separate programs for many of these worthy purposes, regardless of which approach this conference committee adopts, we must do more than simply authorize funding. we must provide dollars and urgently needed by those fighting this crisis. i ask consent into the record of leonard, the police chief participating in the police assisted, recovery initiative sent to us that we provide $1.1 billion in increase funding to adjust this issue. >> thank you. >> that will be the true measure of success of this legislative effort and i thank the chair and

our time. >> recogniziining texas. >> mr. chairman, thank you very much, i am pleased from this moment of history to join my colleagues who have come together with a similar and very important purpose and that's to save lives. the ranking members on the committee dealing with crimes. we see tl after math over the years of a wrong policy. let me simply add to the record of startling facts. when an average day in united states, more than 650,000 opiate prescriptions are dispensed and 3900 people used non-prescription use of opiates. 78 people died from an opiate related deaths.

$55 billion in health and social costs related to prescription opiate abuse each year and opiate poisoning. this conference committee is on the right direction. there are worthy bills. the problem is huge between 2014, almost half a million people died from drug over doses based on the statistic that i just read. >> also to fulfill our obligations for funding, i am glad to be a coresponsponsor of committee, comprehensive of opiate abusive reduction act. i am glad to work with the chairman and the chairman o f the subcommittee. the text of 5446 is largely incorporated in the report and provided to us to be

administered to the department of justice particularly by helping criminal justice and agencies to tackle the opiate problems from a variety of angles. i would encourage or it would encourage the development of alternatives to incarceration that would provide treatments to under line motivation for criminal behavior or conduct associated with mental disorder. breaking news, there is no mandatory minimum in this legislation. combined with other treatments under the committees and proposed to be included in the conference report, the approach congress is taking and the prices of heroine and other opiate is thoughtful and comprehensive. the counties of the united states have had one of their elements or suggestions is providing for a greater use. we have done that. we are training police officers. i hope it signals the departure with some of the failed approaches concerning other direct price in the past. many of you know that our responses of surge cocaine and

out of cocaine. in the 1980s, treatments for crack and cocaine. at that time, congress took action that we are still trying to rectify. let me make one final point. we know in that instance, many of those ins kacarcerated were african-americans. i hope we are turning the page going forward dealing these drastic and terrible accidents that impact our society. with that, i yield back. >> chair recognized the lady from new hampshire. thank you mr. chair and all of the bipartisan members taking part today. many people from both chambers and both parties have been working for a long time to

address the challenges of addiction as the opiate and heroine epidemic has swept across our country. in my home state of new hampshire, the epidemic continues to grow. 2015, the total number of drug over dose in the states surpassed 435. and our population is only 1.3 million people. >> far exceeding the records set just one year before at 325 and well over double the amount. we had in 2013. this rapid rise in over dose reflects a deadly combination in new hampshire. we have one of the nation's highest addiction rates but ranks second to last in treatment capacity. the bill before us today and the program included with in it providing crucial tools to help us beginning to address this epidemic from allowing nurse

practitioners to provid provide -- building communities of recovery and improving prevention and education efforts. however, this legislation still falls short of where we need to be. with 129 americans dying each and every day from over dose, action is needed now. the lack of funding included in this proposal represents a whole in this package and will hamper our ability to provide education and treatments and recovery services in our community across the country. with amendments still to be considered later today, i urge my colleagues on both sides of the isle, please support representatives to ensure emergency funding for this legislation. by doing so, we can deliver help to those in need before it is too late. thank you mr. chairman, i yield

back. >> young lady, we recognize the gentleman from georgia. mr. colins. . >> thank you, we can hear from the opening statement of the magnitude of what we are dealing with. i think it is effective as well of the state of georgia. over doses are up by 300% this year. >> my sheriff say it is becoming one of the longest time where you see it more regularly now than any other confiscations. i appreciate the conference board and the addiction recovery act. i just want to focus on one quickly section 502, this is particularly close to my heart. it is a section that deals with the grand process to expand treatments. as a member of the air force who has served over seas. it is startling of these statistics, that's why i introduce the mental health act

to expand treatment course and most of language reflected in the conference report because opiate epidemic clearly and tragically affects veterans. disorders also have ptsd, one and six veterans of operations suffer substance abuse. we need to help them and we should not cast it aside. this call is on our military and on our families everyday. i am pleased with the report, i am looking for the continue efforts of this conference to bring forward of this crisis. i yield back. >> thank you mr. chairman. in 2004, decenter of disease control, 7,000 americans lost their lives of american opiate over doses. last year, they had full statistic, that number grew four times. 28,000 americans lost their lives in heroine and opiate over

doses. state by state number is going to be worse. 2016 is off to a horrendous start as well. mr. chairman, if there is an affection disease or a natural disaster that's causing this kind of halvoc to our country, getting emergency funding out of the country to deal with this devastation. this bill contains many good provisions in terms of policy changes and authorize languages. the absence of any real resources to help families who right now as we are sitting in this room are scrambling trying to find a detox pad or a long-term treatment pad. lock up they're trying to get out and into a treatment program, and emergency room where doctors brought people back to live. no treatment options available. we need to get much more serious about dealing with the overwh m

overwhelming avalanche of harm and need existing in this country. the amendment will be offered later providing a fully paid for amount of resources that deals with preventions and deals with treatments and also gives resources in terms of education and law enforcement. this is the approach that ultimately is going to make a real difference to those families or look to us and desperately for help so they can help their offloved ones get th treatments that we know works. we have that power and we have that opportunity. we should view this just like we would like any natural disaster and view it like any other type of again, infectious disease. we as a nation sit up and responded with real resource to getting help to the people that rerepresent. i yield back. >> thank you mr. chairman, i

please to support it today. compromise language of opiate use disorder of modernization act and the treat act as passed by the senate health committee. i will submit the remainder of my remarks for r the record, and i yield back. >> the chairman recognize the chairman from virginia, mr. scott. >> thank you, mr. chairman. this is the house version of the comprehensive care vel. i know we have an opportunity to make a real difference. we are losing far too many people to opiate addictions. many of them are found in this bill that are focused in prevention and early preventions and rehabilitation. we know the states need more resources to respond to this kri

crisis and while this takes a positive step in the right direction, offering several programs. authorizing funding levels to ensure these programs making the impact they are designed to make. we have al choi choice, we can it from a criminal justice expenses or we can put up the money now, save lives and keeping families together and save money. mr. chairman, this is a good bill as far as it goes. in addition to the funding issue, there is another issue and that's the bill should include support on initiatives. this provision was included in the legislation and in the house bill that our colleague in wisconsin introduced which i am proud to be a cosponsor of. that bill had over 100 cosponsor and including over 40 republicans and so because of the need of the program to assist those and the bipartisan

support, it will be introduced in an amendment which will include congressional activities as an allowable use. the state block grants to address opiate addiction. mr. chairman, thank you for your leadership and i yield back. >> the chairman recognize a gentleman from michigan. >> thank you mr. chairman, as so many of my colleagues have mentioned this morning. the opiate epidemic has no boundaries a few minutes ago, my colleague, mr. conyers, indicated that 17 people passed away from opiate abuse. >> 449 people passed away from drug abuse. we are considering this this morning containing important solutions to fight this problem. first, the bill we pass on

providing us a grant program to ensure law enforcement and first responders and criminal investigations and drug courses to fight this problem. second, it provides for transparency and accountability to ensure that our solution is stwa actually making a difference and reducing the number of deaths because of opiate abuse and finally it attacks the root of the problems. and international traffickers as kingpins -- and also keeping such destination confidential. >> i applaud the house and the senate for tackling this issue to address this epidemic and i yield back. >> gentleman. i recognize the jegentleman fro california. thank you. >> we are together to address our nation's crisis opiate addiction abuse. i would like to thank the house and state and senate leadership for their work on this

conference report. particularly, i would like to thank members on guiding on this. my colleague before me and millions of americans each year facing the devastating impact that drug abuse and addiction. as an emergency medicine proserious conditipr addiction, i have seen far too many victims to this. i remember when a young man, with purple lips was drpulled o from the car without moving. i saved his life. to get treatments and to live that better life that we all strive for. i have seen this emotional impact on medication abuse and

on individuals and families. today, we have an incredible opportunity to enact meaningful legislation to combat the epidemic opiate abuse and help saves millions of lives. in 2014, more than 28,000 americans dies because of opiate abuse. they suffered and the family and loved ones suffered and their community suffered. today, more americans died from drug over doses than car crashes. it is the leading cause of injuries in deaths in the united states. our continue westiuents are cal to act. they must include resources that'll allow local states and federal officials to implement these ideas and fully address what it is truly a public health crisis. that's why i join my colleagues

in demanding that our actions reflect a seriousness of this health crisis by including the necessary funding as part of this report. we'll produce today. we need funding so law enforcement and first responders are able toll reverse the effect of an over dose and save for lives. more importantly how to prevent opiate abuse. and making lasting measures. we cannot let our words becoming nearly empty and promises and conclusions are critical that we ensure americans are suffering and treatments is important. they need to over come the addiction so that opiate patients and families have an immediate chance to heel and turn their lives around. >> gentleman, time is expire.

