opiate addiction prevention efforts, but it is something maryland has enacted in the last 4-5 months, and hospitals have to provide those services to individuals who come in from an overdose. usually when they arrive, they are revived, good to go, and they want to leave. they refuse outpatient and inpatient treatment. there's nothing we can do. that is they are right -- their right. >> good morning, everyone. thank you for coming to our round table to discuss the opioid epidemic. i'm the baltimore city health

commissioner and i would like to thank congressman cummings for bringing us together and for inviting senator warren to baltimore. thank you to mayor catherine pugh, senator cardin, and congressman darman for attending. and thank you to the team at health care for the homeless for hosting. yesterday maryland released data for overdose deaths. 82 2017, there were 2002 total. of those, 761 occurred in baltimore city. 573 of these deaths in 2017 involved fentanyl. in 2013, 12 deaths involved fentanyl, which is a 5000% increase in four years. these numbers are terrifying and frustrating. terrifying because they keep

increasing, and we don't know if this is the peak of the epidemic. the numbers are frustrating because those of us on the front lines know what works to stop this epidemic. in baltimore, every day residents have used the opioid narcan to save 1130 lives in 2017. that is not counting the lives saved by first responders, police officers, firefighters, or ems. we are having to ration naloxone. every week i have to decide who will get naloxone and who will go without. does it make sense that we are rationing in the middle of a public health emergency? we are focused on treating addiction as the disease that it is, working to ensure all

hospitals have standardized levels of care for addiction treatment, and many partners in the community do exceptional work on a shoestring budget. imagine how many more lives we could save if we had the resources to do so. this is why we stand in such strong support of the care act that will give us the same funding proportional to the directly to local jurisdictions like ours that are the hardest hit. to tell us more about the care act, i have the honor of introducing my congressman, a public health hero, and an inspiration to many, congressman elijah cummings. rep. cummings: thank you. before i discuss the care act, i want to thank you dr. wen for moderating, but more importantly for being a tireless leader with regard to health care in our city and nation. i think you also for your

invaluable assistance in drafting the care act and spreading the word about the urgent need for this approach. thank you, senator warren, for joining us and working with me on the care act. i am so proud of all that we have been able to do together over the years. perspectivefor your and tremendous leadership. i think my distinguished colleagues, and i am so glad they are here. sarbanesardin and john for joining us. and finally, mayor pugh for her to advancing her city and making us a model for the country. withnk all of our families the willingness to share their

expertise and experiences. i think health care for the homeless for the vital services you provide and for hosting us. you have done a phenomenal job. i want to thank you so much for everything you have done to make today's event possible. we are honored to be here. senator warren and i introduced the care act in april to take the proven ryan white act model that our nation has used successfully and successfully employed to fight hiv aids and apply it to the drug prices. it would provide funding and flexibility to enable hard-hit communities to respond to their specific challenges. we are facing an urgent public health crisis. let me be clear, it is an urgent public health crisis. we can no longer nibble around

the edges. people inkilling 175 this nation, including several people in this city, every single day. every day. presidentimate of the trump administration, it is us asg harm in costing much as $500 billion per year. of people with0% the disease of addiction are getting treatment. i ifa size the disease -- emphasize the disease. until we get people to support they need, we will not tackle this emergency, and people who could have been saved will continue to die. i am very pleased that the care

act has more than 75 cosponsors in the house. i am pleased that our entire delegation except one is cosponsors of this legislation in the house. while it won't be today, i believe one day, and one day soon, we will enact this bill and finally, as a nation, invest the resources that will enable us to address this crisis. let me introduce senator elizabeth warren. i could talk at great length about how blessed i am to be able to work with senator warren on everything from protecting consumers and alleviating foreclosures,ing

fighting the opioid epidemic, and to so many other things. she has been a phenomenal, wonderful partner. let me say we need her leadership desperately. her insights and passion today more than ever. if we fight to change the many things that are wrong in our nation, i am truly -- and i mean this with all the sincerity in my heart -- i am truly honored to welcome senator warren to my hometown, a few blocks from where i live. i turn the program over to her for her opening statement. sen. warren: thank you very much. thank you. i appreciate the invitation to be here with all of you. cummings said let's

do more to bring more to this bill to give people hope. there are ways we can fight back against this terrible epidemic that is rolling across our country. i said, count me in. has been ancummings inspiration to people all across and ind and the country, count myself as one who has been inspired by his work. he is a hero, and also a great partner in the hard work to fight for people who are caught in the throes of addiction. i'm grateful to elijah for helping put this bill together, and the two of us to get out and fight for it every chance we get.i want to say a special thank you to my partner from the senate, ben cardin, who is always in the

middle of a good fight for what is right. back for people who need a voice. i'm also pleased to be here with who i knew sarbanes, before the fights started in the congress itself. it is terrific to have you here. you have been a strong voice on behalf of how the federal government can be a good partner in localities where help is needed. thank you for having us here, mayor pugh. you do a great job in presiding over a great city. i hope we can be good partners to you in every way possible. 175ressman cummings said people will die today from an overdose, from the consequences of addiction. i want everyone to think about that.

