you shouldn't have had that years later. of course, those funds have already been spent. it's a very important issue for florida and so many of our cities and counties that are put in this economic fiscal bind. for the residents of puerto rico and the u.s. virgin islands, there's also an extension of disaster unemployment assistance and believe you me, after those island territories, our fellow u.s. citizens have been hit by the hurricanes that roared through last year, that part of the world, there is still a lot of unemployment. and they need that unemployment assistance as a result of the natural disaster that occurred in the -- occurred.

in the case of puerto rico, not just one but two hurricanes, irma and maria hit and devastated that island. this is certainly going to help for those who lost their jobs or they were unable to work due to hurricane maria get back on their feet. mr. president, as the ranking member of the commerce committee, i've always sought to address the national challenges by reaching across the aisle to find bipartisan consensus, and this bill just does that. and as i said in my comments, senator thune has been a great partner to work with, and i appreciate the opportunity of working with him, with senators blunt and cantwell, as well as representative shuster, defazio,

mccall, and thompson on this important legislation. five years, an f.a.a. bill. madam president, i yield the floor. the presiding officer: under the previous order, the leadership time is reserved. under the previous order, all postcloture time has expired, and the question occurs on the motion to concur. is there a sufficient second? there appears to be. the clerk will call the roll. vote:

vote:

vote:

the presiding officer: are there any senators in the chamber wishing to vote or change their vote? if not, the yeas are 93, the nays are 6.

the motion to concur is agreed to. the motion to concur, having been agreed to, the motion to concur with amendment is rendered mute. -- is rendered moot. under the previous order, the chair lays before the senate the house message with respect to h.r. 6. the clerk: resolve that the house agree to the amendment of the senate to the bill h.r. 6 entitled an act to provide for opioid use disorder prevention, recovery, and treatment, and for other purposes, with an amendment. mr. thune: as if in legislative session, i move to concur in the house amendment to the senate amendment to h.r. 6 under the previous orders. the presiding officer: the motion is pending. mr. thune: madam president? the presiding officer: the senator from south dakota. mr. thune: i have ten requests for committees to meet during today's session of the senate. they have the approval of the majority and minority leaders.

the presiding officer: duly noted. mr. thune: madam president, it is oftentimes easy to believe the news reporting on how the senate is broken, bipartisanship is dead. but then you work with your colleagues, both democrats and republicans, from the house and the senate on something like the f.a.a. reauthorization act, which we just passed, and you are reminded that we can still come together and get things done for the american people. the bill that we just overwhelmingly passed and sent to the president's desk is the longest f.a.a. reauthorization since the 1980's, and it'll improve our aviation system for travelers, manufacturers, and innovators alike. the bill also reauthorizes the transportation security administration, ensuring improved screening technologies and more explosive detection k-9's. additional focus on security and surface transportation in public areas, and new pathways to mitigate airport security delays for an overall better travel experience.

it also reauthorizes the national transportation safety board, providing key reforms to the modernize and improve transparency in this important safety agency's investigations, recommendations, and board member discussions. and these important provisions are just the three quarters of the bill in the jurisdiction of the senate commerce committee of which i have the privilege to serve as chairman. as chairman, i would like to personal lay thank the members of our committee for all their hard work this congress and especially to senator nelson, the committee's ranking member, senators blunt and cantwell, the chairman and rank member of our aviation committee, and senators fischer and peters -- the presiding officer: the senate will be in order. mr. thune: -- the chairman and ranking member of our surface transportation subcommittee. i would also like to acknowledge on the house side chairman shuster and ranking member did i as ifio, chairman mccall and

ranking member thompson of the house homeland security subcommittee committee, and ranking member johnson of the house science committee. they have been great partners and i appreciate their efforts in helping to get this bill across the finish line. final i will i would like to thank, madam president, all the staff from both chambers who worked tirelessly, including many late nights and weekends on this bill. without their efforts, the final product would not have been such a success. while everyone on the team worked hard on this bill on my staff, i would like to especially thank nick rossi you adrian arnaki system,cy mean perez, jackie kieshen, jason smith, andrew neeley, chance costello, allison graph, frederick hill, and brie anno manzeli. on senator nelson's starving thanks to kim lipski, tom

chapman, chris day, lawrence wildgoose, and denny bloom. and, madam president, i also would like to place in the record instead of probably going through the whole list, the names of the staffers of our partner committees in the house who played key roles in the legislation. of course, chairman shuster's staff, who chairs the t.n.i. committee in the house, which was very instrumental inest going this bill across the floor in the house and ultimately over to us here in the senate. and then also the ranking member, as i mentioned, peter did i fazio's staff. i would ask unanimous consent to be able to include their names in the record. the presiding officer: without objection. mr. thune: thank you. also chairman mccall's staff and then rank member thompson's staff as well. from chairman smith's staff, who chairs the house science committee, and there was a good amount of science policy included in this legislation, and also as i said ranking member johnsons staff. those individuals were very

grateful and i will include their names in the record. but i'm sure there will be people, madam president, who i have left off this list, and i apologize for that. but it just underscores the amount of collective effort that underpins our work here. and i could also easily expand that list to include those at the department of transportation and the federal aviation administration, who provided valuable assistance and technical expertise. but we look forward now that this has passed and will be headed to the president's deck for his signature, to be working with them on its implementation. so again, madam president, i just want to say thank you to my colleagues who supported this bill, and all those who were involved in bringing us to a conclusion here. this is the culmination of many months of hard work, bipartisan negotiation, and frankly it wasn't easy, and that's a great credit to the staff members that i mentioned and to the individual members of our committee and the other

