I just said take your seat. We will start the next panel on healthcare and the opiate crisis. Mercedes, communication advisor is going to moderate it. With that, i will introduce them to the stage. [applause] its already afternoon. The hours go by very quickly at the white house. Good afternoon and thank you for being here. Not only is a woman but a mother of five, healthcare is a top issue we deal with and also for american families. But we have seen is obama care collapsing. We have an opportunity to talk about how healthcare in america will be better under President Trump. The perfect person to talk about the i introduce the panelist here on the issue of opiates. It has been impacting families across the country and communities being impacted was so Many Americans die every year because of overdose. Its a sad story here in america. We will talk about how President Trump and his team is committed to combating the opiate crisis. Im honored to introduce the two panelist. I have gotten to know them well. They are incredibly talented and being able to talk about the issues of healthcare in the issue. Kellyanne conway needs no introduction and is currently serving as counselor to the president. She was the first Woman Campaign manager to win the president ial campaign. [applause] we are proud of the work that kelly and is doing day in and day out for President Trump. Next to her is administrator seema verna. She is guided healthcare policy and the public and private sector helping to create and implement the first consumer directed Medicaid Program. She was sworn in as the 15th administrator of the centers for medicare and Medicaid Services with a commitment to empower patients to take ownership of their healthcare. Thank you for joining us. [applause] to start off, i will let kelly and come over and talk about the opiates crisis and what the president and his team is working on to combat this issue that is devastating to so many families in the united states. Thank you. Its a pleasure to work with you. I appreciate the introduction. This topic can be harrowing and sad. We also feel since it is a nonpartisan issue we feel emboldened that under this president s leadership will be able to tackle the challenges when it comes to the opiate crisis which we call the crisis nextdoor. That includes prevention and education, lawenforcement a treatment and recovery. Those are meant to be tackled at the same time. Right now as i stand here 116 americans are dying every day from an opiate related death. From 2015 or 52000 people die from junk overdose the numbers went up to 64000. Sadly the numbers may get worse before they get better. We did not get here overnight and we wont be able to change it overnight either. With the president s commitment since in the president has directed his administration to take action. Was a call to action for the whole country. As we travel around the country, we meet different people affected in various ways. Some have lost loved ones to opiates, others of us are successful stories of treatment and recovery. And then they take their successes and tried to help others in need. We meet with lawenforcement, dea agents, Healthcare Professionals faithbased leaders, folks across the spectrum. The reason we call it the crisis nextdoor is that when you look at statistics you see opiates is affecting everyone across these economic lines. No state has been spared and no demographic on touch. Its the rapid miss with which the use and overdose and deaths have occurred. The cdc announced and released at statistics showing theres a spike up in these deaths. Many are being induced by fentanyl. Thats when its in a pill somebodys taken her taking the drug through different means. Fentanyl lace drugs are spiking up. Fentanyl is 50 times lethal than heroin. One hundred times more than morphine. It means that just this past november that administration put out a one pager on handling fentanyl for lawenforcement officers. In addition what we see as challenging and we have had drug demand in this country for many years. With opiates its tricky because it often starts in the Family Medicine cabinet and on the label of that tiny bottle theres the doctors name and pharmacy. That either becomes very tricky for folks who are persuaded that can hurt me because it was meant to help, or theyre using that as a cover for non inherent use of someone elses prescription. Whether through increased funding, awareness record nation we have an opiates cabinet where we meet just a cornet the dozens of programs that already exist across agencies and departments. Thats everything from doj and dhs to treatment and recovery. Certainly prevention education. We see a role for department of labor and housing and urban development. We recognize we need to destigmatize. Taking that away is important to the success of the effort overall. We recognize that those like enough to get treatment go through recovery are looking for housing opportunities and such. Were trying to tackle the individuals affected all at once. How does it affect women . Women tend to be the healthcare consumers and providers. Women are more likely to take a prescription overall than men. Theres a doubling. Since women are disproportionate Healthcare Providers there seen it from both ends. Gives them a heightened sense of responsibility and skill an opportunity to help in the curved. Last week the president signed into law the interdict act and its a bike partisan way to show america there can be agreement on this issue, we havent democratic and Republican House members and senators standing with the president. Recently the department of justice announced its first Office Opening in louisville kentucky. Also to designate a special opiate designated individual. Were trying to work with those with our youth that they are worth more than a pill. They can be somebody, not a statistic. The first lady has taken on this in a bold way. Had the privilege of traveling with her to West Virginia where she was on the ground at the center called the least place. It helps the neonatal