that is a plane crash today, another one tomorrow, another one the next day, the next day, day.ext day, and the next that is our future unless we make change. a publicid epidemic is health emergency. it is not a public health emergency that is without hope. we have been here before and public health emergencies. hiv/aids crisis, we got a taste of what it was like. a problem started, got a little bigger, a little bigger, and the federal government, a nibble around the edge, a little help, a little help, until problems started ravaging communities around the country. then the federal government stepped up. the federal government -- when a

little boy, ryan white, said i have aids, the federal government said it is time for us to put real resources into fighting this problem. that was the ryan white care act. congressman cummings and i was having lunch. we were talking about the opioid ,risis and the hiv/aids crisis and how wants the federal government stepped in and said we would put real resources behind attacking this problem, that is what happened. starteder of aids cases going down. we turned it around. the problem hasn't disappeared, but there are people alive today because of the resources that we put in at the federal level to fight back against this epidemic. we talked about doing this same thing with the opioid crisis.

we said we wanted to make the same kind of national commitment to put resources and to turn this problem around. we talked to scientists, doctors, public health officials , and people on the ground. what would it take to turn this crisis around? forame up with a proposal $100 billion over 10 years, $10 billion a year, that will go directly into communities fighting this problem. it will go directly into the frontlines. people will know it will be here not just for one year, it will be here over a long enough time that you can build a real, meaningful response. do. is what we want to we want to turn this crisis around. we proposed this bill, because we see a public health emergency, but we propose it because we have optimism.

we know what we will do if we put the resources and. this is a bill that holds big pharma, drug companies, and their ceos accountable for their part in this crisis. we are facing an urgent public health crisis, and we can no longer afford to nibble around the edges. we need to put real money and real resources behind bringing an end to this american tragedy that is unfolding before our eyes. it is an honor to be here with all of you. thank you, very much. i look forward to hearing from you. dr. wen: thank you senator warren and congressman cummings. none of the work we do in baltimore would be possible without the visionary leadership of our mayor. them her time at the city council and now as the 50th mayor of baltimore, mayor pugh has fought for the health and well-being of our city will stop

i am proud to introduce my boss, mayor catherine pugh. thank you, dr. wen, you are always on the frontline. and i want to say thank you to congressman cummings and all of you. appreciative of this effort. and joining with senator warren to introduce this particular legislation. i cannot go without saying to senator cardin, who is always here with us and for us, and also congressman sarbanes. i am grateful you are introducing this bill and forward.g to push it what is important about this legislation is the flexibility that comes with it. if you would have talked to kevin linden, he would tell you it is not just about providing assistance to those who are drug

addicted today, it is about the solution to the problem that creates the addiction in the first place. part of that is where people are living and the predicaments in which they find themselves where drug addiction takes hold and assistance. the flexibility of this legislation allows us to address all those issues. we want to make sure those who are in need of assistance, whether it is naloxone, housing, health, whatever those issues are, we are able to address them. this legislation gets to the root of the issue. it is not just the cause or prevention, it is attacking the issue itself. what are we going to be doing from day to keep a plane crashing in this country every day?

i am extremely grateful we are sitting here having this discussion. i am more hopeful for the future because if you look at this legislation in terms of the provisions of the legislation, kevin, joe, and although sitting around the table, this gives us an opportunity to address the root causes and get to the bottom of how we service people in need. i always say, only by the grace of god. it could be any of us who find ourselves in this predicament. everyone of us in this room knows somebody who is suffering today. as we continue to move forward, the call here for those of us who sit at the front table is help us get this legislation passed. us by advocating, being in washington, writing letters, but help us make sure this kind of legislation is not only heard

the passed. we are in desperate need at this particular point in time. i'm grateful to all of those sitting here, that this legislation, congressmen and senators, has been introduced. i know dr. wen was at the forefront offering advice, because that is the kind of commission or is for the citizens of baltimore. we look forward to the passage and assistance we can provide in the future. thank you. i would like to introduce our senator from maryland, senator cardin is a strong supporter of our work in baltimore. he was here on monday at our press conference to defend title 10. you are our superstar. we brag about mayor pugh and our health commissioner all the time and bring her to washington as

quickly as we can -- as frequently as we can to share her expertise. inspiredarren, we are every day in maryland. we have champions on behalf of people in our state. have a moment, we turn to elijah and he gets us up and ready to go. these issues are important to vulnerable people and for honorable communities, he will be their voice. on the opioid crisis, once again, elijah cummings is showing his leadership. senator warren, we don't get you in maryland every day, this is a treat. thank you for coming to maryland. we are inspired by her in our caucus to say we are not going to lower our expectations.

