been doing so for many years. this is a windfall to those match manufacturers who are over prescribing have to

generated to the problem for low income pregnant women on medicaid who need addiction treatment they should have every opportunity to get back contract and that is what this amendment would do. i yield back i will be taking my time. >>. >> unless senator grassley wants to go. >> i will take my time because i will put for this amendment sunday needs to be done in this clarifies it.

i urge my colleagues to vote aye six senator hatch's asking me to speak of this amendment that proposes to strike bipartisan language by the house of representatives to encourage the manufacturing of a drug for relations center were difficult it resistant to crushing the policy supported by the fda by the budget request as those such as opioids it seems to be this seems to be a good practice it is a very large

issue we're having a large discussion in the senate about whether or to what extent to allow medicaid to pay for patients who go into institutions at one dash institutions for mental health. it is something we need to discuss on the senate for because it gets into an area that hasn't been fully that it i will join senator hatch to vote no. >> colleagues, this is a

pretty obvious choice low in the comm pregnant women or you go with that company who gets a windfall it is one thing, colleagues as is often the case to raise the important issue talking about something that had not been done i can see why there might be an argument that the reality is that companies that are making the drugs in the manner that i have described for years and years there is no need to give them this windfall i am very appreciative once again to support the effort that promotes the public interest i hope they will support that.

>>. >> a roll-call is requested. >>. >> [roll call] >>. >> get now comes to the house conferee for the majority we are recognized.

>> i oppose this amendment because it has a bright bipartisan policy this strikes an important policy to represent the key step forward to combat pope you waited use it is an unintended consequence that effectively discourages drug manufacturers from producing opioids that our harder to review specifically from the definition for purposes of populating medicaid rebates and has strong support from the administration. supporting this amendment is a key policy of abuse and i oppose the amendment.

>> i would urge support for the al why did amendment every effort should be made to encourage and facilitate post part of women to ruth seek substance-abuse treatment for themselves and their babies to support continuity of care. >> i don't have that amendment. >> so those speakers on the minority side.

>> go over the legislative efforts i cannot get the sizing enough the importance of this initiative to deal with women with their their most full verbal and working to recover and restore hope for that unborn baby. >> the gentleman yields back so we will instruct the clerk the members are included in the vote and the clerk will call the roll. [roll call]

[roll call]

[roll call] >> hydrocodone and aye and 15 no. >> is not agreed to. mr. scott has an amendment at the desk?

civic the amendment to the conference report offered by mr. scott considered as read >> this adds educational and recovery programs for the title six block grant program this would allow pilot programs to figure out what works this is the opioid bill the person is already imprisoned we will not solve problems of people in jail. this provision and was part of the senate bill with

virtually unanimous support to be introduced in the house with over 100 co-sponsors. >> so i hope he would adopt the amendment. >> up purpose is to provide funding of the implementation including by expanding education and and prevention efforts it expanding access to a treatment would ensure the states include the focus recovering from the lbo wave use disorder in such of focus will help to recover from their disorder as well as leading healthy and

productive lives from incarceration in the yield back. >> i want to join in this amendment it is such a catch-22 to lock people up not getting the many treatment than we act shocked when they come out and is back in the vicious cycle i have visited treatment facilities in house that is effective to make a difference and for my colleagues on both sides is

a very cost-effective choice because we can drop those recidivism rates of the 80th percentile to put people back to work to overcome this disease that we know as the substance used disorder. >> let me take five minutes against the amendment that are administrated by the secretary of hhs to go towards incarcerated individuals the justice department is responsible for providing treatment for offenders in juvenile facilities. i support the goal as a result of a clear delineation when someone is incarcerated the amendment makes it less clear at the

state level who would provide treatment so i urge my colleagues to oppose the amendment. i yield back my time. >> it doesn't direct the states to do anythingbut just make said allowable use so it is more like pilot projects so i appreciate the support of the purpose of the amendment and i hope it will be adopted stick in the future our bike to work with the gentleman maybe we can get language that we accept underside those in favor? >> the amendment is not

agree to. >>. >> alibi to added to the record a statement from the american public health association. >> without objection is my a understanding the risk of further amendments so we have now concluded debates the care act of 2016 fakes to the members of the staff for their hard work and this

very important issue we will announce a unitary time to review the final conference report without objection and staffing is authorized to make changes to the legislation and without objection in the committee stands adjourned. [inaudible conversations]