>> as my colleagues have talked about of the devastation created. in scott county, a rural county in southern indiana, the hiv rate exploded over a year ago as a result of iv drug use. while the spotlight is on scott county for a period of time, we know it helps crisis happening all across the country. we see rising rates of child well failure cases and large any of neglect of children. large number of infants being born addicted to opiates. the epidemic did not happen over night. medical providers and health care workers say much of the the crisis of opiate prescriptions

of over used. this country, we developed a culture of over prescription that's built on expectations and providers lack of awareness and failure to address this over prescription of these types of medication which is a major part of the epidemic which i would say the route from the offset from our communities. i urge my colleagues to support this legislation which includes beginning with section 101, the task force on pain management which is establishes comprehensive task force and comprised with representatives and federal agencies and all sorts of groups and mental health groups and addiction communities. we need to get to the root of this problem. it is going to take all of us work together. i urge my colleague to move forward. thank you, i yield back.

without objection. >> needed five. the issue here is whether you will put the resources. you heard it over and over again. we are preparing today for the house to adopt the mental health bill that has no money attached to it. you are not going to fix a problem that we are talking about today with legislation perfectly decided policies. policies are wonderful but you have to have money to implement it. that's clearly with the problem of this particular piece that we are working on today. you would have a unanimous signature at the end of this

conference if there were some money. if there is no money in it, it becomes like building a house, you say we got a housing problem -- lets build al house. then you build al nice shell but you don't connect the le electricity. this is a public health house we are building. we are not connecting the utilities to make it work. that's really why i think we must consider the amendment in a positive way if we are serious about this. i have heard about it 33 times of how many people died and stuff. i am tired of that. the time is to do something. that means where you put your money in your mouth is. i yield back.

>> ladies and gentlemen, i appreciate the opportunity to serve on this conference committee. there are so many statistics have been cited so far by my colleagues. it is too many to mention and review again. suffice to say that my community is not the only that's seeing this epidemic. to many have suffered from opiate. this is a ticking time bomb in everybody's district and community. as a father of three children, i know full well that unacceptable percentage of younger people finding it very easy to obtain opiate in every possible form. they are available in every school and neighborhood.

the abuse continues to pr prolifirate. i believe it is a great step in the great direction. one of the things it does is i am grateful to be apart of this. it encourages treatments and diversion programs before prosecuto prosecutors, they're very effective in what they do addressing this issue community based programs. addiction problems need treatments and i believe that it is effective in doing that. technology that'll prevent or at the during individuals and

particularly from children. i want the congress committee, my time has concluded and thank you for your effort today. i yield back. >> gentleman, yielding back, i recognize mr. carter. >> mr. chairman, i have been a member of this body for 14 months. this is definitely a problem in our country. i am proud of this body for recognizing this and addressing it. i believe there are numerous challenges of our health care providers and leaders face and this bill helps them address many of those challenges. i believe the key to fulfilling any successful prescription is education. this bill does that. it makes improvements of current

preventions and ensure americans are staying well and informed of their medications. one key components that's lacked in the past has been a real concentration of treatments and treatment facilities. this bill does that. improving treatments for women or training of first responders, this report provides treatments for all americans who need it. i am glad to see this bill recognizing for the need of greater involvement when it comes to monitoring programs. as the author of george's pdmd. i believe these programs will play an important role in our fighting of opiate addiction. i believe pdmp's with the coordination of prescribers and pharmacists can be a corner stone and not fight against american opiate abuse epidemic. i have real concerns with

provisions that include the definition of one pharmacy ace multiple locations. over the past few years, farmly benefit managers have used their money to purchase chains -- i hope i can work with chairman upton and my colleagues to address this issue and issues related to pharmacy market to ensure that everything is being done to help this country. again, i want to thank the leadership and commend them in both chambers on this bill and i am looking forward to send something to the president's desk soon so we can identify this epidemic. thank you, mr. chairman. i yield back. >> thank you. i appreciate very much. i want to thank you mr. chairman and all members and staffs for their tire less efforts and hard work. we have all been touched one way

or another knowing one being affected by opiates whether it is family or friends or heartbreaking stories back home. including this report and the under lining opiate bill, i have been advocating for on behalf of our true american heroes and event rooms and military that have sacrificesed so much. it will provide tl qualihe qual health care that our veterans will earn and reserve. additionally, pilot program author was included it will provide access and treatments in our communities that have shown positive results with those experiencing mental health or

chronic pain. i urge all my colleagues to support this and the under lining bill. doing so, we uphold of who we represent and sending messages that we have covered. thank you. thank you mr. chair. i am very concerned over the issues of opiate over prescripti prescription. i am honored to support this report. veterans facing high rate of chronic pain of traumas particularly ptsd and traumatic brain injuries. veterans are vulnerable to addiction and i see the problem firsthand. the crisis is escalated so quickly that the dea has raided and including several locations.

for two long, the dea relying too heavy on prescription of open ra opiates. >> with that said, i want to highlight two important provisions of this legislation that i advocated for years. the first requires the va to report to state prescription drug monitoring program. these databases have proven to be an important tool to track it. t this will open windows to law enforcement. secondly, the other provision allows the va alternative forms of treatments such as fda approved medical devices for patients of chronic pain and offering veterans than strictly providing opiate. >> i thank you for the opportunity to work side by side

on this important issue facing our nation and i yield back. i recognize mr. mean from pennsylvania. >> thank you, mr. chairman. mr. chairman i knew john tomas decker. he was a scholar and a leader and an outstanding athlete. he's not a toxic. he had a sport related injury and led to opiate abuse and heroine addiction and his death. in so many ways it is the name that's important. we are not talking about statistics. we are talking about real lives and families so struggling with addiction first and then ultimately, the loss of a loved ones. we have so much opportunities with this bill to do meaningful things now. as we are hearing the statistics over 120 people a day who are dying, we must do something now. this is an ongoing process and a commitment that we must make to continue but, we have so much of

the sports related interventions that could be done. i have seen make a difference in the lives of those who are struggling. prescription monitoring, i am sure we can identify those who are using opiate. infant safe care, so many that's going to make a difference in the lives of those struggling families. i heard my colleagues on both sides of the isle to stay focused on these real people and make sure that we do something meaningful today. i yield back. >> thank you, mr. chairman and it is an honor to be able to work with you and my colleagues on this conference committee.

this is about families across the country. high school student that had his life in front of him. a good student and a good athlete with a lot of friends and off to college and ended up dying from a heroine over dose. we have an epidemic in our hands in our country. this legislation is talking about hopefully giving a second chance of recovery for literally millions of people across our nation. every single committee. as someone serving, i have seen firsthand of what this is doing to families right back. no mothers should have to walk to a child's bedroom to find them over dosed from heroine and prescription drugs. so there is meaningful piece of legislation. mr. chairman, i am going to submit the rest of my remarks for the record.