america, we are a country that can accomplish big things. we did it fighting the aids epidemic, we showed leadership in america and globally and we made a huge difference. senator warren is the inspirational voice in our caucus that america needs to accomplish its goals. and we can deal with the opioid crisis. it is great to be here with our great mayor. mayor pugh, you have the toughest job of all. thank you for being willing to step up on behalf of the people of baltimore. , his districtes is a challenging district because you not only represent the people of baltimore, but the people of montgomery county. he does it incredibly well. he is on a key committee that deals with the health issues, and has done incredible

leadership on behalf of our state and nation. it is great to be here with you. kevin, we are proud of health care for the homeless. you started and said you were going to be able to fill a void in our community. i don't think any of us envisioned we would be here where we are today. the tools could be better for you, but you have been able to use and leverages them to provide incredible service so health care is truly a right, not a privilege. i want to make a couple of points. dr. wen gave you the numbers. i know numbers rolloff. it has been seven years in a row we have seen increase in deaths due to overdose. show ite early numbers will be a record year again. we haven't hit bottom yet. we still haven't figured out how to end this. when you come to baltimore city,

there are challenges in any urban center, but the opioid crisis is in every community in maryland and our nation. we've got to figure this out. that is why we need the type of commitments that you hear from my colleagues today. what does this mean? if we really provide these dollars, this means we can invest in finding out how people are vulnerable to different types of addictions. there is great work being done in baltimore on the brain to figure out issues of addiction. we are doing incredible things here. we have to find different ways to deal with pain for those vulnerable to addiction. available be made with the passage of this legislation. we have to stop fentanyl from coming into this country, we have to make an all-out effort. we have to keep that out of our

supply. we have to figure out different ways to treat people. there is an effort to take this out of the emergency room to a more effective setting because people leave emergency room's and go back to their addiction problems. at the stabilization treatment we can get them stable, but it caused some. pierce support is working, but costs money. it has to be 24/7. you have to have the resources in order to deal with that. you talked to kevin about the medicaid program, we have to increase medicaid support, not decrease it. i could go on and on, telemedi ite, integrated health care, costs money to save money. i am excited about this, because i believe we can fix this

problem, but we have to make the investment. it is not simple. it is not easy. ipod my colleagues for providing the leader -- i applaud my colleagues for providing the leadership to get this done. dr. wen: i have the honor of introducing congressman sarbanes , a tireless advocate. he has introduced multiple pieces of important legislation to fight the opioid epidemic. rep. sarbanes: thank you for your leadership. i want to thank heaven for welcoming us to health care for the homeless. it is setting standards for what we need to respond to needs and our city, state, and region.

i want to thank the people around the table who you will hear from the materially. you are on the -- hear from momentarily. you are on the frontlines. this is a topic that gets a lot of talking points associated with it. actually going to do something meaningful? i want to salute my colleagues, andainly senator cardin congressman cummings. in politics, to get through each day you need personal euros. congressman cummings is a hero for us. you forwarren, thank being here and for your leadership on these very important issues. i sit on the energy and commerce committee, a house subcommittee. we had 2 markups.

70 pieces of legislation dealing with the opioid crisis. some was good legislation, others was really kind of window unfortunately. a way for people to have talking points when they went to their district. was missing was a policy superstructure that would pull and alsoer, understanding that we need to put real resources behind this or it won't make a difference. that is what they care act is all about. in those markups, i and others were talking about the care act, because we understood that is what we need as that policy superstructure. warrento thank senator and congressman cummings for introducing this important piece of legislation. it creates a northstar for us. it is the only way to address a crisis of this proportion, and

the only way to address the stigma associated with this crisis and epidemic across the country. we need to get past that, and then we will meet the need in a called for. thank you for being here in baltimore. congressman cummings, thank you for your leadership as well. dr. wen: i would like to begin our roundtable and thank you for hosting us and your leadership of health care for the homeless. from your perspective, what is the biggest impediment to providing treatment in baltimore to those who have the disease of addiction? >> thank you for being here. it is fitting we are having this conversation at health care for the homeless. homelessness represents the failure of every public system imaginable. senator warren, you used the word hope. there is such help in a place

