[inaudible conversations]

>> good morning everyone. thank you for coming to our roundtable to discuss the opioid epidemic first i would like to thanks to elisha cummings and inviting senator warren. thinking to the mayor and to senator cardin and congressman saar baines and also to your team at healthcare for the homeless. yesterday the state of

maryland released data for overdose deaths and in 2017 there were 2282 total overdose deaths in our state and of those 761 occurred in baltimore city. 573 of these death in 2017 and fall fentanyl for comparison in 201312 death involved fentanyl which is a 5000% increase in four years. they are terrifying and frustrating because they keep increasing and we don't even know if this is the peak of the epidemic these numbers are frustrating because those of us on the front lines we know what works to stop this epidemic. here in baltimore everyday residents have used the opioid

antidote narcan to save lives in 2017 that doesn't even include but are first responders are firefighters or ems. we have to ration narcan every week i have to decide who gets narcan and who doesn't does that make sense we ration a life-saving antidote in the middle of a public health emergency? under the mayor's leadership we are treating addiction as the disease as it is to establish a stabilization center working to ensure they're all standardized levels of care for addiction treatment and many partners do exceptional work on a shoestring budget imagine how many more lives we could save if only we have the resources to do so. this is why we in baltimore stand with the affordable care act looking at the severity of

the epidemic and for those sections that are the hardest hit i am so glad to have the honor to introduce my congressman and an inspiration to so many congressman elisha cummings. >> thank you very much dr. wen , before i discussed the care act many people i must think and also dr. wen for moderating today's event but more importantly for being a tireless leader with regard to healthcare in our city and nation. also for your invaluable assistance to draft the care act to spread the word about the urgent need for this approach. thank you senator warden for joining us today and working with me on the care act. i am so proud of all that we

have been able to do together over the years and i thank you for your effective instrument is leadership. also my distinguished kiley -- colleagues senator cardin and congressman saar being for joining us and they have been tireless fighters in this effort and finally the mayor for her tireless commitment to advancing our city to make us a model for the country and also police commissioner and the panel for your sincere expertise and your experiences and finally i think healthcare for the homeless for the vital services you provide in helping us today you have done a phenomenal job also thank you so much for everything you have done to make today's event possible we are honored to be here. senator warren and i introduce

the care act in april to take the proven ryan white act model of our nation that was used successfully and employed to fight hiv aids and apply that to the drug crisis. it would provide funding as well as flexibility to enable hard-hit communities to respond to these challenges. we are facing an urgent public health crisis let me be clear it is urgent we can no longer nibble around the edges. drugs are killing 175 people in this nation including several people in the city every single day. every day. and by the estimate of the

trump administration is causing harm and costing us as much as $500 billion per year. however only 10% of the the people with the disease of addiction get the treatment and i emphasize the disease. the disease. and until we get people the treatment and the support they need the people that could have been saved will continue to die. i am so very pleased that the care act has more than 75 supporters in the house and i am pleased to say and the cosponsors of this legislation in the house.

while not today but one day and one day soon we will finally as a nation invest the resources that will enable us now i will introduce senator elizabeth wor worn -- warren i am blessed to work with senator warren on everything from protecting consumers to alleviate poverty to fight foreclosures and so many other things. so let me say for insights more than ever as we fight to

change many things that are wrong in our nation, i mean this with awesome 30 in my heart i am truly honored to welcome senator moran mom -- warren to my hometown and i turned the program over to her for her opening statement. >> thank you elisha. i very much appreciate the invitation to be here today and healthcare for the homeless. when elijah said let's do something to bring more attention to this bill and to help to get people to vote there are ways we can fight back against the terrible epidemic that is rolling across our country and i said count me in. congressman cummings has been

an inspiration to people all across maryland and across this country and i count myself as one of those who has been inspired by his work he is a hero and also a great partner in the hard work to fight for people who are caught in the throes of addiction. i am grateful to elisha for helping to put this bill to gather and to fight for it every chance we get. also a very professional thank you to my partners from the senate then cardin was always in the middle of a good fight for what is right. and fighting back for people who need a voice in the senate and i am grateful to find out i'm also also pleased to be here with congressman saar being who i knew before these fights started in the congress

and is terrific to have you here you also have been a strong voice how the federal government can be a good partner to show where help is needed most and thank you very much much for having us here. you do a great job and presiding over a great city congressman cummings said 175 people will die today from an overdose and consequences of addiction. just think about that for a minute with a plane crash today and another one tomorrow and the next day in the next day in the next day and the next day. that is our future unless we make change. this opioid epidemic is a public health emergency.