i do think this is an important piece of legislation that requires our attention and requires that we step up meaningfully attack what's going on across our country. i yield back. i would now -- now, i ask you all statements to be made for the record, without objections to order. all that are here have given an opening statement or submitted them to the record. i now call i aming up the confe. >> conference draft of the comprehensive act of 2016. >> so the conference draft will be considered as read. excuse me. i want to remind members of our amendment process. so the conference of the sponsor's house will discuss the amendment for five minutes. each for the majority and then for the minority. that house will vote on the

amendment. if the amendment is agreed to, the process over a repeat of the cou conferees of the over bodies. >> amendment to the conference report on s 5 24 offered by chairman upton. >> it is considered as read. staff issues the amendment. this amendment provides technical edits to the conference report. the edit ensures that grants are carried out to the secretary of hhs and authorization of appropriations is included in that section. it also mimics minor classifications of section 303 of treatments and modernization. i would ask my colleagues to

support the amendment. are there members supporting it? >> seeing none, i will yield back the balance of my time. are there minorities that would like to speak for or against the amendment? >> seeing none. the vote occurs on the upton amendment. those in favor will say aye and those oppose saying no. >> at this point, we yield to see if the senate will exceacce the house's amendment. >> i support chairman upton's and thank you for this

opportunity. we ought to thank members of staff from both chambers from both sides of the isle from their work finalizing the reported preparation for today. it was truly bipartisan bicameral team efforts. is there anybody on the senate minority want to speak? then i will yield back my time. those in favor shall signify by saying aye. >> pooppose saying no. the aye have it. >> the house offer on the upton amendment and the amendment is about to be. >> with that, the conference accepts the upton's amendment. the next in line, he will be back shortly, when he returns, we'll take his amendment up. at this point, the gentleman from new jersey has an

amendment. >> thank you, i do have an amendment. >> s 524 offered by mr. colon. >> the staff will distribute the amendment and the gentleman from new jersey recognizing five minutes to support the amendment. >> thank you, h this amendment will provide critical funding for opiate treatments that's solely paid for that's vetted by bipartisans. we are here today because we are in the mist of precedented of opiate -- our public health and treatment systems have not kept pace of expanding epidemic. those struggling of heroine and opiate addiction suffering from sources and treatment access. only one and ten individuals suffering from substances.

that's why i am offering this amendment which provides $920 million in immediate funding to provide critical tools to attack opiate epidemic and expands the type of providers to be treated opiate depen dense. the funding will go directly to the states to enable to treat in capacity and withstanding access to medication. this proposal provides for a target and response where funding is allocated to the areas hit the hardest by this epidemic. >> it will increase treatment capacity as well as treatments affordable for those seeking for services.

we all agree in the past including and all listen, one, rolling back the start date on our policy that's enacted and i want to ensure that we are applicable. two, changing the way medicare pays for part b and diffusion drugs to the asp methodology which could result in a payment amount that better reflects the transaction. through a requirement that states supporting any provider that's terminated into a uniform and central database that's assessed to all states. and fourth, protecting our medicare program and algorithms. and lastly, allow tg creation of prescription drugs managing programs for beneficiaries and our deep programs. that goes towards the opiate

crisis in this country. >> mr. chairman, i would urge my colleagues to vote in favor of this amendment, these are all policies that we voted on before and funding is needed to address this crisis in a a meaningful way. >> we will fail. anything less than a robust response to address this crisis will result in deaths and place tremendous emotional burdens on families and communities. the need for action is now. we cannot wait until the normal appropriation site. in addition, mr. chairman, if congress does not take a proactive approach in providing this necessary resources. we'll pay for it later through the collateral consequences epidemic and through the criminal justice system. meaning that, we save money today at the expense of lives

loss and increase spending later. so mr. chairman, as time to step up, with funding they need to fight this epidemic, i urge my colleague to support this and i yield back. >> the gentleman yields back. i will clean the time in our opposition. i want to thank, i want to say all members on this conference committee believed that resources to fight the opiate and epidemic and our strategies and families that are suffering and helping our community. i was noting just this morning, the house announced they'll be providing 581 million dhars $58 address opiate. as $525 million increased above the enacted level and some $490 million above the president's budget request.

so this conference report includes my bipartisan party addressing education treatments in recovery of opiate use disorders and strengthening our nation in response to this horrendous epidemic. one example is an important proserious condition in the bill to provide pregnant or post partum women of this disorder. >> with the amendment before us and it is not a bipartisan attempt in fiepdinding resourceo point was this amendment was discussed during the months of negotiations and the house in the senate. the idea included in the amendment were included in a letter that the democratic released saying yesterday afternoon. i would agree with our appropriators that we have to evoke significant resources to combat this.

yesterday over 100 groups voiced their support for the legislation. we must not allow the bill to be weighed down of last minute objections to major bipartisan. that would urge mike humphries in the house to oppose the amendment and would ask that any members of the majority side to speak against it. if not, i would yield back the balance of my time. role call is being requested, right? five minutes on each side. the clerk will call the role. i would note on this amendment,

the confereess a and ways and ms will be weighing in it. >> mr. pitts. votes know. >> mr. lance. >> no. >> mr. guthrie. >> mr. bu shawn? >> votes no. >> mr. sense burner. >> mr. smith? >> mr. moreno? >> mr. colins? mr. colins vote no. >> mr. tran votes no. >> mr. bishop. mr. bishop votes no. >> mr. palone. >> mr. palone votes ay.

>> mr. green? >> mr. conyers? >> miss jackson lee. >> miss jackson lee votes aye. >> mr. colins votes aye. miss etsy votes aye. mr. custard votes aye. mr. courtney votes aye. >> mr. mean votes no. mr. dole votes no. mr. mcdermott votes aye. >> chairman upton votes no. >> we have proxies for all these members. how is this reported?

>> he's not reported. oh, i have a proxy. he votes no by proxy. >> mr. -- how is miss moreno recorded. >> he's not recorded. >> how is mr. mccartney? >> he's not recorded. >> i have a proxy, he votes no. >> mccartney votes no. >> i would ask -- mr. chairman? >> mr. chairman? how is mr. smith recorded? >> mr. smith is not recorded. >> i i believe the only proxy i have is mr. conyers -- >> how is mr. conyers repocorde >> i vote aye. >> how was mr. luhan recorded? >> he's not recorded. >> how is mr. green recorded?

>> mr. green did not recorded. >> i do not have a problem of mr. green. >> other members that are not recorded yet? >> yes, you may. [ inaudible ] >> yes, it is my understanding that the conferences allows for proxy voting and we told all members earlier -- proxy will be included. are there members that we called not voted or changed your vote? >> if not, the clerk will report the tally.

>> you know -- how is congressman lamar smith recorded? >> he's not recorded. so he votes no. >> mr. smith votes no. >> now -- >> mr. chairman on that vote, there are 17 ayes and 11 ayes and 17 nays. >> 11 ayes and 17 nays, the amendment is not agreed to. next amendment, general lady from washington state, miss murray. >> i call my amendment on number four. >> the conference report of s 524 offered by miss murray. >> the amendment is considered

read by the staff and the lady is recognized for five minutes. i am glad that we have been able toll reach some important bipartisan agreement on this issue. our states need more to tackle crisis head on. this investment will provide $920 million in funding for states to expand access to preventions and treatments and services especially for those who are cannot afford it. there is no reason we cannot all support this amendment. we all agree the funding is desperately needed to help our committees and stop the waves of over dose deaths and properly treated addiction to opiate and heroine. we know without more funding to ex pend ax access to medication and treatments, states will not have the researches they need to put people on the pat through recovery to save lives. we are debating a bill to address the opiate epidemic.

it should include the fund necessary to fight that epidemic. this amendment we providing funding and medicaid system treatments and allowing nurse practitioners or physician assistants of revising the drug of -- this is critical for many of our rural communities that had been hit hard by this epidemic. the amendment ais also paid for by a set of parties both supported and would not at a single dollar to the deficit. the bottom out line is when someone is ready for treatment, we need to make sure health care system is ready to treatment them. i am concerned that if we pass a bill that changes our nation, opiate policies but completely ignores the funding, that woumd enable cities and states to put those policies into practice.

