Not only as a woman by the mother of five healthcare is one of the top issues to deal with but what we have seen is obamacare collapsing to talk about how healthcare in america is the perfect person to talk about that today with another issue is opioids that has been impacting families across the country communities with so Many Americans dying every year through an overdose so we will talk how President Trump and his team is committed to the crisis i am honored to introduce the panelist here and they are just incredibly talented. And with the Opioid Crisis. Kellyanne needs no introduction serving as counsel to the president the first Woman Campaign manager to win a president ial campaign. [applause] next to her is the administrator over two decades guided healthcare policy to create the nations first consumer directed Medicaid Program to be sworn in as a 15th administrator with Medicare Medicaid services. And then to take ownership of the healthcare. Thanks for joining us. So first we will have kellyanne talk about the Opioid Crisis what the president is working on to combat this issue. This is a true pleasure so to get right to the topic that can be harrowing and sad since it is a nonpartisan issue we feel emboldened under the president s leadership to tackle the three major challenges when it comes to the Opioid Crisis which we call the crisis nextdoor per prevention and education, lawenforcement and treatment and recovery. And those are to be tackled all at the same time. All of those that are dying from the opioid related death. And then the numbers club at 64000. We did not get here overnight and to change this overnight. So that president s commitment when they tackled the policy part, since then has directed the entire administration to take action for the country. So what is being done and how can they help . As they travel around the country to meet different types of people in various ways. Some have lost loved ones and others are successful and those are heartening. In a try to help others in need to meet with Law Enforcement and with Healthcare Professionals and folks all across the spectrum and we call this the crisis nextdoor to recognize opioid effects everybody across the economic lines. What is fearing is those the overdose of the data that it occurs. The cdc announced statistics there is a spike many are induced by fentanyl and that is possible when released into uphill somebody is taking and then they take the drugs but the sentinel based deaths are spiking up. We suffer from information underload with synthetic opioids. So fentanyl of course they could be more lethal than heroin or morphine. So that means to put out one page on safety and proper handling for Law Enforcement officers. So what is particularly challenging and you have that drug demand and on that label so that was meant to help someone some way and those are persuaded or that they use that as a cover for her not inherent use of somebody elses prescription. Whether through increased funding for coordination here is the cabinet where we literally meet on an ongoing basis to coordinate the dozens of programs and that is everything from interdiction to dhs. And also prevention education we also see a role for department of labor housing and urban development because we recognize first to be stigmatized. To take away that awareness that is important to the success of the effort overall. We recognize that they go through recovery looking for housing jobs so we try to tackle those individuals. So how does that affect women in particular . And if you look at use overall women are more likely to take prescription overall. You see doubling of americans who sought out emergency room treatment that they see that from both ends and gives them a heightened sense of his sponsor ability and opportunity so we are very hopeful about that. So of the bicameral bipartisan way to show america there could be agreement on this issue. So to have the democratic standing with the president has to do with the handling right recently the department of justice announced in louisville kentucky we will be there and also to designate each u. S. Attorneys office. And also with the curriculum that they are worth more than a pill they can be somebody and not a statistic so the first lady has taken on the issue in a bold way you heard her remarks on october 26i had the the privilege to travel with her to West Virginia she was on the ground that helps with neonatal abstinence as newborns are being born dependent. So there are many different ways to go about this recently hhs gave clarification to mitigate unfortunate circumstances we have encountered so many families that say there son or daughter or recess attended but the parents did not even know they had a problem. I know those stories are with us today and thank you for your courage to be on the front line. [applause] there is a circumstance to give Healthcare Providers to share information in a crisis situation. So it has been incredibly helpful we dont want the next facility to cannot get medicaid reimbursement if you have more than 17 bed and also with the groundbreaking work with the non addicted opioids. But for Many Americans they do rely on pain medication. It talks about sports injury it is offered a 30 day supply and it doesnt necessarily meet that but it comes a gateway to other behaviors. We also recognize many people are already in treatment so we need that education prevention piece as well. Lastly, we have been incredibly heartened from responses all over the country from people who did not vote for the president or did not vote at all but they see this as an issue to bend the curve. We talk to the Tech Companies and philanthropic groups and Small Businesses. Everybody comes forward to help. So to organize and duplicate and not replicate. To hear from the brave men and women on the front lines who are willing to help so to call upon you and also to say we are developing a dedicated website at the white house where people can share their stories. The president went first about his brother fred and he shared that story in his own words on october 26 we want the rest of the country to feel