committees who were so involved in seeing this get across the finish line. so i'd say thanks to the members here on the floor and to the members of our committee. and, madam president with that i would yield the floor. a senator: madam president? the presiding officer: the senator from tennessee. mr. alexander: thank you, madam president. madam president, i'd like to extend my congratulations to the senator from south dakota. this is a significant achievement on which he and senator nelson and others have worked very hard. i want to especially thank him for including in the bill something that senator feinstein from california and i have worked on for several years. that is a provision to ban the use of cell phones on airplanes. there's nothing worse than sitting next to someone on a four-hour flight who would make it his or her business of revealing all their intermitt details of their life to someone son a cell phone. and this would take care of that. sometimes -- and i would say to the senator from south dakota, sometimes i suggest to my friends in tennessee that they

look at washington, d.c., as a split-screen television. on the one side are tweets and supreme court contention and cable television and arguments, and on the other side we're getting quite a bit done, like the f.a.a. bill, like the songwriter bill, like the appropriations bills that have kept us first in the world in supercomputing and thanks to the leadership of senator blunt of missouri and senator murray of washington have for the fourth consecutive year included record funding for biomedical research. that doesn't capture as much attention as the other side of the tv screen, but it demonstrates that we're capable in this body both of vigorous contention on arguments and we're also capable of doing the basic work of the senate, which is to take big issues, see if we can come to some agreement about it, and come to a lasting

conclusion, which the senator was able to do. and i congratulate him for it. i want to speak for a few minutes about another example of that. for we are in the midst of a contentious disagreement about the supreme court. at the same time we have an urgent, bipartisan consensus of virtually unanimous agreement to deal with the most urgent public health epidemic facing our country today and virtually every community. and that is the opioids crisis. each one of us has stories about how the opioids epidemic is ravaging our hometowns and our home states. for example, at one of the several hearings we had in the health committee, which i chair, a mother, becky savage talked about her two sons, who she found in her basement after a graduation party one night, both

dead. she was happy that they were in their basement because instead of out driving around town doing what teenagers might be doing, they were at home. but someone brought alcohol, someone brought opioids pills from a medicine cabinet in some home, and someone mixed those two together, producing two overdoses for two children who were not drug addicts, who were not alcoholics, but who made a mistake. or visiting the nice hospital in johnson city, tennessee, where a third of the babies born in the neonatal center there are born withdrawing from opioids because their mothers are addicted. and it takes them days or weeks more to get over that. or listening to the two judges in upper east tennessee, two criminal court state judges, who said that of 6,000 completed cases that they heard last year,

two-thirds of them -- two-thirds of them -- had something to do with the opioids epidemic. or the drug agent from tennessee who was in my office, who deals with meta, all sorts of -- with meth, all sorts of drugs. he told knee what happened when they captured some fentanyl. fentanyl is the white powder which is 50 times stronger than opioids, which comes from china often in the mail. and which this bill that we're about to talk about deals with. but this drug agent, who was an experienceed law enforcement officer, told me that just by opening a small plastic bag with a few of the white powders getting into the air, he was almost overcome and had to leave the room because it would cause him to pass out. that's the epidemic that we're dealing with everywhere in america. before i describe the bill, let me talk about two things that have to do with the bill. were unis -- one is money and

one is moonshot. people often say when i describe our bill, which we call the opioid crisis bill -- but it is now known as the patients and the communities act -- people say, what are with the money? the mo enis not in this 0 bill. we do money in appropriations bills. the congress and president trump have both been attentive to the money. since just march, including the appropriations bill passed in march and the appropriations bills approved by the senate last week, we have directed in the congress $8.5 billion toward the opioid crisis. everything from hundreds of millions for nonaddictive pain medicines to'd 1 billion for grants to states for more treatment, $8.5 billion just this year. that's the money. then so far as the moonshot,

some people say to me, well, we need a moonshot for the opioids. i wish we could have one. we probably need the energy, we probably need the money, we probably need the resources and the determination that it took in the 1960's for president kennedy to say, let's go to the moon in a decade. but, unfort -- unfortunately we can't do that from washington, d.c. this problem won't solve itself from here. we can't assign this task to an agency and say fix it in ten years. that's why we call this bill the support for patients and communities act. the opioids epidemic is going to have to be solved in ames, iowa, and nashville, tennessee, and sacramento, california, and communities all across this country by governors who work with medical faculty to change the curriculum about how doctors learn about pain medicine to states who, like tennessee, have begun to limit the opioid prescriptions to three days at a time to try to avoid the 60-day,

60-pill bottle that someone might take home and use 15 pills and then have the rest taken by a teenager to a party with a terrible result at the end to the judges who deal with opioids in their criminal cases to the nurses and the treatment officials who try to help people with medication. all of this has to be solved community by community by community. we know that. we're not pretending that a single act here can fix the problem, but we do know, and that's why we have had an urgent bipartisan consensus on this. contributions from five senate committees, 72 different senators are reflected in this bill. that's why we have an urgent bipartisan consensus because we want to do everything we can do to provide tools to parents and patients and doctors and nurses and communities and governors,

anyone we can find to deal with this crisis. senator mcconnell has called this opioids legislation landmark legislation, and i believe he is right. in our state, as in most states, more people were killed by opioid overdoses than by car crashes. 1,776 in tennessee last year. that's why the house passed this bill by 393-8 last friday. that's why after today, when we vote on this bill at 3:15, it will go directly to the president, and i'm confident he will sign it quickly. with more than 70 different provisions, there is no way to talk about them all. they are each one important, but here are a few of the most important. senator portman's stop act. i talked about fentanyl, that white powder 50 times more -- more powerful than opioids coming by mail from china. well, fedex and u.p.s. can stop