that funding may never come. far too many families, there is no later or next time. this is the opiate bill this year and frankly, people across the country are running out of time. lets make the tough choices. lets vote for this amendment and lets make sure that this bill takes an absolute and necessary steps forward and expanding access to the life saving treatments that families across the countriy need. i yield my additional time to senator rice. >> mr. chairman, do i have al few minutes? >> 2:28. >> all right, i will be very brief. >> i strongly support this. this is what i meant when we are talking about fighting and inferno with full of water. in the journal of american medical association, 80% of people who are dependant on

heroine or painkillers are not getting treatment. now, i don't want to tell families at home or in oregon and across the country that they ought to wait around for the appropriation process, my staff did research and apparently it had been years since there is a labor health and human services budget. the question is, are we going to be able to tell families now if we are serious about securing the money when 80% of those who need treatment, according to research done by one of the most reputable groups in the country say they are waiting and i don't think they ought to be waiting around for the appropriation process and the amendment and the amendment that never really seems to get there when these families are in crisis. i urge colleagues to support this amendment. >> the lady still has a minute

left, did she yield back? >> gentleman from tennessee, we recognize of five minutes. >> thank you mr. chairman. >> i think the senator from washington, and oregon of their comments. we have bipartisan support here we are talking about today. 94-1 in the senate and 400-5 in the house. but, over the last two years if you follow of what the committee recommended, we increase funding for opiate abuse by factor of seven times more money than two years ago. and if we do what the house appropriation committee announced today, it would be 14 times. so seven times more than two years ago.

14 times more than two years ago. that's an opportunity for bipartisan support. that's the way we always do it in the senate. we operate on two tracks. senator from washington and i worked last year on fixings on no child left behind with members of the house of representatives. the president calls it a christmas miracle. it did not spend one penny because it reforms programs. we do the appropriation process. we passed an energy bill and it does not spend one penny. the bills are good and so are the appropriation bills. we are spending money on opiate and we are doing it the right way. we should finish our work today on reforming the program and finish our work on funding and on funding opiates which is as i said the appropriations committee and the senate wants to do it at seven times o f the rate of two years ago.

the house senate today wants to do it at a rate of 14 times of two years ago. that's an improvement and i think it would have bipartisan support. there is a second reason why i oppose the amendment by my friend from washington state. that's offsets if it comes from the ctury that's already passed by the house of representatives with 324 votes. this is an important legislation. it could be the most important in the year if we could finish it this year in the senate and the house. a whole variety of other initiatives that we'll get treatments and drug discoveries and getting it through the cabinets faster. it is different than the money t the house found when it passed it with 344 votes last year is the same money. we can't spend that money, that

same money twice. so let's recognize that we have bipartisan support for funding, that we are spending money, that there are not -- i cannot think of other provisions in the budget where we're spending seven times what we did two years ago or 14 times what we did to two years ago and we're still talking about additional funding in the senate in a bipartisan way, in the house in a bipartisan way and surely let's don't take the money we would use for 21st century cure which is the house did so well with and try to spend the money twice. so i'm opposed to the amendment. but i'm in favor of the policy and i'm in favor of funding, this is just not the way to do it. we can get it done in the appropriate way at another time soon. >> any members wishing to speak against the amendment from the senate side? if not, time has expired.

the vote occurs on the amendment. those in favor will say aye? those opposed say no? the opinion of the chair the noes have it. recorded vote is asked for on the senate side and the clerk will call the roll. >> mr. grassley? >> no. >> mr. gasly votes no. mr. alexander? >> no. >> mr. alexander votes no. mr. hatch? >> is there a proxy? >> no proxy. >> mr. hatch votes no. mr. sessions? >> no by proxy. >> mr. sessions votes no. mr. lahey votes aye. ms. murray. ms. murai votes aye. mr. wyden votes aye. >> other members wishing to change your vote? if not, the clerk will call the tally. >> mr. chairman on that vote there were three ayes and four noes. >> three ayes and four noes, the

amendment is not agreed to. just the senate votes. is there a next amendment offered by mr. lahey? he has an amendment and the clerk will read the title of the amendment. >> amendment to the conference report for 524 offered by mr. lahey. >> and the amendment will be considered as read and the staff will distribute the amendment to the senate side and the gentleman from vermont is recognized for five minutes in support of his maemt. >> thank you militia and i helped put together the -- this amendment 16797, is that correct? >> it is. >> thank you. i worked to help create the heroin task force program

legislation. i hear from law enforcement people all over the country they have to have additional funds to combat traffickers. this not only affects vermont, it helps fix states like tennessee or wisconsin, michigan. i mention those only because they get critical support sffro this last year. now this draft removes direct task force funding and puts in the a block grand. it would really place the task force program at risk. it would allow it to be spend on nine other allowable issues. we really wanted this the way it was. senator grassley had methamphetamine added to it and i agree with him. i know the director of the

tennessee bureau of investigation, i just happened to mention that state, wrote a letter on behalf of the association of state criminal investigative agencies in support of it. the fact is there's no easy way out of all this. but the fact is, whether you're in a state with large cities or small areas you need this help and this is set soup so that if like every state, where you've got small areas, rural areas, you can get help. your big cities can, too, but you can get help in the smaller areas, it is something that has worked. . that's the other advantage of it. the police, everybody else, they tell us it works. i think we should keep something that works. i yield back my time, mr. chairman. >> mr. chairman? >> gentleman from iowa.

>> this amendment restores a separate stand alone authorization for heroine and methamphetamine law task forces as provided by in section 204 that passed the senate. the amendment offauthorizes the task forces in the state appropriations bill. the conference report currently provides resources for heroin investigations but only as an allowable use under section 201 grant program. the report does not authorize methamphetamine task forces at all. i know these task forces are important for law enforcement in iowa and particularly the methamphetamine task force. given how strained resources are at the state level, i support having these task forces funded through a separate authorization. i urge my colleagues to support the amendment. does anybody else on the majority side want to speak?

i field back my time. [ inaudible ] >> apparently the wrong amendment was distributed on the house side but the amendment is being debated on the senate -- so it will come back, we'll get you the right one. i apologize. the wrong amendment on this side was distributed. i'm sorry about that. i wish the gentleman had raised the parliamentary question earlier. we would have had it in his paw earlier. all right. senate yields back the balance of the time that the vote occurs on the lahey-grassley amendment. those in favor will say aye. opposed say no? in the opinion of the chair the ayes have it. the amendment is agreed to. the amendment now comes for

debate on the house side as it was passed in the senate and the gentleman from virginia, mr. goodlatte, will control the first five minutes. >> mr. chairman, thank you very much. i rise in opposition to this amendment. because the comprehensive opioid abuse reduction act is designed to be just that, a comprehensive grants program, a purposeful area was specifically included to provide for grants for locating or investigating illicit activities related to the unlawful distribution of opioids. language that generally tracks the task force language in section 204 of s-524. in contrast, this amendment would single out task forces resulted in a disjointed rather than comprehensive doj grant program for addressing the opioid epidemic. the leahy-grassley amendment attempts to elevate these pet programs which have only

benefitted a small number of select states and have never been supported in a house appropriations bill. in fact, the justice department's fy-2017 budget submission proposed to eliminate the programs. indefensebly, the leahy-grassley amendment gives the task forces preferential treatment over drug and veterans treatment court program, prescription drug monitoring initiatives, residential substance abuse programs and all of the other extremely important efforts supported by the comprehensive opioid abuse reduction act, moreover, this amendment gives these task forces and exclusive authorization for appropriations that is not fully offset for the purposes of the comprehensive opioid abuse reduction act. it falls short by $15 million. the house went off of its way to offset the authorizations in the act. this amendment would negate that effort. it is an incontrovertible fact

that the funding level provided by by the house for the comprehensive opioid abuse reduction act is already significantly higher than the analogous authorization for appropriations included is-24 and it is fully offset under the houses cut-go protocol. the comprehensive abuse prevention act goes above and beyond to authorization new funding for its diverse purpose areas. its authorization for appropriations was carefully developed as a result of a thorough consideration of both the senate provisions and the house amendment's language as well as a disciplined recognition of the need to focus resources on opioid addiction at this time. the leahy-grassley amendment also introduces unnecessary duplication into the comprehensive opioid abuse reduction act and attempts to shift some of the available funding from the anti-opioid efforts to methamphetamine. under the circumstances, this amendment is simply a poor fit

for this bill, a vote to reject the leahy-grassley amendment is not a vote against grants for investigating illicit activities related to the unlawful distribution of opioids. it is simply a vote in favor of a comprehensive approach that supports law enforcement efforts to address opioid abuse, one purpose of which is to authorize grants for the purpose of investigating illicit activities related to the unlawful distribution of opioids. therefore i urge my colleagues, the house conferees to reject this amendment. >> does the gentleman yield back? >> i reserve the balance of my time. >> gentleman reserves. 1:38. are there other members wishing to speak in opposition to the leahy-grassley amendment? i would note dr. mcdermott indicated it's amendment oll-16797. are there other members wishing to speak against the amendment so the gentleman yields back?