abstinence syndrome. Newborns are being born dependent on opiates another drugs. That has quadrupled. There many different ways that were going about it. Recently the health and Human Services gave clarification on hippo laws. Mitigating circumstances. Weve encountered families across this country who tell their story of their son or daughter who had been resuscitated but the last time there too far gone. And the parents that i didnt even know they had a problem. So thank you for your courage and for sharing and being on the front lines to help other people avoid the same circumstances. Basically what theyve said is that there are circumstances they give Healthcare Providers brought ability to share information in those areas that would not violate hippo. Offices are being incredibly helpful. I think were up to eight states that have a waiver. Essentially we dont want the number of people treated in a facility where beds are available meaning you can get medicaid reimbursement if you have more than 17 beds. Nih is doing groundbreaking work as are some of the private companies. We recognize that Pain Management might not mean Pain Management but many do rely on pain medicine. Were essentially talking about the sports injury, the dental procedure where individuals offer a 30 day supply of prescription opiates and doesnt necessarily need them. It becomes a gateway to other behaviors. We also recognize that many are already in treatment that needs to continue. Lastly, we have been incredibly heartened by the response from all over the country from people who didnt vote dont care much about the political process, they see this as an issue where we can bend the curve for brothers and sisters across the country. We talked to Corporate America and Small Business america, nobody has said no. Everybody wants to help. Part of what were doing is trying to organize and Carry Forward and to hear from the brave men and women on the front lines were willing to help. We like to call upon you to hell. And finally, we are developing a dedicated website where people can share their stories. The president went first and shared his story about his brother fred who passed away at the age of 42. He shared that spontaneously in his own words. We want the rest of the world to share their story too. Whether its a lawenforcement officer, healthcare profession, i think when people look at folks in the neighborhood since i like you and you are like me, gives them the courage and encouragement to come forward be part of the solution. Thank you very much. Thank you Kellyanne Conway been an inspiration to many women. We appreciate your hard work. Im proud to be here and honor to serve the American People and to the ministration thats committed to Womens Health family and children. Pets advancing the best ways to help those in need by making a lasting difference in their lives every day. So little bit about their services. A cms we have programs and we serve hundred 40 million americans to the Medicare Medicaid program and products we have available through the exchanges. We are serving pregnant women and children, disabled and the elderly. Also serving the disabled in our senior population. Its not about the hundred 40 Million People as a whole. I like to look at the individual. I just had a recent Family Health scare with my husband having a heart attack. It gave me perspective of what patients go through and what they have to face with the Healthcare Delivery system. Its not easy to navigate the system. How much is it all going to cost. These are issues all americans face and that cms we want to empower patients. We want to make sure patients and families and women who are making Health Care Decisions for themselves, partners and children that they have the information and tools they need to make decisions that work best for them. We want to get washington out of the way and have that interaction occur between patients and their doctors. Another thing were doing is making sure our programs are modernized to deal with the changing evolution of technology and innovation. Were also trying to do it we can to respond to the opiate epidemic. This can be very personal. I remember a few years ago when my daughter was 13 and we attended the funeral for a kid in her class and her older brother. Take 70 kids he had gone in for routine surgery and became addicted to pain medications. I remember the funeral in the words of his sister who is only 13 at the time. She talked about the anger she felt with her brother about getting mixed up in it. This is the personal issue for all of us, were trying to do what we can to address this issue. We are appreciative of the president s leadership. Because of that hhs declared this a Public Health emergency. It has allowed us to take immediate action. Were trying to make it easier for states to provide treatments to individuals with opiate addiction. When people are ready for treatment we want to make sure the treatment is available. They dont want to hear theres a waiting list or theres not a bed available. We have gotten rid of allowing states to pay it was heartwarming to go to the state of utah to allow for individuals on medicaid to have treatment. There is construction going on and they know that they conserve individuals dont have to worry about a 16 bed limit. I traveled to new jersey where i met a woman named vanessa. She was facing addiction, she could not get treatment because of the imd exclusion that she ended up in jail. Ultimately she got out, got clean, was able to get treatment she is now spending her time helping individuals get services they need in providing resource and support. Victory is on the horizon and we know we can address the issue their stories like vanessa that we hear about that are inspiring to all of us. I look forward to your questions. Thank you. [applause] these are the untold stories. This is the work by this administration by President Trump. No return to the woman on the stage. I want to introduce a few women on the stage. Pam is with us. Rebecca clay fishes the current