like this when people get access to comprehensive services they need and reenter great with broader communities. that is a statistic senator cardin has told me to slow down on. it is the percentage of our clients who have insurance and access to treatment they need. in 2013 that was 30%. that means 70% were uninsured. 90%., 2014 and today, 90%.30% to the affordable care act in general and medicaid expansion in particular brought about meaningful change in the lives of people in the organizations that serve them. foremostirst and creating and expanding access to the services people need. mayor pugh answered the question

in her opening statement. people need access not just to opioid treatment, addiction treatment, but to whole person care. all of the services they need in one location.there is not one critical service we can provide that is not made better and more effective if rooted in permanent housing. someone living across the street under the expressway, no matter what treatment we bring for addiction, mental health, and medical problems they are not going to get better living in a shelter or under a bridge. if we can root the care and permanent housing, and i know all of you share as a goal a national reinvestment in housing available and affordable to extremely low income people, if we can couple that thinking and our care act work the effect is going to be magnified.

when we have learned is housing is health care. housing is health care for specially vulnerable people. mayor pugh: can i respond? that is the direction we are taking our city. it is so important. and said this time time again. shelters are momentary. when people have to pick up their belongings, leave and come back, it doesn't help us solve the problem. the end to drug addiction and the end to homelessness go hand-in-hand. if we are not looking for solutions that involve housing, we are kidding ourselves. that is why talked about the flexibility of this legislation to allow us to look at a portion of this for housing. we, for example, are looking at creating housing for the homeless. this is not sheltering. we are not looking at

sheltering. we are looking at houses for the homeless. if you don't have a place to lay your head, it is hard for us to treat you, it is hard for you to wrap your head around the problem you are facing. in every solution that we look for, which is why we created the we haveation centers, to stabilize people but connect them to the resources needed. almost every case of drug addiction, you will find many of those cases where people need housing. we are dedicating 24/7, every housing project inc. developed -- being developed housing for we have toally ill, make sure part of it goes to those suffering from drug addiction. we can't treat them if we can't house them. dr. wen: thank you for bringing up the issue of flexibility. speaking about the need for

resources. i want to turn to mrs. collier and dr. jones. long-term federal funding for addiction treatment and related services like housing, would they help your organizations to better serve clients in the community? for sponsoring the care act. absolutely. long-term funding for substance abuse treatment with critical wraparound services would make a tremendous difference in our the opioiddress epidemic and a substance use issues we are facing in baltimore. three ofic charity, the most pressing challenges we have seen in addressing substance use, where we have 60ticipated in using narcan

times to save 60 lives into programsalone -- in 2 alone, three issues our willingness to participate in care, the immediate availability aslong-term beds for care, well as the wraparound services most importantly for individuals experiencing co-occurring disorders with mental health and individuals experiencing homelessness where traditional wraparound care, including transportation and especiallyis needed, for a homeless population life skills training, housing, and employment support our critical resources needed for this care. the care act would provide tremendous support for the critical challenges we are seeing.

us toexibility allowing provide outreach to help people understand the resources available, and encourage them to participate in the resources, and having the comprehensive resources available to meet the needs of the individuals suffering with substance use disorders and often co-occurring disorders with mental health disorders as well. >> i agree with all that has been said. i would like to thank you guys for sponsoring this legislation. i think it is critical in order for us to make a true impact in this opioid epidemic. i think the fact that this funding will support evidence-based practices is not only ensure that people are getting the best care they can, but to be honest, to legitimize the standing of addiction as a medical disorder as opposed to a moral failing, which is one of the things that

keeps people out of treatment, and will go a long way to helping us address the stigma that interferes with our ability to help the 90% of people who don't have access, but also have challenges with wanting to access resources available. i believe with the passage of this legislation, which i'm excited about because it puts real dollars behind what is needed and ensures the flexibility mayor pugh was speaking of, i think that is critical in concert with support for patients in communities coming just pass by the u.s. house of representatives, one supporting of the structure and one supporting the implementation, that is needed to get our arms around this huge problem. it will go a long way to saving a lot of lives. i represent bonds for hospital seours hospital.