>> i yield jack? and are there members on the house side willing to speak in support of the amendment? i see none. the vote occurs on the amendment adopted on the senate side offered by mr. lah leahy and grassley. in the opinion of the chair, the noes have it. the amendment is not agreed to and that's the way that it is. the next amendment is -- the gentlelady from washington state, ms. murray has an amendment at the desk. i understand it's hey-16852. and we'll have the staff -- clerk will report the title of the amendment. >> amendment to the conference report for s-524 offered by ms. murray. >> and this amendment will be considered as read and the gentlelady is recognized for five minutes. >> thank you, mr. chairman,

local v.a. medical centers have patient advocates that are responsible for hearing complaints from veterans seeking care and helping them get the care that they need. but the v.a. does a poor job overseeing patient advocates system wide, tracking complaints from around the country and intervening where needed to make sure veterans get the high quality care that they have earned. these failures led to tragedy in thoma, wisconsin, when no one would listen when jason simkikowski raised concerns about how all the medications he was being given at the v.a. medical center were making him feel and act. incredibly, the patient advocate at the facility where jason was treated reported to the chief of staff who was ultimately responsible for prescribing the deadly mix of medication that led to jason's death. to prevent that from happening

again, this amendment would establish a central and independent office of patient advocacy to help patient advocates effectively meet their obligations to veterans, this office will give patient advocates national level support if a medical center will not resolve the problem they are working on and will ensure patient advocates report to an independent office rather than the medical center. a dedicated office reporting to the undersecretary for health will ensure that the program remains accountable to the needs of veterans and their families and will prevent any undue pressure on advocates from the local medical facility leadership. this provision is widely supported by the veterans service organizations and was agreed to by both sides of the veterans affairs committee and is included in the veterans first act. appreciate my colleagues including much of senator baldwin's vital legislation on

opioid treatment in v.a. this provision is a key component and we should include it just as the veterans committee has and i move its adoption. >> does the gentleman from tennessee want time? >> mr. chairman, i support senator murray's amendment and as she says so does the chairman of the veterans affairs committee. >> other members wishing to -- mr. grassley? >> for reasons beyond just this, i think we ought to support it because going back to august 2, 2014, we passed legislation we thought would dramatically change the direction of the v.a. and it has accomplished very little. a new secretary has accomplished very little. we aren't doing enough for our veterans and this is a step in the direction of congress weighing in to make the necessary changes so that the v.a. gets the message.

>> mr. chairman, senator murray, senator grassley, senator alexander and i totally agree on this. it's easy to get a parade and talk about veterans, we have to talk about the things we need to care for them. this does. it should be included. i thank the senator from washington state. >> other members in the senate side wishing to speak on the amendments? seeing none, the vote occurs, on the amendment offered by the gentlelady from washington state those in favor say aye. those opposed say no. in the opinion of the chair the amendment is agreed to. the amendment comes to the house side. this is a good amendment. we need to support it and i would urge my colleagues to vote in favor. other members wishing to speak? seeing none, the vote occurs on agreeing to the murray amendment

from the house side, those in favor will say aye. opposed say no. the opinion of the chair, the ayes have it, the amendment is agreed to as part of the conferenc conferenc conference. is the jackson-lee amendment ready yet? >> we're ready, i don't know if we have the of pease. >> are there copies of the jackson-lee amendment? not quite. so maybe -- copies are coming to the desk. >> okay, why don't we go with the jackson lee amendment as amended by -- i think she has a uc request first, is that right, to change it? >> i do, mr. chairman, members, thank you for your courtesy. >> if the clerk will report the title of the amendment. >> amendment to the conference report on s-524 offered by ms.

jackson-lee of texas. >> i'll just say the gentlelady has an amendment she offers by unanimous consent. is there objection to the cha e changes? we can't do it in the senate t yet. it will come to you if it passes here. so with that, the gentlelady's amendment, she's recognized for five minutes to offer her amendment. >> i have unanimous consent that the amendment be accepted as amende amended. >> the gentlelady has five minutes in support of her amendment. >> i thank you. let me do this for the members and my apologies to you. we have engaged in legislative compromise. it's a sense of congress that decades of experience and research have demonstrated that that the opioid abuse epidemic and other -- excuse me. have demonstrated that a

fiscally responsible approach to addressing the opioid abuse epidemic and other substance abuse epidemics requires treating such epidemics as a public health emergency emphasizing prevention, treatment and recovery. let me thank my chairman and ranking member for working with me on this and ask my colleagues to support it and this is as i started out, i indicated that this is a significant moment in history. we want to move forward and assure as many of my colleagues have said that we have resources. but we also want to use this as a model. many of you are -- need not to be reminded of the crack cocaine epidemic which resulted in now almost two million people who are incarcerated in the nation's prisons, both local, state, and federal. and this point simply says we have found a model that deals with those who are addicted, who

are not criminally involved, who are literally sick and it is important to treat such epidemics, whether it's meth or other drugs, as public health emergencies emphasizing prevention, treatment and recovery. no matter where each conferee ends up on the final conference report, i think it's safe to say the legislation we're considering holds the promise of saving and redeeming lives. tens of thousands. in many of our communities throughout america, we lost thousands of lives, families destroyed through the epidemic of crack cocaine and certainly meth is another one, we know our health professionals were overwhelmed, our emergency centers were overwhelmed. in particular, those who were locked up, 80% of the defendants sentence for crack offenses were african-american. in spite of the fact that they were sick, addicted people with broken lives. i believe it's important as we look forward to this conference

that we reflect what the american public health association has indicated, that the ending of criminalization of drugs and drug consumers, prioritizing proven health treatment and harm reduction strategies, expanding and removing barriers to treatment and harm reduction services, including some innovative ways is a way to address the sickness, this epidemic and certainly we have experienced that in many of our inner city communities. i can't tell you the funerals that i've gone to simply because people were addicted to crack and i'm sure there are many other stories. i'm a member of the opioid heroin caucus. i want to applaud them and i want to applaud the conferees as well. the jackson lee amendment is an explicit expression of the ground breaking work done by the legislation of these conferees and shows the congress has courage to learn from the past and is unafraid to embrace

innovative and promising methods the problem confronting our nation. clearly i want to commend the chairman upton and goodlatte, ranking members conyers and palone, i want to commend senator leahy and grassley and i simply want to say we buried too many people. we know what crack did. we know they're drug epidemics, we don't nope what is next. any city just tried to do something about push users because of the drain on the public health system. we need to realize that we can deal with this in a way that is more than the way we've looked at before so i ask my colleagues to support the jackson lee amendment and i'm not sure, did the gentlelady want me to yield? >> gentlelady from new hampshire. >> i yield the the gentlelady. sorry, i didn't see you. >> thank you very much and thank you to ms. jackson lee. i'm speaking on behalf as co-chair of the task force,

bipartisan congressional task force to combat the heroin epidemic and i just want to join your comments, i come from a rural state, this is a new phenomenon for us but i commend your amendment, i urge a bipartisan support. we have now 85 members, bipartisan in our task force because we recognize that this is a public health emergency, just very briefly, one county in my district, sullivan county, they were able to implement treatment during incarceration, have a year-long program after and brought the recidivism rate from the 80th percentile to the 20th percentile. that is something that everybody can embrace, we can save tax dollars and we can save people's lives. i commend your amendment and i urge a strong bipartisan vote. >> thank you, i ask for support of the jackson lee amendment. i yield back. >> chair recognizes the

gentleman from virginia mr. goodlatte. >> i want to thank the gentlewoman for offering this sense of the congress amendment and i want to especially thank her for working with me and others on the committee to modify the language to make it bipartisan and acceptable to all. i commend her for doing just that. >> if the gentleman will yield? >> i also want to thank the gentlelady from texas for sharing the amendment with us yesterday and working with the gentleman from virginia to modify it. it's a very good piece -- and amendment and i support it as well and yield back to the gentleman from virginia who yields back? >> i yield back. >> all those in favor of the time -- all those in favor of the jackson lee amendment will say eye. those opposed say no, in the opinion of the chair the eyes have it, the amendment is agreed to and the amendment now as modified goes to the senate. chair would recognize the gentleman from iowa.