comfortable whether sadness of loss or grief or a law professional officer so when people look at full sooner neighborhood to say i like you you are like me it gives them current to come forward to be part of the solution. Thank you so much. Administrator . [applause] you have been an inspiration am so proud to be here today with the administration truly committed to womens health, families and children. We are advancing those to make a lasting difference in their lives every day. So from the centers for Medicare Medicaid we have a number of programs at t3 through medicaid and medicare and the products we have available through the exchanges. We are serving pregnant women, children, elderly the most vulnerable population. Also the disabled and senior population. It isnt the 140 million but from my perspective i had a recent Family Healthcare with my husband having a heart attack and he gave me some perspective of what patients go through it was a face when having to deal with the Healthcare Delivery system. It isnt easy to navigate. What doctors you pick, Treatment Options and how much will it cost . So what we want to do is empower patients. Those who make the healthcare decision and for the tools that they need. And then to do return that decisionmaking to have that interaction so one of the other things we are doing is making sure the programs are modernized changing with the innovation in the healthcare industry. And also trying to do what we can to respond to the opioid epidemic. This can be personal and i remember a few years ago when my daughter was 13 we attended a funeral for a kid in her classes older brother and he went in to a routine surgery and addicted to pain medication. I remember the words of his sister who was 13 and talked about the anger at her brother and the tragedy and heartbreak in her voice never being able to see him again. This is a personal issue and we are doing all we can. Because of the president s leadership we declare this a Public Health emergency and it has allowed our agency to take immediate action. And to provide treatment facing opioid addiction. One of the things we found is when people are ready for treatment we want to make sure it is available. Not that there is a waiting list or no bed available. Now we allowed the states to waive the laws that would prevent individuals from getting treatment and it is heartwarming to go to utah to approve one of the first waivers to allow individuals on medicaid to seek treatment. They had construction because they were expanding the Treatment Center because now they know they dont have to worry about the 16 bed limit. Also traveling to new jersey meeting a woman named vanessa facing infection she couldnt get treatment because of the exclusion and ended up in jail and ultimately got out and got clean and get treatment and now spending her time helping other individuals get the services they need to provide resources and support. We know we can address this issue. We appreciate the opportunity to be here. [applause] these are the Untold Stories that commitment by this administration and President Trump. Now we turn to the women on the stage the current attorney general of florida. [applause] rebecca clay fish the current tenant governor of wisconsin b17 and catherine is the first lady of north dakota working on these initiatives fighting addiction and the north Dakota Community b17. [applause] before we turn from the stage and would like to introduce our special guest working hard every day leading the charge ladies and gentlemen the president of the United States donald j trump. [applause] sit down please. I was not very far away so i said i would love to do this. This is fun but thank you all and for the job you have done. It is incredible. You know how successful our tax bill has been we had women front and center. But i am honored to stand here with the women of course from all across the administration. They have been incredible. T12 and everybody appear and pm is doing such a great job in florida. Also the first lady of north dakota for being with us today. [applause] and the Lieutenant Governor of wisconsin, rebecca, great job. We are doing okay in wisconsin. That is for sure. A great place and again thank you very much 2 00 p. M. Arkansas. How did i win arkansas by so much . Thank you very much. Chairwoman of the Republican National committee michigan it wasnt one in decades. Thank you you are representing everybody very well. But what they care about 100 of the issues. We are making incredible process the Unemployment Rate hit the lowest level it has been in 17 years. That is something. Women in the workforce reached a record high. More today than ever before. Especially since it is on my watch i am proud of that. One statistic that just came out is the black Unemployment Rate, the africanamerican Unemployment Rate is the lowest it has ever been. We are honored by that. He have enacted massive tax cuts. Those that start to see their paycheck have a little more money if you pick up that extra two or 300 on a monthly basis then that has a big impact. Little did we know at t started it but they started to give out 1000 to everybody now one after another now they say what about us . It kicked in a lot faster than we thought that the stock market is up again today. We have a long way to go. At the other side had gotten in the market would have gone down 50 . It was stagnant and going down. Just look at the gnp from the beginning. If you look at any statistic, gdp in particular was stuck and headed down. We took off restrictions and regulations and even regulations that we are cutting those also. [applause] you dont need nine different regulations because we have to free up the banks because they are able to do that. A person came up to me at a recent stop all my life i did business with a certain bank i voice paid my debt and my loans now i am prohibited but now i can do business with them. But regulations had a lot to do with that success look at what we have done with the pipelines. From almost day number one. We have plans all over the country and toyota is moving back. Chrysler is leaving mexico moving back to michigan. [applause] and