Lieutenant Governor of wisconsin. [applause] Catherine Bergen is the first lady of north dakota who has been working on these initiatives for fighting addiction in the community. [applause] before we turn to the questions it here from the stage, i want to take a moment to introduce a special guest who has been working hard to lead the charge to empower women and americans. Ladies and gentlemen, the president of the united states, donald j trump. [applause] [applause] sitdown place. I was not very far away so i said i would love to do this. This is fun. But i think you all for the job you have done. I know we appreciate it. What we have done in our tax bill and weve had women front and center, think youll know that but people from all across the administration have been incredible. Kelly and has been something, pam doing such a great job in florida, were proud of you. Everybody up here has been very special. I think first lady of north dakota, catherine for being with us today. Thank you very much. [applause] the Lieutenant Governor of wisconsin, rebecca. Great job. Were doing okay in wisconsin, thats for sure. And also pam, we thank you again. Arkansas, great state. How did i win arkansas by so much. Less leslie, thank you. Chairwoman of the Republican National committee and in charge of our campaign in michigan. Willie one michigan i said i said i have to keep her going. So ronna mcdaniel. Thank you. Great job. Representing everyone very well. I love your appearances. Women represent half of the population but they care about 100 of the issues that face the nation. The womens Unemployment Rate at the lowest level that it has been in 17 years. And women in the workforce reached a record high. Thats terrific. Especially senses on my watch i feel proud of it. I have to tell you a statistic that just came out recently. The black Unemployment Rate, the africanamerican Unemployment Rate is low since ever been. Were very honored by that. That is great. [applause] weve enacted massive tax cuts. You see whats happening, far beyond our expectations we thought of february people would start to see their paycheck have more money in it. You pick that extra two or 300 on a monthly basis, that has a big impact. We thought it would be february. At t started it, these companies started giving out a thousand dollars, now the few that havent the employees are saying, what about us. So kicked in faster than we thought. The stock market is up again today. Resetting the record all the time. We have a long way to go. Had the other side gotten in, the market would have gone down 50 from where it was. Remember that. It was stagnant going down. All you have to do is look at the gnp from the beginning. Look at any statistic, you can look at gdp or any statistic a look at where they were. But gdp was stuck in heading down. We took off restrictions and regulations. We saw plenty of regulations although that we are cutting a lot of those two. [applause] you dont need nine different regulations. Were looking at dodd frank so the banks can loan money to people. They were restricted. A person came up to me at a recent stop and said, all my life i did business with a certain bank and now they cant do business with me. Theyre prohibited from doing it. Now they can do business with that person again. But the regulations had a lot to do with this success. Without taking off those regulations look what we did in terms of pipelines, 48000 jobs from day one. On things that were never going to get built. We are plants all over the country and toyotas nipping back. Chrysler is leaving mexico and moving back to michigan. You havent heard that one in a while. [applause] one of the important things were doing is doubling the child tax credit. Thats important to all of us. America can now deduct 20 of their business income which is something people did not expect they would be seen. My president ial budget was the first in history to include a nationwide program for paid family leave. [applause] and we are partnering with communities to and this drug addiction that has plagued our country. Talk about a problem, were working hard on it. Everybody here, even if theyre not totally involved theyre all working hard on it. Some people within the family themselves are working because their people within the family and trouble. That is number one in our list. It is a worldwide problem. Some areas take care of it through tough measures. But we have a tremendous, massive drug problem in drug population. We have dealers all over the country. And we are hitting them hard, the dealers. What they have done to families and doing to the country something were very focused on. Whether the opiates or drugs as you hear in the traditional sense. Much comes through the southern border. People dont want to talk about it but they come in through many different places and means. But we are on the drug problem as much as you can possibly be on it. We will get it taken care of. The tougher we get the better it will be the faster it will go away. We have got to get really tough on that problem. Its eating away at the heart of our country. I appreciate you being here. It is an honor. When i heard i ran across the street and now i will run back to the oval office, but we have made a tremendous amount of progress. In a very short amount of time. When you look at whats gone on with employment in the stock market, weve created almost 8 trillion worth of value just in the stock market. Thats not mentioning the other things. Were working on immigration and immigration reform. Hopefully at some point we can solve the problem. Well get it done one way the other help. Thank you for being here. Its an honor. [applause] you all can go home now. Im kidding. Well move over, that was quite a treat was slim. [applause] such an honor to work for the president to be part of his team and commitment every day for american families. With that, i want to turn to her women on stage will be asking questions to kelly and on this issue of opiates and healthcare. If you could introduce yourself until swear