it, but the u.s. postal service can't. this gives the government the authority to stop that powder from coming in from china. nonaddictive pain killers. the most common reason americans go to see a doctor is because they hurt, they have pain. there are 100 million americans with some pain. there are 25 million americans with chronic pain. they need help. and if opioids can't help, over a long term, why, they need a nonaddictive pain medicine, which is why we have put hundreds of millions of dollars and have passed fast-track legislation to find that. blister packs for opioids. states have begun to limit the doses of opioids that could be prescribed we -- prescribed. we give to the food and drug administration the authority to require manufacturers to sell opioids in blister packs of three, five, or seven. extend support for medicaid patients. again, senator portman worked hard on this one, as did others.

this expends from -- expands from 15 to 30 days the treatmenr treatment of people with substance abuse disorder, and it expands it to all those disorders. the treat act. senator paul, senator markey have pushed this. it permanently allows more medical professionals to treat people in recovery to prevent relapse and overdose. the bill prevents doctor shopping by improving state prescription drug monitoring programs. it provides more behavioral and mental health providers. support for comprehensive opioid recovery centers. try all three of the major techniques we know. it helps for babies born with opioid withdrawal and for mothers with opioid use disorder. more early intervention with vulnerable children who have experienced trauma. as i said, more than 70 different proposals from senators themselves, equally divided between democrats and republicans. that's why this bill, which is

the most complex one, i suspect, i have ever worked on -- i have worked on some complex ones, but it's as complex as any. it literally had to have the support of every single one of the senators to move through this body once to the house, and i suspect it will almost get it 100% again because of the urgency and participation in this. and i mentioned $8.5 billion. senator blunt says there has been a 1300% increase in congressional funding for opioids over the last four years. eight committees in the house, five committees in the senate, 72 senators, senator portman's stop act, senator paul and markey's treat act. senator rubio worked with us as we moved the senate bill forward and in the final version is his eliminating kickbacks and recovery act which we were able to include in this final consensus legislation. i want to thank senator

mcconnell, the majority leader, and senator schumer, the democratic leader. they have lots to think about. they have many demands on them in their time, but they have made it possible through this whole process to make room for this because they understood the importance of it, and i thank them for that. i thank the chairman and regular members of the other senate committees, senators hatch, cathedrals, thune, crapo, murray, wyden, feinstein, nelson, brown, and their staffs. it's not that easy for that many committees to put down their jurisdictional jealousies and work across committee jurisdictions to work together, but we have an urgent bipartisan consensus that we need a result here. i would thank senator mcconnell's staff as well as senator schumer's staff for all their work on the legislation. they expedited it when it needed to be expedited.

and i would thank david cleary on my staff and evan schatz on senator murray's staff. they are the chief on those issues. when they work together and senator murray and i work together, we often can get a lot done. on my staff, i especially want to thank grace stunts who was the policewoman on all of this, working with the various committees here, the various committees in the house, and her team andy, melissa, martha, curtis, taylor, brett, jim, they did a tremendous amount of work. also, lindsey sydman, allison bartman, jordan heinz, liz, taylor, ashton, elizabeth, christina, evan, and william hartzel. on senator murray's staff, john, andy, laurel, colin, madeleine,

ally, katherine, lori, sherry, and remi brimm. we worked closely with the house of representatives. i called both chairmen, representative walton, representative brady, talked with them before we went ahead with this, and they worked seamlessly with us for the last several months. the chairman and ranking committees of the house who made contributions included walton, brady, goodlatte, fox, shuster, pallone, conyers, fox, defazio, and their staffs. lastly, i'd like to thank the staff at the senate-house legislative council. they write the bill, they help us write the bill, with all of the changes and all of the senators and all of the provisions. they did a spectacular job. and the staff and the administration that provided technical assistance along the way as well as the staff of the

congressional budget office. they have worked literally around the clock. they have worked on weekends to make it possible for us to get through the house, now get through the senate and down pennsylvania avenue to the president of the united states. this wouldn't be here without them. so this is a landmark piece of legislation, madam president. this legislation with more than 70 contributions from united states senators really equally divided by both parties. $8.5 billion of funding since march. this is an important step toward dealing with the most -- most serious public health epidemic in any of our communities. the supreme court debate is important, but in hundreds of thousands of families and literally every community across this state -- across this country, this is more important. this is more important. and this legislation will help. i thank the president. i yield the floor.

a senator: madam president. the presiding officer: the senator from washington. ms. cantwell: i come to the floor to follow my colleagues, senators thune and nelson, and thank them for the f.a.a. bill that we just passed and it's on its way to the president's desk. i so appreciate working with the chairman and ranking member and my colleague on the subcommittee, senator blunt, on this f.a.a. reauthorization bill. as mentioned by the chairman, this is the first long-term reauthorization in decades, and it represents a five-year investment on critical infrastructure investment that our airports need all throughout the united states. it represents for us in the pacific northwest hundreds of millions of dollars of investments in our airports that help us continue to grow our economic and regional economies. everybody in the state of washington knows that we are bursting at the seams when it comes to our airports, that we need more capacity, particularly

