Morning because this was scheduled for 7 00 in the morning but good afternoon this is the National Press club by help to guide the Headliners Committee and on behalf of those 3,000 members and jetblue of 12 will go view here today. Before we get into introductions of our speakers i have not done this before i chair the Headliners Committee for the past couple years and i never really talked about the process with the news maker or a headliner and it seems like before the hurricanes and earthquakes the National Disaster was the hope your a crisis Opioid Crisis and we think it would be important this week while congress is dealing with the budget so how can you take on this disaster so how does this work . That was our sense when we started the process to the National Union of Health Care Workers because he wanted people who were dealing with Mental Health and somebody in congress that could talk about the other side of the korean because at the same time it wasnt that long ago we heard the administration making cuts to programs of mentalhealth. Little did we expect it would become a health care week. It seems we have a lot to talk about of the Opioid Crisis and findings of the panel be put together is truly excellent. We will try to take fest from later years in the first speakers works with newborn babies and children and she can go into more detail but she is at the beginning working with a population the average person he is trading at 23 years of age and ohio. And next dealing with the Adult Population in sacramento goes considerably older than what i just mentioned. And last tim ryan from ohio and in addition into his leadership it cochairs that military and Mental Health caucus so having said that to save time what we will do is start with jackie and then well take one after the other. After each person speaks for a few minutes we will take questions. Hello everyone i am so happy to be here today i am a parent child therapist with the Childrens Hospital oakland so for the past 15 years and have the privilege to working on little babies birth through seven who are impacted by incarceration and here today for the families that i serve that are struggling with Mental Health and Substance Abuse. Some recent statistics that shocked me from the combined Data National survey on drug use and health about one out of eight children are living in a home with at least one parent is a Substance Abuser. 8. 7 million children and the hardest hit is the age birth through to two years old so theyre the most vulnerable and often the Collateral Damage of addiction. We know from the study that came out of kaiser that Adverse Childhood Experiences great the impact adults and children as they grow up with longterm health issues. So growing up in a whole when someone is using drugs and we need to intervene quickly to make impact. I will tell you about a mother i have treated in the past two came to us with a two month build a little baby her baby was is fussy and hatta of rough life the first month she was actively using drugs so was chaotic and difficult increasing his fussiness so when they came to my office to resent her home and said she was a fussy baby and her parents were ejected addicted said she fell into the same pattern but she wanted different. She needed help and was lucky to get into our Program Given the support in her baby was given support now her little boy is to lung negative two years old and strong and okay and his mother is in recovery and doing well. This is day story they got the treatment they deserve to but it took long and steady treatment. Sadly this is not always the case but our system is a disaster and overburdened and inadequate ready for i came here i spent hours on the phone with a father who had a oneyearold baby he wanted help. He wanted to change his life the he was on methadone and i called for hours to find a Treatment Program for him and each person said no. We dont take people on methadone. I found one place that would take him but the line was one month long and he would have to detox. That makes no sense. A father who wants to get help and changes life for the better than no access to treatment. We can do better for the kids and the families. So were here to tell you i have never met a baby that does not love their parent despite all they have gone through the above never has meant a parent struggling with addiction that doesnt one different for their baby. They know it is a painful process and they want to change the pattern in their family. The kids deserve better and the families deserve better. Thank you so much. I everyone. Thanks for coming out this afternoon i a. M. With auriemma house and akron ohio i serve as the coordinator of Treatment Services. Akron is our home office of the recently opened a Halfway House in marietta. We are a Nonprofit CommunityCollections Agency that also treats clients for substance disorders also in a proven medically assisted Treatment Agency and we can give a vivid trawl that is a non opioid matt so what that does it treats the opiate to reduce those physical cravings and put together a treatment plan so they can unpack the psychological things they are dealing with. One in this room has been affected one way or the other, a be a know somebody, family member, coworker, friend, it affects everybody. The 2015 theres 2015 overdose results in death. In 2016 an increase to 64000. Thats a 23 increase. In my home state of ohio, we are at ground zero. In 2015 we had 3050 overdoses