then to double the child tax credit. Womenowned Small Business can deduct 20 of the business income which is what people did not expect they would be seeing that my president ial budget was the first to include for paid family leave. [applause] and we are partnering with communities to end drug addiction. That is a problem we are working very hard on. Even if they are not involved they are all working hard. So people within the family there has never been a time like this. Son areas take care of that but we dont. But we have a tremendous drug population we have dealers all over the country and we are hitting them hard. But it is something we are focused on whether the opioids or the drugs much comes through the southern border. People dont like to talk about it but it happens to be true. And then they come in many different ways. And then we get it taken care of one way or another. We have to get tough because that eats away at the heart. So that being said i appreciate you being here, it is an honor so i ran across the street when i heard. [laughter] so now i will run back to the oval office 17 spee17 but we made made a tremendous amount of progress. In a very short period of time. Looking at what has gone on with the stock market with 8 trillion worth of value. Just the stock market not mentioning all the other things that there are so the country is on the right track and hopefully at some point we can solve that problem. But we are working on getting it done one way or another. I will see you soon. Thank you very much. [applause] you can all go home now. [laughter] just kidding. So that was a treat. It really is such an honor to work for the president to be part of his team every day. So now we turn to the women on stage who are asking questions on this issue of opioids and healthcare. Please introduce yourself and tell us where you are from and then we will start with questions. I am with Phoenix House as a drug treatment provider nationally but unfortunately i have been in the field over 40 years this is the sixth administration i have worked with in the attempt to solve this problem. In this political world it is not a political issue. It is nonpartisan. So do to the intensity and toxicity of chemicals on the streets or what can we do realistically about providing instant access . As much as we like to think it exists, it doesnt. Those who wait to get in, get a bad, but when they leave their resources are not there to maintain medication. Before. For who approved waivers in many different states. We have other states in the pipeline. That would be a major piece of that. States are putting proposals together not just about expanding treatment but we need to develop when others detox that is when one people are leaving the facility we want to make sure that outpatient services. When i look at the problem from the medicaid and medicare perspective dealing with that only the addiction but other comorbidities. An increase in hepatitis and hiv. From the medicaid Perspective Program delivers 50 of the nations babies. Theres many babies being born with withdrawal systems. What is that mean over the longterm, what are the children going to need growing up . Looking at the foster care system because markets are going into foster care when need to think about the Health Care Needs for these children. As the comprehensive system. As were looking at states its prevention and also enforcement over the long term. Were trying to encourage states to avail the services. We had a joint meeting last week with the leadership of cms are doing Exciting Research around medication and stressing evidence around medication insisted their people. Working to make sure they are aware of the. Even though this has president ial behind it will believe the best ideas and Solutions Come from washington, we believe those closest to those of a know best and how to service them. Firehouse chiefs with a Good Samaritan law which i believe 41 states are so do you will be pot prosecuted, they do a handoff and it is about accessing overdose reject bursting drugs. We recognize sometimes in multiple doses. Some are running out early in the month. His listening, learning and coordinating that. But not displacing or preempting what the states are doing. Different areas have different needs. I hear you clearly. I believe this president will bend the curve im happy with what weve heard from people in the private and Public Sector about great ideas and the local employers can be very helpful in that demand two. They see it. They in seen employees who can pass truck tests. We will continue to believe these solutions will come from the ground up. My name is emily, im currently ready to hit six years sober next month. [applause] tried many different methods there is a Great Program that helps save my life, im six months pregnant and now wife, homeowner and employee. [applause] i have the privilege of working at the program after i completed for three and half years. I now work ride shattered, a company that employs women previously addicted. My question to you is, with the current statistic of what the cdc put a the said three out of four new heroin users started off with prescription opiates, with the current plan to reduce the and has it been looked at about reducing the chemical compounds that are put into it by the fda, was a looked at significantly reducing the amount put out similar to the 80s when jean put that out for the methamphetamine problem . The major chain drugstores along with farm and others have said they favor prescription seven days, not 30. So you do go home with a smaller amount. Other states are great examples where you have republican governors working with democratic legislators to reduce the first time prescription depending on the state. Its possible and is happening. All at the administrator talk to the chemical compounds. There are some administrators and a full on offense on this issue. Its positive because with supply comes to man. I want to go back to something i said 40 minutes ago, because its in the medicine cabinet in your house, nobodys in a back alley with the needle come in out of the rain, that tammy battle