from, lets start with questions. Thank you. We are a drug treatment provider nationally. Unfortunately i been in the field for over 40 years. I was telling my colleagues that this is the sixth administration i have worked with in an attempt to solve the problem in this political world rent its not a political issue. This is a nonpartisan issue. My question is, due to the intensity and toxicity of the chemicals on the street, what can we do about providing instant access. As much as we like to think it exists, it doesnt. I have people die waiting to get a bed. On the backside of it when they leave the resources are not there to maintain the medication they need. So all the good work that was put in into a treatment goes for no caps theres nothing there to support. I think this is about Building Systems of care. We have to look at this is comprehensive treatment. When people are ready for treatment making sure theyve had access. So the president s leadership round to having a Public Health emergency has allowed us to expand services. Kelly and has mentioned states weve approved waivers in. That will be a major piece of that. The best states not just about expanding treatment but we want to develop a continuing of services. When others detox thats only one piece of the puzzle. Some people are leaving that they may should have outpatient services. When i look at the problem from the medicaid and medicare approved perspective were dealing with the addiction and other comorbidities. Weve had an increase in hepatitis and hiv. I look at it in terms of the Medicaid Program delivers 50 of the nations babies. Theres a lot of babies being born with withdrawal systems. What does that mean over the long term . What are theres children going to need as they grow. Looking at the foster care system. More kids are going into foster care and the systems are overwhelmed. So what are the Health Care Needs for these children. Its about building a comprehensive system. Also working to figure out how can we develop that comprehensive system. His prevention but also treatment. Enforcement over the long term. Weve heard about the medicaid assisted a therapy and we are trying to encourage states to avail those services. We had a joint meeting last week with the joint leadership of nih and theyre doing Research Round medications and stressing new evidence and how important it is. I want to add that even though this has president ial pope but behind and administration wide attention and effort, we dont believe the best ideas and Solutions Come from washington. We believe those closest to those in need know best on how to service their needs. Had firehouse chief who doubles as Health Professionals in your driving your overdosing friend, you will not be prosecuted. Theyll do a warm handoff. Its about accessing some of those drugs to counteract the overdose. Weve heard all types of things. Its listening, learning and coordinating that from here but not displacing or overwriting or preempting what the states are doing. Different areas have different needs. I honestly believe this president will bend the curve in the other direction. Im happy with what ive heard from people they just needed administration to put into practice and give it a try. We also talk about the local employers. It is because they see it. They seated employees who cant pass drug tests. We will continue to believe these Solutions Come from the ground up. The next question. My name is emily. Im currently about to hit six years sober next month. [applause] ive tried many different methods, faithbased program help save my life. Im currently six months pregnant. Also now a wife, a homeowner, and employee. [applause] have the privilege of also working at the program after i completed for three and half years. I now work for shattered, company that employs women who were previously addicted. To help on the other side of the exit plan. My question is what the current statistic with the cdc put on this is three out of four new heroin users start with prescription opiates, was the current plan to significantly reduce that. Has it been looked at about reducing the chemical compounds that are put into it and regulated by the fda . Have they looked at reducing the amount put out some were similar to the 80s when they put that out for the meth and methamphetamine problem . The major train jokesters along with farm and others have said they favor first prescription of seven days, not 30 pretty. Some states like massachusetts and new jersey are great examples we have republican governors working with democratic latest legislators to reduce the first time prescription to three, five, seven days. Its possible and happening. All let the minister talk about the chemical compounds. Youre talking about a full on offense on this issue. Lets face it, with supply and oversupply comes more demand. I want to go back to what i said 40 minutes ago, because its in mom and dads medicine cabinet in your house, the liquors locked up and nobodys in the alley with a needle in there. They have a label these bottles have a label with the doctors name on it thats what makes it, we have to make sure that people know just because its there doesnt mean its for you and that you should try it. Now for the medical perspective. When they were grateful for is the cdc has put out guidelines for prescribing their very much needed. What were doing is taking the guidelines and working with them about getting it out our healthcare facility. I think youll hear a lot more from us on this issue. In trying to enforce some of these guidelines. Also monitoring provider behavior. We have a website where you can track where prescribing is going on. Its a great tool for local communities. This is a local issue. We want to support their efforts in getting the data is very important in that regard. The nih in particular is doing a lot of work on research and evaluation about what are the best strategies for dealing with pain. Their happiness because we have to figure out what are we paying for, are there other things we could pay