that resulted in death. In 2016 it increased to a 36 increase. Its out there. Its affecting a lot of people, its affecting families, children, employers, it is a national crisis. When i was coming out here waiting to board the plane i picked up a journal of the front page it reported that in akron the city of akrons we had 58 overdoses, they didnt all result in death but 58 overdoses. Probably higher because were pretty good in the Summit County area, yes in one week, this probably higher because were good about getting the narcan out to the families whose loved ones are afflicted with this disorder. So some of these were probably brought back by the narcan and not reported. You may have also read in a recent article that in one week, they had 18 overdoses that resulted in death in cincinnati and the surrounding area. 180 overdoses in one week and 200 opiate use is that resulted in arrest where they either passed out in their car, bathroom, were driving, there is a possession charge and were incarcerated, 201 week, the saddest thing is the innocence. The babies, that one week theres 15 babies born potato. Related medical concerns going on. Fifteen in that one week. Most of the clients but i treat that get to me pretty much of lost everything by the time they get to us. They lost their job, their insurance, their family, housing and with the aca and the expansion of medicaid in the state of ohio this is helped our clients to get the Treatment Services they need. Without the Medicaid Expansion in the aca they would get help. Even with the expansion were strapped and overwhelmed, we dont have enough staff or facilities. The growth of this epidemic is alarming. So in closing, i am concerned that if the aca is repealed in a cut and medicaid, a lot of my clients and good americans will continue to suffer and die. Thank you. [inaudible] good afternoon. Thank you, my name is kenneth rogers, psychologists working with a medical group in Northern California specifically the sacramento area. I serve as Vice President of the executive board of the National Union of healthcare workers. My comments today reflect partially my personal expense working with patients and also the expense of my colleagues i represent. I speak to you about how the opiate crisis is personal to the work i do as well as the consequences of failing to provide full Mental Health. Paul not all patients i work with have some sort of opiate addiction, those who do have serious underlying mentalhealth issues. Opiates, by the very nature are pain relievers. The people i work with are in pain, theyre anxious, depressed, and have turned to opiates to deal with this pain. This dissolution comes at a cost. When people turn to opiates they miss out on family celebrations, gatherings with friends, church events, marston partly, work. This report is supported by National Findings from a recent Brookings Institute report the found that between 1999 and 2015 roughly 20 of the reduction in the mens workforce participation was because of painkiller abuse. One patient in particular comes to mind, when i started working with him he had gone through treatment for chemical dependency are ready. The medical group has a specific department for chemical dependency. I work with Adult Psychiatry on an outpatient basis. When this person came to me he was no longer on the opiates per se, he was using them periodically but he had started his recovery but was out of work, disconnected from family, and severely depressed. He lost his business that he founded himself and he was trying to find a way back. The treatment that was required was months of individual and Group Psychotherapy so he was able to completely get off the opiates and also reconnect with his family in his life. He eventually went back to work in the very business he lost. He sold his business to some friends of their goodnatured enough to let him return to work at that location. It was very humbling for him. He founded the business the most people dont want to return to work at a place they found it as an employee. But this is what you do to get back. This example is an example of somebody who is in treatment and per had the resources to get the treatment he needed. This is not all of the patients we work with. There are many people who came to our attention through the Medicaid Expansion that were not having any treatment at all really think they received at all was three Emergency Room Services when the head crisis situations. In this case, these people were not getting treated at all. They would just keep coming back periodically and a lot of my colleagues in the emergency room were aware of this and brought this to my attention. We believe the way forward is by im sorry. Emergency services alone are not is what is needed for effective treatment. This crisis also Mental Health parity crisis as well. We better enforcement of Mental Health parity with medical help, stricter enforcement of existing parity loss, more resources for those who have lost the ability to recover. More clinicians to help on the ground, this is something ive been working on with my colleagues since theres a National Shortage of Mental Health providers. Oftentimes even like a group here like is the next link group with Excellent Benefits we can hire all the physicians we have in the rest of us have to pick it up and not fix our wellbeing because were working more hours and we have more patience and we have hours to work. So, so unless thing i would be remiss if i