but it is not a public health emergency that is without hope. we have been here before. the hiv-aids crisis we got a taste of what that was like problem started and got bigger and bigger and united states federal government nibbled around the edge with a little help until it started to take off and ravaging communities all around this country. then, then the federal government stepped up. the federal government when a little boy ryan white said i have a the federal government said it is time to put real resources into fighting this problem congressman cummings and i were having lunch and we were talking about the opioid

crisis and the hiv-aids crisis and how once the federal government stepped in to say we will put real resources behind attacking this problem that is exactly what happened. the number of aids cases started to go down we turned it around. the problem has not disappeared it is still there but there are people alive today because of the resources we put in at the federal level to fight back against this epidemic. we talked about doing the same thing with the opioid crisis and said we want to make the same kind of national commitment to put resources into turn this problem around. we talk to scientists and doctors and public health officials and to the people on the ground what would it take to turn this crisis around?

they show up with a proposal for $100 billion over the next ten years at $10 billion per year to go directly into the communities fighting this problem. directly to the frontline. and people will know it will be here not just for one year but eight years and a long enough period of time to build a real and meaningful response. that is what we want to do to turn this crisis around. we propose this bill because we see a public health emergency but we propose that because we have optimism we know what we can do if we put in the resources it is also a bill to hold big pharma and drug companies and the ceos accountable for their part in this crisis. we are facing an urgent public health crisis we can no longer afford to nibble around the edges we can put real money in

real resources behind bringing an end to the american tragedy unfolding before our eyes it is an honor to be here with all of you thank you very much and i look forward to hearing from yo you. >> thank you so much. with the work that we do without the visionary leadership of a leader since the time as a member of the city council and a state senator and now as the mayor of baltimore our mayor has always fought for the health of our cities so i am so proud to introduce my boss. >> first let me say thank you dr. wen you are on the front lines for the citizens of baltimore and also to the congressman cummings and all of you sitting here. we are so appreciative for his

effort and also joining with senator warren to introduce this specific piece of legislation i cannot go without saying to our colleague senator cardin was always here with us and congressman sorbet i am grateful you are introducing this bill in continuing that is really important with this legislation is that flexibility that comes with it. and to tell you that it's not just the problem going to drug addiction today but the problem that leads to addiction in the first place. part of that is where people are living and the predicaments they find themselves through drug addiction when it takes hold

and they need assistance. so the flexibility of this legislation allows us to address those issues. we want to make sure that those who need assistance whether housing or help or whatever the issues are we can address them with this particular legislation getting to the root of the issue it isn't just about the cause or prevention but attacking the issue itself. what will we be doing every single day to keep the plane from crashing in this country every single day i'm grateful we are having this but i'm more hopeful for the future if you look at this legislation for all of those that are sitting around this table it really does give us an opportunity to address the root causes and really get to

the bottom of how we service people in need because i always say by the grace of god can any of us if we find yourselves in this predicament the reality is everyone of us in this room know somebody who was suffering today. if we continue to move forward i think help us get this legislation passed help us by advocating and being in washington and writing letters and to make sure that this kind of legislation is not only heard but passed because we are in desperate need. i am grateful to all of those who are sitting here putting our congressmen and senators that have been introduced i know dr. wen also because that

is the kind of commissioner she is for the citizens of baltimore and we look forward to the assistance we can provide in the future. >> thank you very much and would like to introduce the senator from maryland and our national leader on healthcare and so much so he was just here on monday at a press conference to defend title x. >> first of all you are our superstar. mayor i we meet with your health commissioner all the time and we like to share her expertise thank you very much for your dedication to healthcare. elisha cummings and senator ward we are inspired every day by you on the hill this is one of the great champions we have for the people in our state and whenever we have a tough

moment we turn to elisha and he gets us back up and ready to go we are so proud of his leadership on so many issues that are important to vulnerable people and he will be there voice and hear on the opioid crisis he is showing his leadership. thank you for coming to our state we had the opportunity to be inspired by the caucus to really say we will not lower our expectations. we can accomplish big things we have leadership in america and globally and make a huge difference and senator moran -- warren is that we need to

accomplish the goals through the opioid crisis it is great to be here with her great mayor. thank you for being willing to step up on behalf of the people of baltimore also mr. saar baines who represents me in the house his district is a challenging district not only the people for the city but also montgomery county and he does incredibly well he is on the key committee that deals with the health issues and has incredible leadership over our state and nation it is great to be here with you and we are so proud of healthcare for the homeless you started and you said you could fill a void in our community and don't think any of us envisioned we would be where we are today.