one challenge we struggle with his resources. more if we had more. we have patients that show up in our emergency department who use the emergency department as a route of access. it is not the appropriate route of care. if we had more operations like this, we could drive people to the resources they need to get help more immediately, and get people to long-term support with housing they need. we need help on the frontlines with primary care dividers. primary care providers need to be educated how to manage pain, and also how to be part of the solution and giving them the support they need. we do have the policy that went

into implementation, the state targeted response to technical longtance, that will go a way to helping nontraditional providers to get the help they need. we don't have enough providers, which speaks to the other issue. we have a workforce shortage. we need more drug counselors, more addiction specialists like myself so that when we have access to these resources we had people to provide services. the needs are great, and i believe this legislation will allow us to make a true impact in helping to save hundreds, if not thousands and millions, of lives. i thank you for your leadership and courage to ask for what is really needed. dr. wen: thank you. today, we have three special guests, in addition to our other special guests.

they are here to share their stories of recovery. can you tell us about the challenges you face in accessing treatment programs? >> the first challenge was dealing with the stigma against medication assisted programs. you were considered not in recovery, still an addict. there was a lot of scrutiny to deal with. while, that discouraged me from seeking treatment. i only had one choice, medicated assistance programs. i only had one hope, to let the treatment, or take the treatment, and see if it works. that is what i did. another problem that i had was access. once i decided i wanted treatment, i would walk a mile

or two and they would tell me they had no slots. you don't tell someone suffering from substance abuse disorders you have no slots. they will go back out and do with they need to do. do.hat they need to i've seen a lot of friends who are not here today pass away because they got treatment too late, or they did not have access to treatment. i think treatment should be available for everybody. if you can't bring the people to the treatment centers, some way to get the message and treatment out to them. really fighting for this bill. it is nice to see all of you here, soldiers fighting for a cause that is very dear. i never thought i would see this. you gave a hopeless person some hope. i think we just need to fight

the good fight. save lives, save families in our community, and people like me. services?und >> there's so many areas where people need help. they need resources. you have mental health issues, where a lot of substance abuse users have mental health issues. it is very important. we have to nip it in the bud from all ends. it is a major problem. we are at war. we need to strengthen our army, we need weapons, we need and that is the only way we are going to do something and make a difference.

we need the billion dollars and anything else we can get. amen. >> good morning, everybody. i was raised in baltimore city. i struggled with the disease of addiction for many years. -- the biggest challenge i had was not having insurance all. insurance, you can't get the treatment you really need. that insurance -- it wasn't until i came to health care for the homeless that it was a blessing for me, because thank god, the attention i need it. i got the comfort and help i needed. it was not just that i was using . i needed other things for mental health.

i needed the help, health treatment. so many things that health care for the homeless helped me with. that, i have a lot of hope i don't have to use anymore. i feel like a better person. i feel like i need to pull somebody else up that is still struggling, and that is why i am here today, to try to help those that are still suffering and try to help them to come in out of the cold. with everything the mayor talked about, it is the thing that really helped me, though services and my dealing with the addiction part. i want to thank -- i am grateful to health care for the homeless because today i see a better future. [applause] >> my name is john.

i am a baltimore county resident. i struggled with the disease for a long time, still struggling. the biggest thing is the health care and everything. getting to appointments, that is the biggest thing to me. i struggle getting around. i cannot walk far. think god for health care -- thank god for health care homeless. it has been a blessing for me. it is still a blessing. i work hard every day, but it is a fight. when it a lot of help. "p. cummings: you mentioned transportation." if you can't move, you can't go places, even if you have treatment, you cannot get it. we are trying to have as much flexibility as we can.

people don't even think about it, because a lot of people have cars but they do not think about the fact that you may need the treatment over here and you are over there. you have to get from one point to another and you may not be able at sometimes to walk it. you sure cannot afford a cab. i got to. that is why the flexibility is so important, because it will address issues like transportation. it will address things like homelessness. you talked earlier about ilemedicine, and dr. wen and talk about that all the time, because treatment has not caught up with technology. that is why research is also important, because if we had

some of that technology in place we could address some of those issues and you do not have to struggle to get it because they can get to you. >> long-term residential would be nice, because shelters do not work. everything i have come close to, and the city, was helping out mission. that is a beautiful spot. i wish i had graduated from it but i didn't. that is a different story. it is a well spot. mayor pugh: helping out mission takes in about 500 people in its care. 100 of those are from harford county and surrounding jurisdictions because of the care we provide in the city, which is why this legislation is important. other jurisdictions need to have that same kind of care. i very much thank our individuals and recovery for

sharing your stories. i want to make sure all of our panelists have a chance to speak. we are surrounded by people who are doing such good work. i want to see if there is one thing that a better government can do. what would that one thing be that would make the biggest impact on the people and communities? first of all, thank you all for your leadership. a couple of things, in my estimation, need to happen. rollinggedy is hopefully across the finish line with funding. you have to have an engagement strategy, sort of like what mayor pugh has been doing with the call to action strategy. create this network of collaboratives around the city so as treatment becomes available, the penetration into the community is actually there. thing -- i am one