did not mention is that my colleagues and i are very frustrated that our pleas have been consistently answered with schemes to provide less and not were service for some of these issues. Were hoping we can start to get these issues addressed more directly, thank you. Thank you. Im tim ryan, its been hard and i think tyler touched upon it in states like ohio that this is an epidemic happening everywhere in the country. We happen to be in some of the worst shape but just at the course of a week in my Congressional Office last week have your staff change i think maybe thursday night we get a picture from a district director and across the street theres ambulances, the neighbor with three kids overdosed. That same night i think theyre about 18 overdoses in the county that one night. There is a bad batch of fentanyl going around, not that there is a good batch but a very intense batch that made its way into the county. I was at a Christmas Party in december a friend of mine is a cop in the city of warren in trumbull county. Its probably 10 00 oclock at night and were hanging out he pulls out his iphone keeps present and hes in charge of the drug issue really with the pd. He pulls it out and shows it to and theres five or six Different Communications from the corner. He said these are all heroin overdoses. It just keeps happening over and over again. I was touring the school a few months back in my district and i remember we didnt bring it up because we are theyre talking about several issues of the principle kept talking about how many parents of kids in the school over the course of last year to have overdosed and died. So it becomes an epidemic in the schools. They have dozens of kids who have lost parents because of the drug overdose. And many others just overdose but maybe their parents didnt pass away. This is how deep this gets. I know i want to thank you for being on the front lines as im wrapping up, and i know we have questionandanswer session, the debate this week on the graham, cassidy bill is front and center on the opiate issue. There is no way you can talk about opiates and overdoses in the cares act in all these things are trying to push and youre going to be pro trying to deal with this epidemic. Theres no way you can vote and support the Graham Cassidy bill. Just to give you an example, the cares act gives 1 billion. This was a big achievement in congress today. A billion dollars, the Graham Cassidy bill, takes 9 billion from the state of ohio between now and 2026. 200,000 people accessing treatment in ohio will be thrown off and told to pull themselves up by their bootstraps. This is on acceptable in the United States of america. This is an epidemic that needs to be dealt with in a comprehensive way, from lawenforcement, to treatment, to overdose issues to treatment, all the way down incomprehensibly. We have a bill, the congresswoman to get rid of the imd exemption which means if you get federal funding you cannot have a facility that allows more than 16 people if youre dealing with Mental Health or addiction issues. The recommendation coming from governor christie and his team to the president is to provide waivers to the state to make sure the federal money flow so we can make sure were getting the people the treatment they need. We will cover more in the q a, but i want all of you to know that if you are concerned about this issue, if this is an issue in your state your district, your community, your school, what is happening with the healthcare repeal bill today is an atrocity. It is unacceptable in the United States of america. Thank you. Were not going to open it for questions. We have quite a few reporters that are watching via the live stream. And if youre watching online i want to submit question you can send those via email to questions at press stop orgy. In addition, we have the cspan audience. The other thing the housekeeping item, if you please identify your name and News Organization first. Im elizabeth with the new york times. I was curious about the 21st century cares act. I was reading material from time price and he was talking about how he was going to pull back think about the second round of funding and subjected to different criteria, are you familiar with this . I asked them and theyll get me an answer but im curious about that. I have not heard, i can say that there is a level of frustration with the administration right now that the president said this is going to be deemed an emergency, yet that is just what he said, nothing has happened since then. All he has to do is tell secretary price to implement this as an emergency and again, im not here to get political, im here to stand up for the people in ohio who are asking for help from the federal government. He was in ohio campaigning talking about these issues, New Hampshire as well and this was going to be a priority for him. Its almost october and we are not getting the kind of help we need. To be supporting, the healthcare bill in the rose garden a few months back, the same kind of deal, hundreds of thousands of people in ohio alone and people would not get the services they need. High level of frustration was some of us, so we are frustrated and that would not surprise me if there is some change or pull back. But i do not have details. Thank you. Im with the president has negotiated with Senate Majority leader and House Minority leader nancy pelosi about things with debt limits, have you had any frustration that theyve been able to come to a