seeing none, the vote occurs on the amendment passed by the house conferees, those in favor will say eaye, those opposed no. in the opinion of the chair the ayes have it. the amendment is included as part of the conference agreement. the next amendment is offered by the gentleman from tennessee mr. coen has an amendment at the desk. >> thank you, mr. chairman. >> it's number 112 and the clerk will report the title of the amendment. >> amendment to the conference report on s-524 offered by mr. cohan. >> the amendment will be considered as read. the staff will distribute the amendment and the gentleman is recognized for five minutes in support of his amendment. >> mr. chairman, i in my opening statement talked about the messaging problem this congress and our governments in general have had with heroin and marijuana and other drugs. a young man who -- i dated his mother and we had a conversation

one time at dinner about marijuana. and he smoked marijuana. he shouldn't have, he was young but he did and he said "nobody my age believes marijuana is bad for you because we smoked it and we've seen it doesn't have the same effects on us people say it does." that young man died from a heroin overdose. he was from a very prominent family in memphis, east memphis, "fortune" 500 world. i talked to a family in new york, friends of mine, young man, young man's now a prominent actor and musician. i asked him about marijuana several years ago and he said "my friends all smoke it, they don't have a problem therefore they don't see a problem with other drugs like cocaine and crack and meth and heroin." we have mismanaged the messaging of this for years so kids do drugs because they don't believe

the government. they don't believe people when they tell them not to do heroin, not to do meth, not do crack, not do marijuana. marijuana doesn't belong in that class. this amendment would tell nih to study marijuana and see if it's an appropriate alternative to opioids. it may be. and study they should do. i have a further amendment, 109, that ask it be rescheduled to schedule 2 so they can study it. all of the groups that are in favor of this have asked me to withdraw the amendments. that i believe the best i can do today is message so with the permission of the committee i move to withdraw the amendment and hope that we will in the future better address this issue and speak the truth to what the effects of heroine are and opioids compared to marijuana.

>> gentleman withdraws his amendment. appreciate that. and the next amendment is offered by mr. wyden. amendment tam-16328. the clerk will report the title of the amendment. >> amendment to the conference report for s-24 offered by mr. wyden. >> and the amendment will be considered as read. the staff will distribute the amendment to the senate side and the gentleman from oregon is recognized for five minutes in support of his amendment. >> thank you very much, mr. chairman. mr. chairman and colleagues, this is an amendment designed to make sure that when you have task forces and the conference report creates an interagency pain management task force you don't create a situation where the fox guards the henhouse. there are non-federal members

that will be serving as part of this task force and i think it's important that there be clear rules to make sure that there isn't bias in the work of the task force. there will be representatives of professional associations and pain advocacy group which is often receive substantial amounts of funding from pharmaceutical manufacturers. i have raised this issue before with the secretary of health and human services and the national academy of medicine and it seems to me if you're going to have non-federal participants you ought to have clear guidelines to make sure the business of the task force and any financial interest is fully disclosed. as of right now, the conference language has no safeguards to ensure that either occurs and this is an approach that does

not micromanage what the rules of the road ought to be but it requires there ought to be rules. there ought to be rules to make sure that special interests don't hijack the work of the task force, particularly in the opioid area in effect encourage overprescribing. so i hope my colleagues will support the amendment. it is a no-cost amendment, obviously it deals with conflicts of interest and i urge colleagues to support this in a bipartisan way. i compare this to the kind of work that senator grassley and i have done over the years to watchdog for these kinds of abu abuses. i hope colleagues will support it. i yield back. >> the gentleman might want to yield to the gentleman from iowa, mr. grassley? he seeks the time. >> i would be happy to yield to my colleague from iowa. >> with my reputation for transparency and public policy i'm going to support this recommendation and support this

amendment and recommend that my colleagues do as well. >> mr. chairman? mr. chairman i'm in favor of transparency and public policy but i think the conference report already provides that. it requires that the task force to provide the public with at least 90 days to comment on any recommendations made by the task force. so if we have an urgent situation here and we're trying to find the best practices for pain management to recommend to doctors and hospitals and others dealing with the abuse of pain medication i'm afraid that having the secretary develop guidelines and procedures and the federal government, that takes a long time and it would discourage, i'm afraid, many of the best minds, the people who know the most about what we're talking about from volunteering

their ideas and suggestions. so i like transparency, i like openness and i like the provision in the conference report that requires the task force to provide the public at least 90 days to comment. i also like the idea of having people who know the most about the subject available to tell us what the best practices are. so i'm going to vote no. >> mr. chairman? i don't think i used all my time. >> you didn't but he yielded back but mr. al sandler yield to you. >> one additional minute? >> the gentleman is recognized. >> thank you. the concern i have that is with respect to this task force. there are no standards in the bill with respect to conflicts. we've had this problem before, colleagues. i don't know why we'd want to open this up again, particularly at a time where there's been concern that through these task forces there's been

encouragement for overprescribing of opioids. so i thank my colleague for the extra time and appreciate senator grassley's support. >> the gentleman yields back? >> yeah. i any we need a roll call on this. >> okay, the senate will ask -- a roll call has been requested on this amendment. the clerk will call the roll. >> mr. grassley? >> aye. >> mr. grassley yovotes aye. mr. alexander votes no. mr. hatch -- >> is there a proxy? >> no by proxy. >> mr. chairman hatch votes no, mr. sessions? >> no by proxy. >> mr. sessions votes no. mr. leahy. >> aye by proxy. >> mr. leahy votes yeah. ms. murray? ms. murray votes yeah. mr. wyden? mr. wyden votes yeah. >> other members wishing to vote or change the votes? seeing none the clerk will report the tally. >> mr. chairman, on that vote there were four ayes and three nays. >> four ayes, three nays.

the amendment is agreed to on the senate side which then sends it to the house side. does the house have the language of the bill? i think we do have it. i will claim the time on the majority side and would just note that this amendment to the pain management task force was never raised as part of either chamber's deliberations that we're aware of during committee or floor considerations. particularly given some of the vague terminology used, it could have unintended consequences that have not been carefully considered such as making qualified participants less willing to participate in the task force, including some of the foremost experts in pain management. it could also cast unwarranted doubt on the integrity or validity of the recommendations raised by participants, including patients and veterans so i would respectfully urge my

colleagues on the house side to vote no on the amendment and ask if anyone in the majority would like to speak? seeing none i yield back. i would recognize mr. palone for five minutes on the minority side. >> and i would disagree and urge the that my colleagues support the wyden amendment. it seems clear to me that it is moving in the direction of ensuring greater transparency. and i think is important to address the potential conflict of interest. pal loan so i would urge my colleagues to vote in favor. i would ask for a roll call. >> i would note to the clerk on the house side the general conferees, energy and commerce and judiciary are appropriate to vote on this amendment as passed

by the senate and the clerk will call the role. >> mr. pitts? mr. pitts votes no. mr. lance? >> mr. lance votes no by proxy. >> mr. lance votes no. mr. guthrie? >> mr. guthrie votes no by proxy. >> mr. guthrie votes no. mr. kinsinger. mrs. brooks? >> mrs. brooks votes no. mr. goodlatte? mr. goodlatte votes no. mr. sensenbrenner? >> votes no by proxy. >> mr. sensenbrenner votes no. mr. smith? >> splchlt smith votes no by proxy. >> mr. smith votes no. mr. moreno. >> no by approximately. >> mr. colins? >> mr. collins votes no by proxy. >> mr. collins votes no.