here in a professional capacity -- but i personally benefit for being -- benefited from being an long-term residential care. without that long-term treatment when there is severe addiction, 30, 60, 90 days does not necessarily work. end, as people are more into sobriety and community , we have to have connections to the workforce. there has to be an ability for a person working their way out of recovery to become employed. one thing that is not apparent in the community is the capacity for workforce providers and drug treatment providers to leverage their respective expertise so that drug treatment can focus on drug treatment. workforce development can focus on getting people into the workforce, and there is a way in which we can leverage those to create a seamless as -- system.

>> let me just say this. this legislation for law enforcement in general, as law-enforcement has increasingly enhancedhe fact that treatment capacity in this country is a must, because we cannot do our job without it. you certainly cannot arrest your way out of it. we have had to make a cultural shift in terms of how we deal with the situation, i.e., our law office -- law enforcement assisted diversion, homeless outreach teams. this provides a level of capacity that allows us to so closely integrate the missions into law enforcement, and dealing with this from a more clinical way that along forstmann way. sen. cardin: i would like to turn to dr. nolan. dr. nolan: thank you for inviting me here and thank you

for your leadership. the institute is a foundation and we are always looking for innovative ways to spur different kinds of programs, different ways of thinking differently about the issues that we are addressing, like the opioid crisis. in terms of what the federal government can do, i noticed at both the state level and the federal level these commissions that they are talking about expanding treatment and things of that nature, there is not a -- aboutscussion it harm reduction. naloxone is an important overdose tool and there are other ways we can embed treatment. people being kicked out of housing because they are still using, would you kick somebody out of treatment for diabetes because they had cake over the weekend?

thinking about things differently in terms of access for treatment, in terms of lowering the threshold for treatment. hodgeshodges -- mr. mentioned how difficult treatment was. we can get treatment mobile and in doing that, we can make them toons that allow get the types of services they need. those are the things i would suggest, to really rethink what we mean by treatment. rethink what the threshold is for treatment, recognizing that if her many people if they could make it to the clinic on tuesday at 9:00 a.m. they probably would not need treatment. all of the things that come along with opioid dependence. that is my suggestion. >> good afternoon, everybody. to answer your question, i think legislation asof

the government taking responsibility for what the government created in the first place. when we are talking about root causes of violence, talking about root causes of addiction and homelessness, we are talking about oppression. we are talking about people living in criminal conditions that they did not create themselves, criminal conditions that policies created, criminal conditions that laws created the can someone thought having a good quality of life was a privilege and not a right. even if we talk about things like transportation and housing, a lot of those kinds of bills forlegislation are designed people with a certain kind of privileged to be able to get back and forth were they need to go. when there is opportunity for transportation, to actually benefit baltimore, is not that. that is not our privilege. we do not get to get from housing to jobs to picking up our kids to get into health

care. we do not get that privilege. it is not a right for us. soul perspective, not blaming the victims for the impression -- oppression you caused in the first place but legislation saying, we are taking responsibility. we know that people are self-medicating. people are genetically disposed to addiction and you put them in oppressive situations. people have all kinds of lead in their blood. there are so many things happening that policies and legislation create in the first place. this is, for me, it is the government having more -- moral fortitude and accountability to say we are going to do something that does not blame the victim and criminalize victims of what we are creating, but we are going to get deep into the root

causes and gives actual resources that are needed. from my standpoint, we on the front lines are all doing such exceptional work. miss williams, who is doing work on wine right, would like to say a word. white, like to say a word. >> [indiscernible] i am 40 years old and have lived here all of my life. one of the things i have noticed is a provider and resident of the city as i have seen people struggle with both hiv and opioid addiction for a very long time. it is very refreshing to see this legislation come about and to be pushed forward with vigor. i think it is significantly -- this is a public health

emergency we are in. the lack of housing is a public health emergency. emergency andic certainly opioid addiction is a public emergency. it has been that way for quite some time, so the recognition of this as such is quite refreshing and feels very respectful. thank you very much for that. one thing i have noticed in my work, particularly as it relates to the synergy between hiv and opioid addiction, at different i have of time -- noticed it has been something looked at as a moral failing. we looked at opioid addiction is a moral failing and other points in our history we have looked at hiv as a moral failing. one thing that has been critical with the ryan white act, and it is smart to be thinking about how we address opioid addiction from that lens, because we put a