similar revolution like with the opiate addiction. I think that was a good first step. But what ive been saying to everyone as is appropriate for us to have these conversations, thats what we get elected to do, talk to people especially those who dont agree with, the debt limit the Harvey Relief was a clear shot, those were clean bills. Get into the opiate issue any Start Talking about money, you Start Talking about complicated policy initiatives and quite frankly about healthcare and healthcare reform in the aca, that complicates things in washington, d. C. When we see on tv, we see a category five hurricane, we suits going on in puerto rico, these are people who need the kind help the United States can afford to give citizens of its own country. If you have a similar thing happen that happens over the course of five years that is just as much an emergency is an act of god, people tend to drop the ball on those initiatives. We can do both. I dont know how you can live in a state right now that has the level of problems that we have in your advocating for throwing people off of their healthcare. Thats whats happening. Im not confident its going to happen just because ive been here a while and experience tells me otherwise. I hope we can continue having these conversations. There are two clear differences with what were trying with regard to healthcare in the United States. Obama care is not perfect. But were clear in what we wanted to do, cover more people to make it more affordable and we wanted to have rights in their that were activated through the essential benefits package. The republican plans, now three of them are throwing people off of healthcare and make it more expensive with regard to preexisting conditions. Its hard to have a negotiation when you have two completely fundamental differences with what youre trying to achieve. Hello, bob weiner, mg Means Committee at the press club and a member and former Spokes Person of the white house and the National Drug control policy a few quick questions, especially with your phenomenal panel, congratulations on amazing, timely wonderful event. To follow up on what you said, how is treatment going under the Affordable Care act and the parity legislation, wife that stays, why isnt it enough to cover the gaps that we havent treatment . Why isnt it enough to provide the treatment the same parity for mental and drug abuse is physical health, second, what about legalization in the culture . Is that one of the reasons when he throw that out there and half the states have now put some form of it together that makes it more difficult and justifies the use of all drugs including opiates. There are two questions there, one had to do with parity. And why is a it sufficient under the Affordable Care act to sit. This is a crisis, so although there has been some improvements around Mental Health parity, its not enough. We see that in our day today working scum i see it every day at work, we have a long line of folks that need to get in for treatment and i dont think we have gotten to the issue of Mental Health parity an adequate treatment around substance abu abuse. I would like to comment on the first question the issue with parity is enforcement, within working with the medical group, this was a significant issue for us in past years. Theyre now in compliance with the department to manage healthcare and policies related to parity, but for a long time they were not and a lot of our competitors are not. If these things are not being enforced than its a big problem. Getting that enforcement to take place in a balustrades very important. Another thing i would like to touch base on regarding the medicaid coverage, my clients lose those benefits when theyre incarcerated so when they come out and reintegrate with us before we have him for up to six months we have to reenroll them in medicaid, theres some things that we have to do and we guide them through that as well but if theyre working parttime or fulltime at a lowwage they be making too much money to get that medicaid benefit so then we want to get them into the aca, its a process. When you say legalization, not sure what you mean. You know the states that have legalized marijuana. Of the impact overall on the drug issue and justifying its use in peoples minds. When i was growing up they often describe cannabis as a gateway drug, and some of the clinical work ive done i seen it in reverse, that when people are trying to get off of the opiates and stronger substances they will turn to cannabis. But i dont have meaningful information in terms of the impact that would have her not have based on the opiate epidemic specifically. This is a problem not just a problem with Illegal Drugs but with prescription abuse when its a significant issue. Theres a recent article where some counties in california that there are more prescriptions than people in these counties. For these kinds of medications. Just a follow up on your last point, some of the issues that were seen were injured workers are being prescribed opiates can you address that specifically and whether or not there could be some legislative fix . I know thats a state issue but everything the federal government can do to combat that issue . I think there have been some strides taken and controls of how doctors prescribed the medication when i talk to primary care physicians they often talk about the prescriptions and its not a freeforall, ten years ago people would have prescribed these medications