at seattle-tacoma international airport where we saw an increase of nearly two million passengers. it's been one of the fastest growing airports in the nation for the last five years. so this long-term infrastructure bill, that will provide hundreds of millions of dollars to airport investments in our state, will help us meet that growth and demand. this bill is also a major down payment on security and efficiency to help us handle that growth and impact to our economy and to transportation. that is one of the reasons why this bill has provisions to bring more canine units to airports throughout the united states, including the state of washington. the canine units have been vital to helping us cut in half the time of getting passengers through the airport screening process, and i believe they are a tremendous deterrent to making sure that our airports are safe and secure from those who may want to do harm. the fact that we are improving the ability of these canine

units to be supported by local and regional airports is one of the great aspects of this bill as well. i also want to note that our airport infrastructure across the state includes a lot of small contract towers. that is, airports that help us with regional transportation, private transportation, a diverse range of operations, and yet these airports often are in the shadow or work in conjunction with the regional airport, whether that's feltsfield in spokane or walla walla airport and making sure that these contractor airports receive support and funding so they can continue to help our aviation and flying public is a great aspect of this bill. also, many of my colleagues have talked about the other improvements to the safety and security. we are continuing to make a down payment on next-generation technology that is our air traffic control system. i can't say enough about how

important it is for us to continue to move forward on nextgen aviation system. it helps us fly more efficiently. it saves fuel costs. it helps our system operate more efficiently. and the bill's innovation also takes the next step forward on unmanned aerial vehicles. so i again want to thank our colleagues, particularly senator thune and senator nelson, for their great work on this, and my colleague, senator blunt. making aviation investments is critical, critical to continuing to grow an aviation economy in the united states. it's also just critical to grow economies around the state because air transportation helps them attract and keep businesses in the area. so while we have satisfytac bursting at the seams, we have other of our regional airports still trying to grow and giving them this infrastructure investment will help for the future. so i again thank our colleagues

and am glad we are moving forward on the first long-term aviation infrastructure investment in decades. some of us may remember here the last bill in which i think we had something like 23 extensions over many, many years before we finally got a bill, so this helps the first time in many decades that we now have a five-year picture that we can look at and see the investment for aviation moving forward. so i thank my colleagues and will continue to work with them on other aspects of aviation improvement for the future. i thank the president. i yield the floor. and i would suggest an absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

quorum call:

a senator: mr. president. the presiding officer: the senator from inn inn. -- from indiana. donnelly mr. president. the presiding officer: the senate is in a quorum call. mr. donnelly: i ask it be lifted. the presiding officer: without objection. mr. donnelly: i've come to discuss the opioid epidemic which has taken the lives of too many hoosiers, harming family and friends across my state and our country. this is a public health crisis. it is a complex problem. addressing it will require all of us to work together in a bipartisan way at the federal, state, and local levels. i'm very pleased the house and senate have worked together over many months to right -- write this bipartisan legislation. the support for patients and communities act. this bill provides important new tools to combat the opioid epidemic and to work to ensure that those providing

prevention, treatment, and recovery services in our communities have the resources necessary to help those in need of assistance. i'm also proud this legislation contains several bipartisan bills i helped lead over the past year. for hoosiers in northern indiana, one particular provision in this legislation is particularly significant. on july 26, 2017, dr. todd graham was senselessly murdered in south bend after refusing to prescribe an opioid to a patient. to honor dr. graham's memory, i helped introduce the bipartisan dr. todd graham pain management improvement act with my friend and fellow hoosier, senator todd young. this bill directs the department of health and human services to study medicare's payment and coverage policies for nonopioid pain treatments. it could also help increase access to nonopioid treatments

and prevent future patients from developing an addiction. it would never have been possible without the leadership and courage of julie graham and the graham family. another way of increasing access to nonopioid pain treatments is to encourage the development of new nonopioid pain treatments. i helped introduce two bipartisan bills to achieve that goal. these bills require the f.d.a. to clarify how nonopioid pain treatments can qualify for expedited approval and to clarify how it will assess treatments that reduce the need for opioids. provisions based on both of these two bills are included in this legislation so we can get closer to helping treat pain without the risk of addiction. on another front, as we work to provide health professionals with new treatment options, we must also make sure there are enough health professionals to provide substance abuse disorder treatment in communities that need them.

there are far too many areas in my state of indiana and across america that lack access to meaningful addiction treatment and the trained professionals to provide it. earlier this year i worked with senators lisa murkowski and maggie hassan to address this issue by introducing the bipartisan substance use disorder workforce loan repayment act. this bill provides up to $250,000 in student loan forgiveness for trained addiction treatment providers who will work in areas with a shortage of mental health professionals or an above-average overdose rate. this new addition -- initiative helps recruit more providers to work in addiction medications and medicines and to serve in areas that most need their services. i'm very proud to report that the donnelly-murkowski-hassan bill was included in this larger

legislative package. drug overdoses killed more than 72,000 americans in 2017, including nearly 30,000 from opioid overdose. in indiana, 1,840 hoosiers were lost to overdoses just last year alone. that's heart breaking -- heartbreaking, as each person is someone's loved one and someone's family member. we have a lot of work to do, and i won't rest until we reduce this overdose rate because one overdose is one too many. the support for patients and communities act will provide critical resources to communities across indiana and across america. i look forward to seeing this legislation passed here in the senate and then signed into law by the president. i look forward to continuing to work with my colleagues on both

sides of the aisle to address this epidemic. mr. president, i yield the floor and i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

a senator: i ask that you vitiate the quorum call. the presiding officer: without objection. mrs. capito: thank you, mr. president. today i rise to support the passage of the patients for communities act. the support act -- actually, i think that's a great title -- the support act. the support act combines the work of the house of representatives with the senate's opioid crisis response act which we recently passed with overwhelming bipartisan support.