yes the tools are better but you have been able to use them and leverage them to provide incredible service so healthcare truly is a right and not a privilege it is probably you have accomplished dr. wen gave you the numbers but increase seven years in a row of death to overdose. guess what? 2018 the early numbers show will be a record year again. we still haven't figured out how to end this but yet when you come to baltimore city there are challenges just like any urban center we have to figure this out that's why we need the commitment that we hear from our colleagues today

but to invest to find out how people are vulnerable to different types of addictions there is some great work being done right here in baltimore to figure out on issues of addiction. so there is incredible things find different ways for those dealing with pain vulnerable to addiction and with the passage of this legislation we have to stop fentanyl from coming into this country to make an all-out effort because the increase of the death we have to keep that out of our supply and then to figure out different ways to treat people. to take the problem out of the emergency room because people view the emergency room to go back to the stabilization

problem but it cost many we have to invest in i am here support is really working but it cost money. so we have the resources to deal with that and with the medicaid program to increase the medicaid not decrease and telemedicine and integrated healthcare that cost money to save money. so i am excited about this that we have to make the investment and it's not easy and things to my colleagues for providing the leadership to get this done. >> next i have the honor of introducing john saar baines as we heard is on the right side of history introducing

multiple pieces of legislation to help fight the opioid aid endemic here and around the country. >> thank you for your leadership and your outstanding leadership in baltimore city and think for help the homeless that is an outstanding resource setting new standards every day in terms of what we need to do to respond to so many needs in our city and state and region and the people that we will hear from momentarily you are the ones on the front line and your perspective and insight is the most valuable in terms of how you make sure the policy like the care act and other initiatives actually meet the needs of people. this is a topic that gets a lot of talking points associated with it but are we

actually going to do something meaningful? i just want to say in politics to get through each day need personal heroes and congressman cummings we have all said is a hero for us in terms of the fight he carries every single day and senator warren for these important issues. on the energy and commerce committee we have had two markups and we looked at different piece of legislation dealing with the opioid crisis was legislation other was windowdressing for people to have talking points going back

to the district but what was missing was a policy superstructure to pull that all together to understand to put resources behind this art will not make a difference. that is what the care path on -- act is all about we understood that is what we need with that superstructure i will think senator warren thank you for introducing this piece of legislation the only way you can address the crisis of this proportion and the only way frankly to address what continues to be the stigma associated with this crisis across the country may need to get past that thank you for being here and thank

you for your leadership as well. >> i like to begin thinking for hosting us and for your late leadership here and from your perspective what is the biggest impediment to providing treatment to those that have his addiction long -- disease addiction? >> it is important to have this conversation. the homeless represent the failure of every public system imaginable. but yet senator war and you use the word hope and there is such hope in a place like this when people get access to those services and reintegrate with the broader communities. there is a statistic that senator card into slowdown on the percentage of those that

now have insurance and access to the treatment that they need in 2013 it was 30%. today and in 2014, 90%. the affordable care act in general and the care act in particular brought about meaningful change in organizations that served them first and foremost experience in access to the services that people need. and people need access not just for addiction treatment but to whole person care with all the services that they need not a single clinical service we can provide at healthcare for the homeless if

rooted in permanent housing. someone living across the street under the expressway no matter what kind of treatment we bring to them, they will not get better if they are living in a shelter or under the bridge. . . . .

with that stigma that interferes with that ability of the 90% of people who don't have access but also have challenges for what is available. the passage of this

legislation i'm excited about because the foot behind why it is needed and that was critical that was passed recently and that together with that infrastructure and the implementation needed to get our arms around this problem to save a lot of lives. and an essential hospital in southwest baltimore that has been greatly impacted by the opioid epidemic and we would do more if we had more people show up an emergency department using that as a

route of access if we had more resources then we could drive people to the resources they need to go to and to help people get the long term support that they need we need help on the frontline with primary care providers to be educated not only how to manage pain but also have a solution with use of this medication we do have some help with policy that was targeted helping nontraditional providers help people get the help that they need because they don't have enough providers we need more drug counselors so when we do