has a label and thats what makes it so different an unsuspecting for many communities. Just because its there doesnt mean its for you and that you should try it. Now for the medical perspective. Went they were grateful for this at the cdc put out guidelines that are critical and needed. What were doing is taking those guidelines and working to get it out her healthcare facilities. I think youll hear more about them from us on this issue and trying to force the guidelines. The anything were monitoring provider behavior. We have a website where you can track where prescribing is going on. Its a great tool for local communities. From the federal government perspective we want to support efforts to get data. The nih in particular is doing work around research and evaluation about the best strategies of dealing with pain. We have to figure out, the other things we could pay for. Russell trying to figure out how to make sure the locks own is more available. They can better require medication available for individuals in the program. Im linda from michigan. Im the judge there were families against narcotics. I also have a child thats in that recovery. Ive dealt with this firsthand. It seems that there is a disproportionate amount of methadone being used for young offenders. I Read Everything thats come out and i know they say methadone should be used for a small percentage. But in our community is being funded for about 90 of people in publicly assisted treatment. Is there monitoring that will take place to make sure all forms of medically assisted treatment are being used and being used appropriately for each individual . We appreciate the struggles that are going on in michigan. One thing i think is important is that doctors and patients need to make decisions about what will work best. When it comes to treatment Different Things will work well a person doing what we can in terms of monitoring. What providers need is evidencebased guidelines to understand whats available and what will work best. Thank you for your leadership is awesome to have you in that role. One thing were doing is asking our citizens to unite the Grassroots Movement to Start Talking about the disease of addiction to eliminate this stigma. As some of his better recovery for 15 years. I know firsthand the devastation and disease that can cause have my disease prevented me the shame and stigma from reaching out for help in recovery. So i concur one aluminate in this shame and stigma is important for this process. To have specifics you might be planning . We appreciate you being here and to help others. There are existing materials and communities have done a good job place to place if you think your coworker or family worker with Behavioral Changes in someone say theyre tired or having a bad day you hear all these different excuses for why somebody seems like theyre in a different router mindset are not fully present. Because you dont think of your coworker or child a salon with the back alley with the vei neee coming out of their vein. You can do it in the privacy of your home and thats what is happening. If some people who read every label about what they put in their body and have one or two ingredient and then they buy a pill for 5 and laced with fentanyl. It is awareness. People dont believe it can happen to them. There are no comorbidities for some folks. Tobacco in some states, marijuana, drinking, im only doing in moderation, its the pill for start out as a gateway to accidental overdoses. Think you need to have the conversation even if you dont think its relevant. We have to start you on. The first lady made it clear, we have to educate our youth. Now we see shock ads in other industries, the warm the heart stories of treatment and recovery and you dont need to do that to be cooler feel better about something, really getting people in touch with treating the hope person but the best way to tell people you dont need to feel shame or stigma stigmas to give them a form where others go first. Its powerful that the president went first and told the family story. When i met linda i met her and Drug Court Judge and her daughter had everything going. Allows other people to come forward and say that. It has to start peertopeer. They want to hear from people who share common experience. But these fatality rates also for older people too. Were not just talking about teenagers in high school. The senior population is increasing to everyone and everywhere. To that extent it should make you laugh you alone for unusual. Would make Good Progress with our Prescription Drug monitoring program. Loosing prescriptions go down so i believe it often involves more than just our department of health services. Sometimes as the department of corrections or department of children and families and workforce development. We have a medicaid waiver and would like to drug screen so we can pay for medicaid recipients. To talk to us about wraparound care. The Services People need pretreatment tickets recovery. It is comprehensive treatment. In a point that kelly and made that we dont always know whats best in washington. Before i came to cms i was working with states and i can tell you we had great ideas. Sometimes they were not listen to in washington and we had to fight to get reforms. What i think is important is that we listen to local communities and understand what the issues are and test out new ideas and even largely dealing with poverty around the Medicaid Program. Were willing to try and be a partner with states and local communities and try out innovation and ideas. My pledges to have a new era of flexibility. States are best positioned there on the front lines and they know their frontlines better than we will know in washington. I think we can learn from each other for these things. Thank you. And thank you for the women here on the stage. Thank you for the work you are doing. Relisted, President Trump is committed to in terms of dealing with the opiate crisis. These wonderful women are working day in and day out to ensure we find the right solution for these families. Will good break. Will reconvene for the National Security safety panel at 3 10 p. M. Thank