as we anticipate voting on this ground-breaking legislation soon and sending it to the president's desk, i wanted to highlight some of the provisions that i think are most critical, many of which i worked with my colleagues on the other side of the aisle to -- to move forward. the support act successfully builds on the work congress began with the passage of the comprehensive addiction and recovery act back in july of 2016. and it is a critical next step in our fight against an epidemic that continues to devastate families and communities across this country, especially in my home state of west virginia. this legislation reflects what we have learned in the past few years since we passed cara. west virginia has just been struggling so much with the opioid crisis. we have been struggling longer and harder than many of our other states. this is not something we're particularly proud of, but it's

a reality with which we live and we really face the challenge. this crisis has shaped our ongoing response to the epidemic as well as my contributions to the bill. in west virginia, we understand better, i think, some of the causes of the crisis and how we can then deal with them. we have discovered what's working in our state and we have learned that the ripple effects go far beyond those struggling with addiction. it affects families and children and communities. when thinking about next steps for fighting the opioid epidemic, one of the first things i realized was that the form for state funding was not providing adequate resources to the hardest hit states, states like west virginia. i joined with my colleague, senator shaheen, from new hampshire. her state also has been devastated by this epidemic to help work in changing that

formula. i'm pleased that this bill reauthorizes the state grants in a way that ensures that states like ours, small states with very large problems, will begin to receive more resources and those resources that we desperately need. something else we quickly realized in west virginia was we didn't have the treatment facilities or the trained workforce to adequately support individuals seeking treatment. to address these needs, i worked with my colleague, senator hassan, from new hampshire to create a grant program establishing comprehensive opioid recovery centers or corcs in the most affected areas, and i worked on provisions to better increase and prepare our health care workers. we also realized sadly that there will always be bad actors who attempt to take advantage of those in crisis. i have talked to friends of mine whose young adult children are in the throes of addiction who

will literally pay anything, anything to get the help they feel their loved one deserves, making them particularly vulnerable, i think, to bad actors and to folks that might take advantage of that. so we introduced the opioid addiction recovery fraud prevention act with senator cortez masto from nevada. this measure will help fraudulent -- hold fraudulent substance abuse and recovery centers accountable by empowering the f.t.c. to bring enforcement actions against them. another issue i hear about often is the need among employers for potential employees who are able to pass a drug test. our economy's booming. our workforce is expanding, but we're having difficulty in some areas finding enough employees that can actually pass a drug test. it's not unusual.

i will hear ten people get tested and only two will pass. and so we have that need also for them for recovering addicts to be able to find that pathway back to employment. to address both of these needs, this legislation authorizes grants that will allow job training and treatment services including several provisions from the care act that i sponsored with senator brown from ohio. as to the causes of the crisis, there are many, but there are two areas that come up again and again. first is the need to reduce the number of prescriptions for opioids. to get at the root of the problem, senator feinstein and i introduced the using data to prevent opioid diversion act. our bill, which is now a part of this support act, provides drug manufacturers and distributors with data to identify pharmacies that are suspiciously ordering prescription opioids, and it grants law enforcement the authority to hold them accountable as they should be if

they fail to use this data, identify, report, and stop suspicious orders. had something like this been on the books before, we may have been able to stop -- and i want you to hear this statistic -- the 780 million oxycodone and hydrocodone pills that were distributed to pharmacies in my state alone, my one million population state, in the years between 2012 -- 2007 and 2012. 780 million pills, including the nearly 9 million pills that were distributed between 2007 and 2008 to a single pharmacy in a town where the population is 392. the second issue that comes up often is the need to reduce the amount of synthetic opioids like fentanyl which is killing, killing people, which are

hundreds -- which is a hundred times more potent than heroin. the stop act which will help prevent the shipment of synthetic opioids into the united states through the international mail system where the vast amount of these originate. this measure which senator portman led and i joined with him to introduce imposes tom new requirements for our u.s. postal system. by better targeting illegal packages, we can keep those dangerous drugs from ending up on our streets and in our local communities. west virginia has a more mature opioid epidemic that has helped us to learn what is working and what is not working. one great example of something that is working is our quick response teams, our q.r.t.'s, which has been piloted in huntington, west virginia. based on similar programs around the country, a q.r.t. is a three-pronged effort by medical professionals, mental health agencies, and law enforcement.

these teams contact individuals who overdose within 72 hours of their overdose to help get them into treatment programs. in other words, let's just not have them come into the emergency room, stop the overdose, and have them walk back out with no follow-up. these quick response teams, given the success of the q.r.t.'s in our state. i worked with senator murphy to include a grant program in the support act that will allow communities across the country to implement similar programs. when it comes to what is not working, over the last year or so, i began to hear from hospice staff who, due to a d.e.a. rule -- i seriously didn't understand this rule -- were not allowed to destroy unused medication unless authorized by state law. that -- you know, a lot of times in hospice, particularly with elderly people in hospice or anybody who is in a great deal

of pain has med occasions on -- medications on the shelf, and if it's left to the disposal of a family member, you can see how it's just ripe for falling into the wrong hands of a grieving family member or possibly somebody in and out of the home who has an addiction issue. so i worked with senator collins to ensure the support act includes language that would allow hospice employees to dispose of those controlled substances. another example of a policy that's not working is a 40-year-old regulation related to substance use disorder privacy records. this came to my attention following a terrible tragedy of my fellow west virginian jesse grubb which was caused by confusion and misinformation. jesse was a daughter, a great sister, an athlete, and someone who was recovering from addiction. following surgery from a running injury, despite her family and her best efforts to make it clear she was not to be