in large doses without questions but in the last few years theres been a shift and that things. In terms of legislative end of it, im not sure. One of the things we try to do them promote is through medical schools beginning to further educate doctors and improve education with regard to the guidelines, limiting prescriptions to seven days and those kind of things. Theres also an opportunity for us to look at chronic pain alternative ways to dealing with pain, theres a variety of other alternative techniques we can embrace be for we start pushing heavy narcotics that have caused these problems and educating doctors and Healthcare Professionals on how to understand those alternative techniques and promote them as well. Like to ask one last questi question, in talking to some reporters there seems to be an unevenness to the way Mental Health is offered around the country. Other some places doing better than others, whether states are specific programs or pilot programs or partnerships, or anything of that nature is there some good models there to look at right now . The medical groups model is a great model, but we just dont have the numbers, its been a real challenge. It was interesting because for a long time there is a reluctance to hire. Its with great irony that when the parity issue became very important it became a situation where there simply were not the people thats a surprising thing from our and. I like to speak about the work that we do with young babies. Her program is unique in that we are able to begin treatment with the parents while their custody, start evidencebased treatment and parent psychotherapy. To me that is innovative. Wonder why thats not happening at other places could you can begin treatment while a parent is in custody and help them on the reentry and help their babies as well and give them specialized treatment. Thank you. I think the biggest and most important thing we can do is have this done in a comprehensive way. Whether talking about babies and using that as an opportunity to get with parents, the comorbidity issue of both depression and addiction and how those all fit together, i think its important to see the big picture. I think its important that in our schools we Start Playing offense a little bit, theres a lot of phenomenal social and Emotional Learning programs that are showing Significant Impacts on these kids in dealing with their social and emotional issues. I mentioned a little bit about the schools, there are violent households and violent neighborhoods, a lot of economic insecurity out there we need to start teaching our young people how to handle these very high levels of stress. Jackie mentioned earlier the Adverse Childhood Experiences these kids are having at a young age, they have a Significant Impact us are happening but were learning that even further down the line that these childhood experiences are affecting their health and costing us a lot of money. So teaching these kids in school how to handle. Complicated lives in scenarios is important and a great investment in the longterm because we see the cost were talking about hundreds of billions of dollars over the next decade or two. Some of that should be an investment earlier in teaching our kids how to help themselves in ways that are more healthier. Thank you. Im a member of the National Press club, most of you on the panel are dealing with the opiate issue from the backend, after the dependencies are taking place. Would like to ask and its been mentioned that there are growing pushes out there to try to deal with this on the front and, theres an organization in your home state thats maybe created by your nurse anesthetist to come up with new pain blockers so dont have to use opiates as a companion to anastasia. Cvs pharmacy has announced theyre going to restrict the number of opiate pills dispensed to people who have trauma or post surgery, this Congress Working on this . Is there anything youre trying to do to close the door on the backend . I appreciate that, i think thats a huge point. Youre talking about Research Money and overseeing budgets come through congress that are very generous. This is been a trend going on for 15 or 20 years weve been able to stem the tide a little bit with the recovery act where he tried to bump up nih funding to try to make up lost ground. These are things we need to research and encourage some of these medications. Again, begin to train, theres a lot of mindfulness based approaches near talking about chronic pain, acupuncture, some of these things people dont get reimbursed. A lot of these techniques that would help there is no reimbursement which doesnt necessarily encourage more people going into those fields. Theyre starting to show signs of success, mindfulness based which helps with the morbidity issue which 12 weeks after program your scene 80 of the people feeling better about things and even up to a year later having been able to tame their addiction they begin to understand some of the deeper things causing the addiction which ultimately we want to get to the deeper understanding of why people are trying to numb the pain. Maybe as part of the prevention issue two. This takes resources. This lets get frustrating. Were a wealthy country, we dont want to waste money, we need to make the government run more efficiently. When we have problems in the country we need to come together and solve them and that means research and not all the research is going to pan out theres a general