have access to these resources so that the needs are great and i do believe this legislation will make a true impact hundreds if not millions of lives and for your leadership and your courage. >> thank you. today we have a very special guest in addition to our others you are here to share your stories of recovery. tell us about the challenges that you face to access treatment programs. >> the first challenge was dealing with the stigma of the medicare specific programs you are not considered in recovery but as an addict and there is

a of scrutiny to deal with. after a while and in fact that stopped me from seeking treatment and that was medication -assisted programs after a while i realized i only had one hope was to go into treatment to see if it worked. and that is what i did. another problem that i had was access once i decided i wanted the treatment i walked a mile or two and they said they had no slots. you don't tell somebody with a substance to be -- abuse you need to do what you need to do. i have seen a lot of my friends are not here today pass away because they got

treatment to late or no access to treatment so i think treatment should be available for everybody if you cannot bring them to the treatment centers get the message out to them. i am really fighting for this bill it is nice to see everybody fighting for this cause right here never thought i would see it. it gives a homeless person some help. so pick up the good fight to save lives and help people in the community and people like m me. >> wraparound services. >> there are so many areas where people need help.

mental health issues substance abuse, users have no help it is very important we have to nip it in the bud. it is like a major problem. we are at war we need weapons and the soldiers and the army. we really want to do something to make a difference. >> good morning everybody. i would say baltimore city suffers from the disease of

addiction my biggest challenges not having insurance if you can't get the treatments that you really need it wasn't until i came to healthcare for the homeless that was a blessing for me because i got what i needed. i needed everything from mental health and health treatment. and today i have a lot of hope and i don't have to use anymore.

i feel like i need to hold somebody else up that is struggling and i try to help those into coming out of the cold. everything he talked about those services helped me and not just the addiction part. i am very grateful to healthcare for the homeless. [applause] >> name is john, baltimore county resident i'm struggling with the disease for a long time and still struggling. the biggest thing is the healthcare getting to the appointment i can't walk far

so i'm a hard time getting around so thank god for healthcare for the homeless they have helped me a lot it has been a blessing for me and it is still a blessing every day. we need a lot of help out there. >> you mentioned the word transportation. so i guess if you can't move. places even if you have it you cannot get it. >> so trying to have as much flexibility as we can. people don't think about that because a lot of people have cars but they don't think about the fact treatment is over here but you are over there. >> or you may not be able sometimes.

>> and then we talk about all the time how we haven't caught up with technology because if we had the technology in place and also why research is important if we had that technology in place we could address those other issues in your hand trouble getting to it because they could get to you. >> also long time residential would be nice. in the city it is a beautiful

spot and recommend thousands of people i wish i graduated from it but i didn't but that's a different story. >> taking about 500 people in its care and 100 of those are from surrounding jurisdictions which why we think this legislation is important with that same kind of care. >> thank you for coming to share your stories we have limited time but i want to make sure everybody has a chance to speak. is there something the federal government can do? what would it be to make the

biggest impact? >> first of all thank you for your leadership. and that call to action strategy to create this network of collection around the city so when treatment becomes available it is accessible to the community and is there. mr. moses said i'm here to professional capacity to benefit being a long-term residential treatment and without that long-term residential treatment with outpatient treatment it doesn't necessarily work for those who are addicted but on

the backend as they go back into that community has to be the ability and the one thing that is not apparent in the community is the capacity for the workforce providers with their respective expertise and workforce development and there is a way we can reference those individual capacities. >> let me just say this legislation in general if it increasingly comes with that enhanced treatment capacity it is a must we cannot do our job

without it and as we have had to make a cultural shift as to how we deal with the situation of assisted diversion or the hot teams this could provide that level of capacity to integrate into law enforcement in a more critical way than my enforcemen enforcement. >> ever like to turn to doctor nolan. >> thank you all for your leadership. we are always looking for innovative ways to think differently or the issues we are addressing likely opioid crisis or what the federal government could do from both

the state level and the federal level with these commissions update talk about with treatment there isn't a lot of conversation about addiction so it is a prevention tool but there are many other ways we can embed the way we think about treatment the way housing works or being kicked out of housing if you think of any other treatment would you kick somebody out and diabetes because they had cake? so think access to treatment to lower the threshold also mentioning how difficult it was we can meet treatment mobile we can get treatment to where the people are and in doing that we can make connections to those other

types of services that they need so we really need to rethink the threshold for treatment and to recognize that for many people if they can make it at tuesday at 9:00 o'clock in the morning they probably wouldn't meet treatment. so those are my suggestions. >> good afternoon everybody. to answer your question i think that kind of legislation is a relief from the grip -- the government created in the first place. and talk about oppression in those criminal conditions that policy created had that