prescribed opioids, she was discharged from the hospital with a prescription for 50 oxycodone pills. jessie overdosed on those pills. thieves 30 years old. following her tragic death, senator manchin and i introduced jessie's law. jessie's law makes it easier for doctors to know if a patient has a history of opioid abuse, requires h.h.s. to develop best practices for prominently displaying this information in electronic health records when requested by the patient, so they can see right there as they are discharging this patient. although jessie's law passed the senate in august, it had not passed the house, and i'm glad to see it's in the support act. still, while this may help avert future tragedies, many in the addiction community have encouraged further action to assure providers can safely and effectively coordinate high-quality treatments for patients with substance abuse disorders. to meet those needs, senator manchin and i introduced

protecting jessie grubb's legacy. part two is not in the support act, and we will continue to work on this -- on this legacy act to make sure this important policy change happens. something we have seen in west virginia are the ripple effects of the opioid. these are the children, the families. an unbelievably increasing number of children who are being raised by their grandparents, raised by their great grandparents are in foster care. it's putting a major strain on our social services, but on that individual child who through no fault of their own is ping-ponged from house to house in a very emotional kinds of ways. there are more babies receiving neonatal care, and i work with my colleagues to make sure that the crib act that i worked on with senator brown as well, this measure clarifies states'

ability under medicaid to provide care for infants with neonatal abstinence syndrome in pediatric recovery centers like lily's place that we have in huntington, west virginia. the first lady actually visited lily's place, and we welcome her to come back. we also reauthorize residential treatment for pregnant and postpartum women. a grant program i worked with my former colleague senator ayotte to include. this identifies resources to identify, prevent, and mitigate the effects of trauma related to the opioid epidemic on infants, children, and their family. if nothing is done with this -- with the generation and the ripple effect of the children, i feel we're at real risk of losing not just one generation to opioids but the next generation as well. fortunately, there are lots of things that are being done. i will mention one, the martinsburg initiative in west virginia, which is a combination between shepherds university, the martinsburg police department and the berkeley county schools as well as the

boys and girls clubs of the eastern panhandle, working together as a -- as a combination to work based on a c.d.c. study that shows when children have adverse childhood experiences like exposure to drugs and alcohol, it can have a major impact on their physical and mental development. when we started cara two years ago, i said it was a good support and support act is a great next step. a lot of this has to do with funding. the defense labor conference report that the president signed into law last week includes $3.8 billion for the opioid epidemic, an increase of $206 million. with this year's funding, the funding for the latest program is increased $3.5 billion over four years. so clearly we have a commitment for this as a body as all of us working together. i would like to applaud the effort of all the committees involved, and especially the dedication of the help committee, chairman alexander,

and his staff and those who have worked together. i look forward to continuing my work with my colleagues to work on ongoing and emerging problems in this space. methamphetamine is something that is way on the rise and taking over -- unfortunately taking over from heroin, which is just -- a terrific tragedy. there's no one silver bullet when it comes it the epidemic of opioids, but one thing is are for certain, i and we will keep fighting. we will fight back against those who are bringing deadly drugs into our communities. we will fight for those struggling with addiction and seeking treatment. we will fight for children -- the children caught in the middle and every other person who is affected by this crisis. i'm going to keep fighting for states like mine that even in the darkest -- our darkest hours in west virginia with this crisis, we've continued to move forward to a better -- overdoses

are down in huntington, west virginia, by 41% because of the community effort. that is a brighter drug-fee future that we're -- drug-free future that we're all fighting for. i yield the floor. the presiding officer: the senate from minnesota. ms. klobuchar: i join my colleague from west virginia and thank her for her leadership on this work. the continuing problem of opioid abuse, the epidemic that has swept our nation. it has struck at the heart of my state, like west virginia's. in my state there were 694 deaths from opioids and other drug overdoses in 2017. that is more than the number of people who died from car crashes and homicides combined in the state of minnesota. no matter where i go, i hear heartbreaking stories. it's not just superstars, beloved superstars like prince that we've lost in minnesota, it is teenagers in duluth, it is

young people in our farm land. 12-year-olds, one story i heard from some people at a small town gathering -- 12-year-olds court the by drug pushers. the drug pusher said go home to your parents' medicine cabinet. here's a list of stuff we want you to look for. if you bring this stf -- this stuff out to us, we'll give you a beer. that was happening in my state. shelly elkington, her daughter, casey jo, was a champion swimmer who hoped to study nursing like her mom, but in 2008 she was diagnosed with crohn's disease. after painful complication, she received opioids for pain relief. as many of you know, four out of five heroin users got their start on prescription drugs. the very pills that are supposed

to ease someone's pain end up getting them hooked, or worse yet, getting them killed. that's what happened to casey jo. she died of an illegal drug overdose, but she first became addicted because of that painkiller she took that day. that's what's happening to too many families in minnesota and across the country. here in the senate we've made some progress on the epidemic. last congress i led a bill with three other senators, senator rob portman, of ohio, sheldon whitehouse, of rhode island, and kelly ayotte, of new hampshire. it's called the xrens i a -- comprehensive addiction and recovery act, known as cara, and that was signed into law. it encourages states and communities to pursue several strategies, including increasing