for that are alternative to the opiates available . A lot of work is going on in that area. We also want to figure out how the locks on is more available. We have time for one more question. Hello im linda from michigan. Im a judge there and run an Organization Called families against narcotics. It just became a national organization. I have a child who is in recovery so i have dealt with it firsthand. My question, it seems in our community there is a disproportionate amount of methadone being used for young offenders. Ive Read Everything that comes out and i know the guidelines say methadone should be used for a small percentage yet its being funded for about 90 of people going into publicly assisted treatment. Is there monitoring to take place to make sure that all forms of medically assisted treatment are being used . And then its been used appropriately for each individual . We appreciate the struggles that are been going on in michigan. One thing thats important is doctors and patients need to make decisions about whats best for them. When it comes to treatment Different Things will work for different people. Were doing what we can to monitor whats in fact effective. They need evidencebased solutions. Were going to ask one more question. Thank you kelly and for your leadership in finding solutions. Its awesome to have in that role. One thing were doing is asking our citizens to unite in a Grassroots Movement to Start Talking about the disease of addiction and so we can eliminate the stigma. As someone who has been on longterm recovery for 15 years. [applause] i know firsthand the devastation the disease can cause. My disease prevented me from reaching out for help in finding recovery. So we concur with you on eliminating the shame and stigma around the disease of addiction. I wonder if you have any specifics you might be planning as part of the administration around . Thank you for being here and always been willing to share your story and help others. There are existing materials and communities have done a good job on the telltale sign. If you think your coworker Family Member or sometimes they just say theyre tired or the have and it that day or over eight, you hear different excuses for why somebody seems like theyre in a different mood or mindset. Because you do not think of your coworker and Family Member as someone in the back alley, that is not who is getting hooked. You can do it in the privacy of your home, thats where is happening. If some people who read every label about what they put in their body and have to have one or two ingredient and then they buy pill for 5 and its laced with fentanyl. It is awareness because people dont believe it can happen to them. There are no cool morbidities for some folks. Any other is tobacco. Tobacco in some states, marijuana. Drinking. It is the pills that start out as the gateway to heroin use and accidental fentanyl overdoses. Its having a conversation even if you think its not relevant. We need to start young. The first lady made this clear, we have to educate our youth. We do that through shock type ads in other industries, the warm the hearts stories of treatment and recovery and you dont need to do that to be cool to feel awake or better about something, really getting people in touch with treating the whole patient. But these sharing the stories would be great. You dont need to feel shame or stigma. In that regard as powerful that the president when it first and told his family story. Everyone has one. When i met linda she was a Drug Court Judge and she told the story of her daughter who had everything going for her. He started this network that is now national. It allows others to come forward to say that. Starts peertopeer. Thats two people want to hear from. But you also see fatality rates in older adults too. Were not just talking about teenagers in high school. The senior population is increasing. To that extent theyre not alone but also not unusual in their circumstances. You said it well. Thank you, im rebecca. Weve made Good Progress with just Prescription Drug monitoring program. Weve seen prescriptions go down 12 but we know many cases it involves more than just the department of health services. Sometimes its the department of children and families and department of workforce development. So we would like to drug screen so that we can pay for treatment for medicaid recipients. Talk to us about wraparound care and the Services People need to get treatment. You write comments comprehensive treatment. Its a point that kelly and me. We dont always know whats best in washington. Before i came to cms is working with states and have my own consulting company. I can tell you we had great ideas sometimes those were not listen to in washington and we had to fight to have those type of reforms. What i think is very important is that were listening to local communities and understanding what the issues are test out new ideas and innovation around how were dealing with the epidemic or poverty. I can tell you we are willing to try and be a partner with states and local communities. To try out innovation and ideas. That is my pledge, to have a new era of flexibility. States our best positions. They know their population better than we will know in washington. We want to partner with them and learn. Thank you so much. Thank you for the women on the stage. Thank you for all the work youre doing. Thank you for listening in on the work the administration is working on. What President Trump is committed to in dealing with this crisis. Wonderful women are working day in and day out to find the right solution for these families. And i turn it over to kelly. Will go to break and when we reconvene at nine and ten. [inaudible] [inaudible] [inaudible] [inaudible]. The mayors of houston, key west in ponce, puerto rico on efforts to rebuild after recent hurricanes. Karen pence, wife of Vice President mike pence spoke at the mayors winter meeting. Talked about arts therapy and benefits for mental health. This is part of the conference that is 20 minutes. [applause]