lot of concentrated effort into developing a bill that will be flexible. what i am hearing all around the room as people talk about the flexibility associated with this we and just bill and what are talking about is the social determinants of health. i see this bored of legislation is something that has tremendous value in addressing those social determinants of health. we talk about that these issues are diseases, and they certainly are. there are many social components that are embedded in both of epidemicsemics -- that makes such a difference before someone can get to their physician. this is the kind of promise we need for a bill, to be able to address something so significant that has ravaged communities for so long. transportation, telehealth, things around mental health disorders, and recognizing that you cannot

address opioid addiction without talking about mental health, talking about issues around trauma, and certainly addressing issues around homelessness. we have learned that every single service is so much better. >> that is the core tenets of social health, and we have the front lines have been saying that we know what works. we just need the resources to help us get there. this sense of optimism is a sense of what i feel in listening to our partners and our federal elected officials coming here today. i want to end with concluding remarks from senator warren and congressman cummings. sen. warren: addiction is a medical issue, not a moral failing. we need to treat it that way. i listened to mr. hodge talk about how hard it is to get treatment or to find treatment beds available. there is nowhere in america

where if someone comes in and says, i have hurt my leg, they say, you have broken your leg, we will have a spot for setting your leg probably in the next two weeks. can you come back then? that doesn't happen in america because we take a broken leg is a serious medical problem, and that means we have a serious commitment to put the resources in to make sure people can get the help they need. there is nowhere in america where we say, you have been diagnosed with cancer. we are giving you one chemotherapy treatment and if the cancer comes back, you have had your treatment. you are done and sorry it did not work out for you. because we that treat medical problems with humanity and we make commitment as a country to do our best.

we don't always get it right, but at least to push in that direction, but not so with addiction. i am glad to be here at health care for the homeless and i admire what you are doing. i just look at the statistics nationally. someone you love could come to you today and say, i get it. i have a serious addiction problem and i don't want to be one of those people who is going to die. i need help, and yet that person nationally would have a less than one in 10 chance of getting the medical care they needed. that is wrong. it is morally wrong, and we have a responsibility to do better. i am delighted to be here with congressman cummings. i plan to be here with the mayor, with the people that are on the front lines in this battle. we have put together the care

act to try to give you the resources you need to do the work that you want to do, every single day. congressman cummings and i come we cannot do this work. but is not our expertise, we are here to try to put the wind in the sales for those who are doing good for those who need it most. thank you again, elisha, for ah, forg me -- elij inviting me. rep. cummings: i want to thank all of you for being here. we have accomplished exactly what i hoped we would. i am very pleased to have my wife here. she is a strong advocate on these issues and always has been. andknow, as i sat here williams,o you, ms.

and i was thinking about all the things that have been said here, you just made me realize that we are on the right track. word that seems to have flowed around this whole table, it is "flexibility." when i was in the hospital for over six months over the last year or so, one of the things that just struck me when i talked to a lot of the patient s, one lady said i can get the and she was talking about her ailments in the hospital -- but i cannot get the cure after she got out. you can do a little bit here, but if you can't get the follow-up and the wraparound and the transportation and housing and things like that, it is not going to work.

the other thing that means so much is the word "dignity." when people talk about the dignity, thats affects their dignity. i think that when we look at training doctors to make sure doctors begin to look at this from the perspective of a disease, and to train them to actually address this as a perhaps, i dot not want to be bothered with somebody who has got a drug problem. that doesn't help either. again, our aim here is to .ducate ourselves we need to be educated. if you give them frontline testimony and provide us with the ammunition we need when we go to washington to push this and push it and push it. i am truly honored.

thank you. health care for the homeless, thank you for everything you have done. again, mayor, i want to thank you and my colleagues and i want to thank senator warren. i cannot say it enough. people say, senator warren has got great politics. i say, no, she doesn't have great politics. it is not about politics for her. she believes this. she believes it. there is a big difference between believing and just playing politics. again, i want to thank all of you for being here and participating. [applause] dr. wen: we are asking for all panelists to rather behind us together -- gather behind us for a quick photo.