mr. trot? >> mr. trot votes no by proxy. >> mr. bishop? >> mr. bishop votes no by proxy. >> mr. bishop votes no. mr. mccarthy? >> mr. mccarthy votes no by proxy. >> mr. pallone? >> aye. >> mr. pallone votes eye. >> mr.ly han? >> aye by proxy. mr. sarbanes votes aye. mr. greene? mr. green votes aye. mr. conniers? >> if eye by proxy. >> mr. conyers votes eye. ms. jackson lee? a. >> eye. >> ms. chu votes aye. mr. cohen votes aye. ms. esty votes aye. ms. customer? ms. custer votes aye. pl

mr. courtney votes aye. chairman upton? >> votes no. >> chairman upton votes no. >> members wish to change the vote. seeing none, the clerk will report the tally. >> mr. chairman, on that street there were 11 ayes and 15 nays. >> 11 eyes and 15 nays, the amendment is not agreat to. chair would recognize the gentleman from tennessee, mr. cohen, to offer amendment number 109 and the clerk will report the title of the amendment. >> mr. chairman, as in the last amendment, i think this may go beyond our call on rescheduling marijuana and i don't want to put people to that issue nor do i want them to vote no on process rather than substance and i hope in the future we will get this straight and we will at least have study on mare wan in which we should and i would ask unanimous consent to withdraw the amendment at this time. >> the request is granted, the

amendment is withdrawn. the chair would know recognize ms. murray for an amendment and the clerk will report the title of the amendment on the murray 2 cybill the amendment on v.a. bonuses. >> amendment to the conversation report for s-524 offered by ms. murray. >> the amendment will be considered as read. the staff will distribute the amendment and the gentlelady is recognized for five minutes in support of her amendment. >> thank you, mr. chairman, i'll be short. this is a simple amount that adds language it is the sense of congress that reductions due to the limitation on bonuses at the v.a. should not disproportionately affect lower-wage employees. it also says v.a. should prioritize awarding bonuses to incentivize high-performing employees in those positions where the v.a. struggles to retain good people. the v.a. certainly needs important reforms in many areas but i hope we can agree that the

rank-and-file employees should not be targeted first over top executives. both the majority and minority on the veterans affairs committee worked on this language for the veterans first act and i hope we can spoupportt for this language here. >> mr. chairman? i support this amendment and urge my colleagues to support it as zblel do you want to call for a voice vote? >> those in favor say aye. those opposed say no. the ayes seem to have it, the ayes do have it and the amendment is adopted on the senate side. >> amendment is adopted on the senate side. now comes to the house side. let me say i think this is a very good aechlt i would urge my colleagues to support it and yield back. with that the vote occurs on the amendment offered in the house by the adapted meant by ms. murray. those in favor say aye.

those oppose say no. in the opinion of the chair the ayes have it the amendment is agreed to and made part of the conference the chair will now recognize mr. wyden. >> the medicaid and windfall amendment. >> goe-16301 i believe is the number and the clerk will report the title of the amendment. >> mr. chairman, i am not offering that amendment but if you want to -- >> did you -- >> ask me to offer the medicaid windfall amendment i would be glad to do that. >> that's fine. go ahead. you want to do the -- >> medicaid windfall. >> ern-16169. >> yes, that's it, mr. chairman. >> and the clerk will report the title of the amendment. >> amendment to the conference report for s-524 offered by mr.

wyden. >> and the amendment will be considered as read. the staff will distribute the amendment and the gentleman is recognized for five mnz. >> mr. chairman, there's confusion here. this is the amendment that i've authored on the medicaid windfall, not the amendment on -- >> that's right. >> you got it, medicaid windfall? >> correct. >> colleagues, in the medicaid program the drug companies pay a rebate to the state and the federal government to offer their drugs to the 70 million americans on medicaid. currently, drug companies making opioids pay the full rebate. there is a provision in this bill, however, that would allow the companies to get special treatment, special treatment and a reduced rebate if they sell opioids that are considered so-called abuse deterrents.

now, the truth is this is a windfall to the companies because they are already theiring their drugs in that manner and they have been doing so for many years. so what this amendment does is it strikes the windfall to the manufacturers who at least in some cases with overprescribing have distributed to the problem and instead funds care for low income pregnant women on medicaid who very much need addiction treatment. these women who need assistance ought to have every opportunity to get back on track and that's what this amendment would do. >> does the gentleman yield back? >> i do. in fact, mr. chairman, only -- i

want to wait and hear the response, i'm going to retain my time. >> you reserve your time. chair would recognize the gentleman from tennessee on the wyden amendment. >> unless senator grassley wants to go? >> i would take my time off of wyden's because i'm going to vote for this amendment. i think it's something that needs to be done and this clarifies it and so i urge my colleagues to vote aye. >> mr. chairman? >> tennessee? >> mr. chairman, senator hatch, chairman of the finance committee, has asked me to speak on this amendment which proposes to strike bipartisan language included by the house of representatives to encourage the manufacturer of drug formulations that are more difficult to abuse that are resistant to crushing up for injecting or snorting by drug addicts. it's a policy supported by the prosecution and included in the president's budget request.

so what the policy seeks to do is to provide an important incentive to develop abuse-deterrent formulations for drugs such as opioids. that seems to me to be a good incentive, a good practice, one that's consistent with our goal here. on top of that, this amendment would replace that policy with another policy that's a very large issue and hasn't been fully vetted. we're having a large discussion in the senate about whether or to what extent to allow medicaid to pay for patients who go into institutions for mental health. to do that for all patients who might go is a very expensive proposition and is something that we'll need to discuss on the senate floor and find a way to pay for and be consistent and

fair to all patients. so because it gets rid of a valuable incentive that could discourage opioid abuse and gets into an area that hadn't been fully vetted i'm going to join senator hatch in voting no. >> mr. chairman? >> gentleman still has two minutes left. >> thank you. colleagues, this is a pretty obvious choice, we are going to choose low income pregnant women. you do that by voting for my amendment or you go with the companies wi companies who are getting a windfall here. it would be one thing, colleagues, because senator alexander, as is often the case, raises an important issue. if we were talking about research, if we were talking about something that hadn't been done i can see why there might be an argument for what's in the conference report. but the reality is, the

companies have been making the drug in the manner i've described for years and years and years. there's no need to give them this windfall. so this is a clear choice. i'm very appreciative of senator grassley and my colleagues on the finance committee once again supporting an effort that in effect promoats the public interest and i hope colleagues will support this. >> gentleman yields back? >> ask for a role call vote. >> role call is requested. clerk will call the role. >> mr. grassley? >> aye. >> mr. grassley votes aye. mr. alexander? >> no. >> mr. alexander votes no. mr. hatch? >> no by proxy. >> mr. hatch votes no. mr. sessions? >> no by proxy. >> mr. sessions votes no. mr. leahy? mr. leahy votes aye. ms. murray votes aye. mr. wyden votes aye.

>> any members wishing to change your votes? seeing none, the clerk will report the tally. >> mr. chairman, on that vote there were four ayes and three nays. >> four ayes and three noes the amendment is agreed to and comes to the house conferees. and that -- before the majority, you are recognized for five minutes. >> thank you, mr. chairman, appreciate this. i oppose this amendment because it strikes a bipartisan policy kwhvs included in the house passed bill and which the administration supports. this amendment strikes an important policy that represents a key step forward in combatting opioid abuse. this policy fixes an unintended consequence with the medicaid drug rebate program that effectively discourages drug manufacturers from producing opioids that are harder to abuse. specifically this policy would exempt abuse deterrent

formulations of drugs from the definition of line extension for purposes of calculating medicaid rebates. this policy is bipartisan and has strong support from this administration. supporting this amendment would remove a key policy to help combat opioid abuse and i oppose the amendment. i yield back the balance of my time, mr. chairman. >> gentleman yields back. does the gentleman want five minutes in support of the amendment? >> yes. >> i would urge support for wyden amendment. in my opinion, every effort should be made to encourage and facilitate pregnant and postpartum women to seek substance abuse treatment, both for themselves and for their babies. this amendment ensures support for this vulnerable population when seeking treatment, it will support continuity of care and will maintain the continuity of care so i support this amendment. it is as mr. wyden said fully offset and i would ask for a

roll call mr. chairman. >> mr. chairman? >> i yield to my colleague -- >> parliamentary inquiry. what section is being struck by this amendment? >> i don't have the amendment -- >> 705. >> 705 is what i'm told. further speakers on the minority side? seeing none, roll call is requeste requested. >> i'm just -- a brief moment. i want to support the wyden amendment because over my legislative efforts i've been working with pregnant women. i can't emphasize enough as a woman the importance of this initiative dealing with women when they're most vulnerable and they're working, i hope, to recover and restore a better health for that unborn baby. i support the amendment, i yield back. >> thank the gentlewoman.