the availability of in a locksen -- in a loksen to save lives. later in 2016, this senate and this congress made $1 billion in funding available in treatment and prevention with the passage of the 21st century cures act. i got to be there at the signing with president trump and vice president biden. earlier this year we made an additional $3.3 billion available as part of the government funding bill. that is all progress, but we still have a lot of work to do, and we are taking an important step forward by passing this legislation today, which includes more than 70 provisions to take on addiction. we have worked with the administration, we have worked with the house, and we see this as a bipartisan priority. one of the major pieces that's in this legislation is based on the stop act that i introduced

with senator portman to help stop dangerous synthetic drugs from entering our country in the first place. we know this is a serious problem. powerful synthetic drugs like fentanyl, which is up to 100 times more potent than morphine, keep coming in from china. in my state there were 172 deaths involving synthetic opioids last year. that is a 74% increase from the year before and more than 90% of those deaths involve fentanyl. it is the reason that i joined with senator portman to introduce legislation to close the loophole that allows substances like fentanyl to be shipped into our country in the mail, using the united states postal service. that's what traffickers are doing and they are sending these drugs in the mail to our country from china and from other places. under current law, the u.s.

postal service doesn't require advanced electronic data for packages entering the country. that makes it easier on the traffickers and harder for our law enforcement officers to locate packages that contain illicit drugs. our commonsense legislation requires that these shipments provide this kind of data to make it easier for our customs agents to detect packages containing synthetic drugs and stop them from being shipped to communities across the country. the way i look at it is this, if target, hometown company in minnesota, can find a pair of shoes in hawaii from a simple skew number, i would think we would be able to stop traffickers, criminals from sending in incredibly dangerous drugs that literally can kill people with just basically a size of a pinch of salt that we would be able to stop them from bringing them into the country in the united states postal service packages.

that's just wrong. with 318 million international packages entering our country without advance electronic data last year, it is clear we must do more. i look forward to this measure being signed into law as part of this package. another provision in this legislation is a provision, the salts act, that i authored with senator graham. it passed the judiciary committee in may, and our bill will help to crack down on criminals who sell and distribute analogue synthetic drugs. senator graham and i have been trying to pass this for a long period of time, and i'm glad this is finally getting done. the issue of synthetic drugs hit home to me when a few years ago a 19-year-old from blaine, minnesota, ended up overcoasting -- overdosing on a

drug called 2ce. i worked to outlaw that drug and i remember who worked on that bill in addition to senator graham was senator grassley and senator schumer and others, and we combined the bill and were able to get those listed on the list of illegal drugs. but you know what, that's not enough. because what we're seeing is that new synthetic drugs are constantly coming into the market. criminals are adjusting the chemical composition of these drugs. so what we do is get one listed, and then they change it a little bit so it's no longer on the list because it has a different chemical composition, but it is still an illegal drug for the purpose of getting people hooked. what we did here, the bill that senator graham and i have, it will make it easier for the law enforcement to prosecute criminals who have the analogue drugs, those are the similar drugs where they change one of

the compositions just to make it so it's not on the list. the bill addresses a loophole that allows drug dealers to skirt the law by labeling these drugs as not intended for human consumption, when really they are placing people in danger every day. so that slap -- so they slap that label on them and say, see, we didn't mean it to be illegal and change the composition so it's not on the list. what this bill does, in the opioid package, it considers things to make clear that these dangerous substances are intended for human consumption no matter what label they slap on them such as the market labeling or the difference between the price and the price of the substance that it's represented, like candy or bath salt is normally sold. that is a good clue it is not just candy or bath salts.

when i first -- since i introduced this bill, the drug enforcement has -- but we know that criminals are continuing to come up with new analogue drugs, and this measure will help us to meet those threats. the last provision in this bill that i want to talk about is based on legislation that senator rubio and i introduced, and that is the eliminating kickbacks in recovery act. our bill targets unscrupulous actors that prey on patients seeking treatment to exploit their health insurance by making it illegal to provide or receive kickbacks for referring patients to recovery homes an treatment facilities. these kickbacks, already illegal under federal health care plans like medicare, but there is no federal law to prohibit them in private health insurance plans. when people are struggling with addiction, they are focus should be on getting well, not on

worrying whether treatment facilities are trying to take advantage of them to make more money. it's simply outrageous. our bill will crack down on health care facilities or providers that try to game the system to take advantage of these vulnerable patients. so those are three provisions that i've worked on that are in this bill, but as we know, there's a lot of other good work that's been done in this bill. in the end the way i look at this is our first goal is to stop people from getting addicted in the first place, and that means doing all we can to stop the fentanyl and carfentanil and to means to have our kids understand what's happening and how dangerous these drugs are. that means working with our doctors and health care providers so they are not overprescribing opioids since we now know that four out of five heroin users got their start on legal prescription drugs. we want to put limits, and

that's going on all over the country with republican and democratic governors, and we must do more here. the second piece of this is making sure that we have treatment available for people who are addicted, and there's all kinds of work being done on treatment from saboxoze to work done with the medical device industry as they look at potential ways to get people off of these drugs, to traditional treatment methods. we have to be open minderred to all -- open-minded to get people off of these drugs because they are hard drugs to kick the addiction on. that means that we're going to have to put resources into that. i personally support senator manchin's bill, the life boat act, that allows a penny additional fee on these drugs and so that money can be used to pay for treatment. those are the kind of innovative ideas that i think we should be using on the federal and the state level.