consensus that everything you research your supposed to have some product there that you can show everybody, look what happened. Some of this research wont present itself right away but over time people build on that research that didnt look like it had benefit but it takes time and resources to do that. I think it takes general acceptance by the country and the people of the country that its worthwhile. We have examples of how that can be the case especially faced with the epidemic thats costing us 700 billion. Thats significant. To say that we need to bump the nih budget to try to solve this problem, think most people would say thats a reasonable investment for us to make. I was wondering if anyone could talk more about the effect on the workforce . I think you mentioned the job and also if there is a rule for employers to play in helping with this especially as you look at the workers comp. Issue. A complicated question. The players are different in terms of how they handled the situations. There are some protections for people who have a Substance Abuse issue, they can turn to their employer and get out in terms of fmla and that sort of thing. But for more longer term treatment it becomes very challenging. I dont have a good response for that. Certainly this certainly something we see on the ground level quite a bit one of the primary ways that people with these addictions it affects the work tremendously. And quite often they do live there just jobs because they dont show up even past the point of their intervention. A lot of companies they have Employee Benefit packages that include the eap, so they will get them in an offer to get treatment and what have you. Eventually if changes are not made they will lose their jobs. I dont know what the dollar amount is in lost productivity but one more question. Im jean, freelancer and covering this for the wire, you mentioned not enough personnel to treat these issues, can we speak to that . Im sure salaries are an issue that is there a sufficient number of people coming to the pipeline, is that the sheer numbers of patients were presenting . They speak more about that . The problem is, for treatment of most of these conditions requires advanced education. Traditionally this education is underfunded and there isnt compensation from the employer for past college dues, college debt crew. Some of the medical programs have loan repayment programs and reimbursement programs for the medical school costs, these dont exist for a lot of the Psychiatric Services especially with chemical dependency. In terms of the number of providers, there just are not enough. Because of that aspect of it. I think its less a salary issue in terms of these providers are being provided to know. I will say for some of the support staff the salary issue has become significant. But the failure for reimbursement on educational cost has been a significant issue for Mental Health folks. I think whereabouts wrap it up. I started off this News Conference by giving you a sense of how we come up with ideas for newsmakers and how we make these things work. One of the things i didnt mention is we dont compensate speakers at the press club for traveling from california or ohio, but we give each of them one of these valuable press club mugs which im sure more than makes up for it. So we have one of these for each of you. As for now, we want to thank you for coming. It was a very good discussion and we will all need to watch for this debate in question on parity goes from here. Thank you. [applause] the cspan buses traveling across the country on our capitals tour we recently stopped in her spirit, pennsylvania asking folks whats the most important issue in their state. My name is larry, im from harrisburg. Im concerned about the libraries, i feel they are the hubs of small communities, Resource Centers to large cities. The Knowledge Base to the state. I am here to make sure theyre able to make sure they get the funding they need and the keystone grant is not taken away from them. Im sue helms, the state legislator here in pennsylvania, as i go door to door, the number one issue people talk to me about his property tax elimination. They just cannot afford to pay the property taxes anymore. However lately been get in question and talk about the opiate crisis which is something we have to correct and look into. Well do that, will work on legislation and put more money into it, we plan to solve the problem. Hello, my name is dana. The most important thing to me in the commonwealth of pennsylvania his continued support and increase support in our educational institutions. Thats from early age preschool throughout college and also support for the arts. Also museums and libraries. The most important issue is the responsible Energy Production thats taken place across pennsylvania. Not only because of the direct jobs impact, but, if we maximize our opportunity, we remain competitive we can bring manufacturing back to pennsylvania and brandnew industry and help make energy secure. Cspans washington journal, live every day with news and policy issues that impact too. Coming up on tuesday morning, Michigan Republican discusses tax reform and efforts to reform the Traffic Control system. The cspan bus tour continues in maryland. Floyd rutherford will be our guests to talk about top issues in maryland. Then ohio democrat will talk about nafta negotiations. Watch washington journal, live at 7 00 a. M. Eastern on tuesday morning. Join the discussion