thank you. [captions copyright national cable satellite corp. 2018] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org]

sen. warren: if we can put the resources necessary, we can beat back this terrible epidemic and reclaim our america for all of our people. rep. cummings: i am so grateful that senator warren came today. act, a pieceis an of legislation that has been paper andy "the sun" "the new york times." it is the leading piece of legislation to address this issue and it addresses it in a very comprehensive way. there is testimony that we heard reiterates what we have been learning, and that is that we have to have flexibility and we have to get the dollars and we need -- to where they are

most needed, and where they will be most effective and efficient. sustained dollars over a 10 year period, $100 billion. that is very important. we cannot address this issue as if it is something light. you have 175 people dying every day. wasne of the things that said the other day along with flexibility is taking responsibility. flexibility and responsibility are things that are plaguing our community across this nation. senator warren said it right, a plane clash -- crashing every day. we have got to get our arms around this. we will say to the country we are taking responsibility. those who are in the greatest need will be able to utilize the money made available in a way

that meets the needs of their communities. i want to say thank you to dr. wen, someone on the forefront of what we are doing in the city of baltimore. when i think about the creation of the stabilization center and the flexibility that exists, and health care for the homeless, understanding that health care is important, but also connecting people to real solutions is also important. at is what you talk about homelessness and if we can make that connectivity and create this flexibility and take this responsibility, we will see our country move forward. thank you all. >> i want to thank senator warren and congressman cummings for their lead on the care act. a lot of people are supporting it on the house side. ms. mccrory said something about how when she reached the stage of recovery, she turned into somebody who could then turn and help others. while we need professionals to

step into the treatment space, we can add to the workforce that is helping people recover by helping people, citizen caregivers, citizen workforce that can step in and then it is a multiplier and we begin to tip things in a positive direction. that gave me a lot of hope today. sen. warren: i agree. glad to have senator warren introduce the care act. you all know, this is what we on the front lines have been asking for. we have been asking for three things. funding to local jurisdictions that are the hardest hit. never two, that it is sustainable. number three, it has to be proportional to the severity of the epidemic. it cannot be a million dollars here and there, which sounds like a lot, but as congressman cummings said it is not just the cost of intervention but the cost of doing nothing.

the cost of doing nothing is people's lives and communities being destroyed. we are glad to move forward as an example for the rest of the country. >> in her opening remarks, senator warren talked about the importance of hope. throughout our conversation, we realized the importance of coupling help with action. , whene have taken action we passed medicaid expansion that was resulted in real benefits in helping people to read integrate back into the community. we are not here just being hope full, we want to bring about collective action. >> addiction is not just a crack problem. it affects democrats, republicans, independents, libertarians.

i talked to my republican colleagues every ingle day about the scourge of addiction they say back home i have problems. what the congressman and i are doing are offering solutions, we will keep working at it until we get everybody on board. we need this change now. >> i have no doubt that they will come around. there is too much pain into much suffering in all of our districts not to do something. that is part of what we are doing here today. about $500 billion a year, that was in 2015. used can imagine what it's gone up to. i think they can come around.

i have been in the system people are saying and i have not received out. how are you going to use the program to bridge that gap. -- the mayor has talked about this flexibility. it's not enough to treat the to treat theave mental issues. something as simple as transportation. you can have the cure right there, but if you can't get here, i feelng out even better about this today, because a lot of things that were brought up that i had not thought of. cityen you think about the this has been a

part of the conversation. we understand what takes place. we are doing what we can read things we have. that is what this legislation creates for us. we have additional resources to address all of the additional issues. we are taking responsibility and having flexibility is what this all brings to our cities across the nation. >> this bill is not about washington dictating ways to handle addiction. this bill is about putting resources into the hands of the frontline fighters. what may be needed in baltimore may be different from other ,ities and rural communities and in other parts of this country. we want what works. that is what we are about here. we want to be evidence driven, money, results for this

but we want to be in the fight. >> and we want to be effective and efficient. reason why it is so practical is because of this great lady here. noteelped us with this word for word, you know why? because she is on the front line. thank you very much. we appreciate everybody. >> thank you for being here.

>> this news conference will be available later today at c-span.org and today's washington journal also on over your its and challenges in baltimore. >> sunday night on q&a,

constitutional lawyer david ."ewart on his book "impeached >> it's a scandal. the chapter on johnson i will not speak beyond that. this should be expunged from every library in the country. it focuses on edmund ross who is credited for casting the vote that saved johnson's tale. they call it the most heroic moment in american history. i think it was purchased. was not a heroic moment. >> sunday night at eight eastern on q&a. on c-span next week in primetime, monday, former president george w. bush and bill clinton on lessons from a life in politics.

tuesday, nasa administrator jim brighton stock on a proposal to create a military spaceport. wednesday, the national government -- governors association meeting, thursday at 10 p.m., the netroots conference with corey rocher -- cory booker. theday more from me netroots conference. >> anthony kennedy talked about his retirement from the court which he announced in june. he's both at the ninth judicial conference in hama, california -- anaheim, california.