last going after the bad guys, the people that are trying to get people hooked on these drugs, and that's where two of the bills that i just discussed, the analogue bill that i have with senator graham and the bill that senator portman biewfd with me -- introduced with me, that is the bill that basically, the stop act, that requires the postal sstles to -- service to track these packages. it is a combined effort. there is a law enforcement piece, but we cannot forget at its core, we want to stop the cycle of when people are getting adicked and sad -- addicted and when they get addicted, we have to give them the treatment they deserve. i used to be a prs cuter -- prosecutor and i said we want to run our offices as efficiently as possible. there was one important way that we weren't like a business, we didn't want to see repeat customers many we didn't want to see cycling in and out out of te

criminal justice system and the best way to ensure that doesn't happen is to make sure that people get the treatment they need to go and -- so they can go on and lead happy, productive lives. with that, i yield the floor and i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

a senator: thank you, mr. president. i ask the quorum call be lifted. the presiding officer: without objection. mr. merkley: thank you. mr. president, i ask unanimous consent for my intern srvos sierra be granted floor privileges for the balance of the day. the presiding officer: without objection. mr. merkley: thank you. the most important words of our constitution are the first three, we the people. this describes the entire purpose of our constitution. that is, to create a government responsive to the people and produce laws that reflect the will of the people.

and that requires a close adherence to the vision embodied in the constitution, including the advice and consent vision in the constitution. we know that the founders of our country, they struggled with how to appoint people to high positions in the executive branch and to our courts. and it was alexander hamilton that laid out the deliberations. he said, well, if a body or an assembly has that power, there will be a lot of horse trading back and forth and we won't get the best people suited to the positions in the executive branch and in the courts. so the responsibility should rest with one person, and that's how the nominating power came to be vested with the president. but the founders also discussed the fact that a single person can go off track. the president might have favorite tism towards people -- favoritism towards people from his or her home state. the president might favor people

who had turned down favors for him or her and so forth. so they said the way to avoid this is to have the senate be a check, a check upon the president and would tend to greatly prevent the appointment of unfit characters. that's what alexander hamilton summed it up, our responsibility is to review the record of individuals and make sure that no one is appointed who is of unfit character. well, that's -- well, that separation of powers has been honored over the centuries. the president nominating and the senate reviewing the entire record of the individual. to honor its responsibility to figure out is this individual fit or is this individual unfit. but now we have something we have never seen before which is a president's team has intervened in a massive way to block a thorough review of the

nominee's record. now, there are three parts of this intervention. the first was to weigh in with senate leadership and say don't request anything about his three years as staff secretary. and there was a conspiracy then between the president's team and a few senators to prevent the entire body from being able to review nominee kavanaugh's record. that's unacceptable because each and every one of us have that responsibility, each and every one of us take the oath of office. this isn't just a responsibility that exists for one or two people who refer to themselves by titles like majority leader or chairman of judiciary. this is a responsibility that every one of us has, and that responsibility has been violated with this violation of the separation of powers. the second thing that the president did was proceed to appoint an individual to use the

stamp presidential privilege, meaning executive privilege, to deny access to the senate for some 100,000 documents for when the individual served in the capacity of a lawyer on the team of white house counsel. now, in this case the senate did request the records, but this is solely the exercise of the president and perhaps, therefore, is the clearest example of the violation of the separation of powers. and we have from the individual himself a statement. the white house has directed that we not provide these documents. that's referring directly to the documents that william burck marched presidential privilege 100,000 documents. why are these documents important? well, we know from the more limited ones we received that it

addresses his actions and his opinions on a host of important topics. well, the documents reveal, for example, that while he said he wasn't involved in the discussions around certain nominations, we know that at least in a modest way he was from the documents we have. but we don't have the bulk of the documents to explain the whole story. he said he wasn't involved in the discussions regarding the use of torture, but we have a limited glimpse from the documents we did get that he was involved in those discussions. the remaining documents probably have a much more expanded vision of his involvement. he said that he wasn't involved in the receipt of stolen documents that regard nomination discussions, documents stolen from the senate democrats, and yet we find out from the existing documents we have that he was, that these were received

directly by him. so there we are with this limited glimpse of three cases that he misrepresented the story. certainly didn't get the full story. what's in the hundred thousand documents that were censored that we never got? we've never been in this situation before where a president deliberately obstructed the view of the nominee's record in this vast procedure. now, did the president's team go through carefully and say oh, well, because of the sensitivity x, y, and z. therefore, we're going to block documents a, b, and c and, therefore, create an index explaining that? no, they did not. we have a whole scale blockage of key parts of the record. and there's more than that. there's also the president's role in marking documents

committee confidential. so here is the challenge. we have a responsibility, a constitutional responsibility that has been violated. and that's why today i filed a motion to compel the president to provide those hundred thousand documents marked presidential privilege to us in the senate so we can review them and do our responsibility under the constitution. now let me switch topics. i've heard senators here say, well, we certainly couldn't vote for this individual if he lied to the committee in his testimony. that certainly would mean he was unsuited to serve. and yet we have numerous instances in which he has lied to the committee. and he is unsuited to serve. at a minimum, the president should withdraw this nominee. it is certainly an enormous,

enormous dark mark on the integrity of the court to take someone who misled the senate, democrats and republicans, about numerous topics. we had just in those three issues that i mentioned deception, issues related did he receive stolen documents. he did. he said he didn't. was he involved in the proceedings for certain nominees. he said he wasn't but he was. was he involved in the conversations over torture. he said he wasn't but he was. and that's just with the limited information that we have. and then we have the hearing, the hearing in which he said things like his friends who were at the gathering with dr. ford refuted her story. straight out lie. not a one of them refuted his story. they said they didn't remember. they said they didn't know. they certainly didn't refute. that's a lie. he said she wasn't in the