quality of life and that privilege if we thought about transportation and that bill and legislation with the people with a certain kind of privilege and where they need to go in with those opportunities you don't get to go from housing to jobs. we don't get that privilege. so just from the soul perspective to not keep making legislation to blame the victim. and to take responsibility for

that oppression for those that are self-medicating and then you put them in oppressive situations so like so many things and to create in the first place if the government has the moral fortitude to say we will do something that doesn't criminalize the victims but dig deep into the root causes with those resources that are needed. we could be at the roundtable the entire day. we are all doing such exceptional work.

>> so and then to see as it push forward and it is significant. it is a public health emergency. hiv was a public health emergency and certainly opioid addiction is also. it has been that way for quite some time.

and then between hiv in this edition with different periods of time we look at opioid addiction looking at hiv as a moral failing. and with the ryan white act and how we address addiction from that lens. then to talk about that flexibility. and that also that helps to determine. that has tremendous value.

we talked about these issues with those many social components. to make it so much different. this is the kind of promise with 80 and for a very long time. instead tuesday can recognize he can't recognize addiction without talking about mental health addressing issues around homelessness. and that is so much better we on the front lines have been

saying we know what works we need the resources to get there. what i feel for those officials coming here today i want to end with senator warren and congressman cummings. >> this is not a moral failing it is an addiction we need to treat it that way. and when someone comes in to say you broke your leg we can have a spot to set your leg in the next two weeks can you come back then? [laughter] that doesn't happen because it

is a serious medical problem and that means we have a serious commitment to put the resources to make sure people get the help they need. somewhere in america and if cancer comes back you had your treatment you are done. with humanity and we make the commitment we don't always get it right but in that direction with healthcare for the homeless. and to say and also with

congressman cummings with the people on the front line in this battle. to try to give you the resources that you need to do the work that you want to do every single day. this is not our expertise. we cannot do the work but we are here to put the wind in the sales.

for those who need it. thank you. [applause] >> i want to thank all of you for being here. . . . . >> you just made me realize that we are on track. i tell the story that when i was

in the hospital for over six months of the last year so one of the things that struck me was one lady said, i can get the treatment that she was talking about her ailments in the hospital, but i cannot get a cure. so in other words, you can do a little bit here but if you can't with wraparound in the transportation and housing, and things like that the other thing that means so much is the word dignity. dignity. when people talk about the stigma, that is dignity. when we look at training doctors to make sure doctors look at

this from the perspective of the disease and to actually address this as a disease and not -- like you want to be bothered with someone who is a drug problem. that doesn't help either. our aim is to educate ourselves. we need to be educated. you give them frontline testimony and you provide us with the ammunition we need when we go to washington to push th this. so, i am honored. thank you. health care for the homeless everything you have done and all of our panelists, again, mayor i want to thank you and my colleagues. i want to thank senator war. i cannot say it enough, people

say senator worn has great politics. said no, you have to understand it's not about politics for her. she believes this. she believes it. there's a big difference between believing and playing politics. and again, i want to thank all of you for being here participating. [applause] >> on newsmakers this weekend, the house democratic senator ben cardin of maryland as a member of the senate foreign relations he talks about this was secretary mike pompeo. president trump's recent meeting in helsinki with russian president, vladimir putin. watch sunday at 10:00 a.m. and 6:00 p.m. eastern on c-span.

>> this might bring them great but there's also certain points beyond which that is like they're 14 now. all of those factors swirled together to create the perfect dumpster fire of mass censorship by people. >> science-fiction author will be our guest. that's five sunday august 5 at noon eastern. his other books include the magic kingdom, little brother plus other novels. interact with corey by phone, twitter or facebook.

our special series special edition with corey, sunday august 5. live from new to 3:00 p.m. eastern on the tv on c-span2. >> next, look at how the opiate epidemic is being addressed in baltimore, maryland. the city's commissioner of health and other public safety officials. elisha cummings is also part of the conversations. from today's "washington journal", this is three hours. >> host: if you take a look across the country and in the papers that represents cities and states, opiates are problem there too. this is the seattle times. recent statistics show a people a day in one county after fighting the tightening of rules there. sarah says that opiate overdoses have nearly doubled compared to last year. possibly because stricter rules for prescribing the drug. a weeklong survey