>> gentleman yields back, a recorded vote has been asked for so i would note -- instruct the clerk that the general conferees, energy and commerce and judiciary members are included in the vote and the clerk will call the role. >> mr. pitts? >> no by proxy. >> mr. pits votes no. mr. lance? >> no by proxy. >> mr. lance votes no. mr. guthrie? mr. guthrie votes no. mr. kinsinger? mr. kinsinger votes no. mr. bucshon? mr. bucshon votes no. mrs. brooks? >> no by proxy. >> will mrs. brooks votes no. mr. goodlatte? mr. goodlatte votes no. mr. seine seine brenner? >> no by proxy. >> mr. sensenbrenner votes no. mr. smith. >> no by proxy. >> mr. moreno. >> no by proxy. >> mr. moreno votes no. mr. collins? >> no by proxy. >> mr. collins votes no. mr. trott?

>> no by proxy. >> mr. trott votes no. mr. bishop? >> no by proxy. >> mr. bishop votes no. mr. mccarthy. >> no by proxy. >> mr. mccarthy votes no. mr. pallone? >> yes. >> mr. pallone votes aye. mr. luhane? >> yes by proxy. >> mr. sarbanes? mr. sarbanes votes aye. mr. green? mr. green votes aye. mr. conniers? >> yes by proxy. >> mr. conyers votes aye. ms. jackson lee. >> aye. >> ms. jackson lee votes aye. ms. chu? ms. chu votes aye. mr. cohen? >> yes by proxy. >> mr. cohen votes aye. ms. estie? ms. estie votes eye. many custer votes aye. mr. courtney votes aye. chairman upton? >> votes no. >> chairman upton votes no. >> member wishing to change

their vote? seeing none the clerk will report the tally. >> mr. chairman, on that vote there were 11 ayes 15 noes. >> 11 ayes, 15 noes. the amendment is not agreed to mr. scott has an amendment at the desk to be offered with mr. pallone as i understand it and the clerk will -- is it number 056? the clerk will report the title of the amendment? >> amendment to conference report on s-524 offered by mr. scott. >> and the amendment will be considered as read. the staff will distribute the amendment and the gentleman from virginia is recognized for five minutes. >> thank you, mr. chairman, mr. chairman this simply adds educational and recovery program for offenders in prisons, jails, and juvenile facilities to the title six block grant program that would be an allowable use for states. mr. chairman, this would allow pilot programs to enable us to

figure out what works? these programs as it's already been said, this is the opioid bill and it's hard to -- it would be hard to explain a comprehensive bill that does not deal with persons already in prison. we're not going to solve any problems by putting people in jail and having them come out as addicted as they went in. this provision was part of the senate passed bill with -- that passed with virtue unanimous support and was introduced in the house with other 100 co-sponsors. 40 of which were republicans so it has strong bipartisan support. so i would hope, mr. chairman, that we would adopt the amendment. >> the gentleman yield? >> i yield. >> i'd like to -- i'm pleased to join mr. scott in offering this amendment. the purpose of section 601 is to provide funding to states for the implementation of a comprehensive response to this crisis. including by expanding education

and prevention efforts, inproving state prescription drug monitoring programs and expanding access to treatment. this amendment would ensure states include a focus on helping offenders recover from opioid use disorder as part of efforts to expand access to treatment services in the state. such a focus will help ensure offenders get the treatment and support services they need in order to recover from their substance use disorder as well as to lead healthy and productive lives upon their release sfwr incarceration. i think this is an important amendment. i urge my colleagues to support this amendment and yield back to mr. scott. >> thank you mr. scott and mr. pallone, i want to join you in this amendment and appreciate you bringing it forward. we have such a catch-22 that we're just locking people up and not giving them any treatment and then we act shocked when they come out and end up back in

this vicious cycle of committing crimes in order to pay for their drug habit. i've seen, i've been, i've visited treatment facilities in house within our incarceration that are effective that they can make a difference, turn people's lives around and for my colleagues on both sides of the aisle i just want to say it's a very cost-effective choice for the taxpayer because we can drop those recidivism rates from, as i said, the 80th percentile down to the 20th percentile. put people back to work in their communities raising their families and they've overcome this disease that we know as substance use disorder. so thank you, i yield back, appreciate your time. >> you can reserve it, i'll give you an extra minute. let me take five minutes against the amendment. the amendment would direct the grants awarded under section 601

straited by the secretary of hhs to go towards incarcerated individuals. currently as we know the justice department is responsible for providing treatment for offenders in prisons, jails and juvenile facilities. though i support the goal of what the gentleman is trying to do, theres a clear delineation between who's responsible for care in different settings when someone is incarcerated or not. the amendment would make it less clear on the state level who is held accountable and responsible for providing treatment so i would urge my colleagues to oppose the amendment and yield back my time. does the gentleman still wish his minute? >> yes, yes, thank you, mr. chairman. reclaiming my time. i'll just say that it doesn't direct the states to do anything, just makes it an allowable use and there's not a lot of money on this line item so it would be more like pilot projects so we can find what works and doesn't work. so appreciate the support of the

purpose of the amendment and i hope the amendment will be documented. >> you know, in the future i would like to work with the gentleman. maybe we can get language that we can accept on our side but appreciate the amendment. with that, time is expired. those in favor of the amendment will say aye. those opposed say no. my mike was on. in the opinion of the chair the nos have it. the amendment is not agreed to. >> mr. chairman? i have a unanimous consent for introduction into the record. thank you, mr. chairman i'd like to add into the record a statement of the american public health association for science, action and health. i ask unanimous consent to place this into the record. >> without objection. it's my understanding there are no further amendments to be offered. is that correct? any member wish to offer an

amendment that was put in by last night? so seeing none we've now concluded debate on the amendments filed for today's meeting of the house and senate conferees on s-524. the kara act of 2016, we will amend the text of the conference report to reflect the amendments adopted today, i want to thank members and staff for their hard work today and over this congress on this very, very important issue. at some point following the meeting we'll announce a time and place for members to review the final conference report text and to then sign that conference report without objection. staff is authorized to make technical and confirming changes to the legislation approved by the committee today. so ordered and without objection the committee stands adjourned.

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[ indistinct conversation ] c-span's "washington journal" live everyday with news and policy issues that impact you. coming up thursday morning, texas republican congressman blake farenthold will join us

and karen bass will also talk about the fbi's recommendation of no criminal charges against mrs. clinton as well as the 2016 presidential campaign. plus representative bass will discuss possible house votes on gun violence. the baton rouge police shooting of alton sterling and president obama's announcement to slow the pace of afghanistan troop withdrawal. be sure to watch c-span's washington journal live at 7:00 a.m. eastern thursday morning. join the discussion. fbi director james comey testifies on capitol hill thursday on his recommendation that hillary clinton not be prosecuted for her use of a private e-mail server. director comey will appear before the house oversight and government reform committee live at 10:00 a.m. eastern here on c-span three.

>> if we're going to invest a total $100 million into higher education in the commonwealth, we have to change the way we deliver education and more from the dollars we're getting. sunday night on "q&a" aei resident fellow gerard robinson talks about the state of education in the u.s. >> there's a body of literature that's pretty clear there's certain courses you should take -- math, science, english -- that should be in place if you expect to be successful in college to simply accept students who haven't filled that obligation is doing a great disservice to them and it's sullying the effort of affirmative action which is something i support. >> sunday night at 8:00 eastern on c-span's "q&a." book tv has 48 hours of non-fiction books and authors every weekend. here are some programs to watch out for.