Nursing homes and i have seen and avancements and the side by to mass the effects and the evolution of igh cannotics whi they do have the side effects, but i do thank the gentleman for bringing it to loit. Medication plays a major role ap pharmacistswing and are playing a greater role. This is a evidence that they and they ress the have free roles and address the crisis. And support early worg in pharmacists can case compinging. Hinks new roles would increase Early Detection and follow plifeyu. Secondly, they can play the ue in med case review, strategies decision d shared neighboringing. And improve ers to medication. Pharmacists can help farm ay services. Over the years, the relation etween the two have be cooperative. With this this new relationship rgs they can change the at tudes. Ripttive wing from my hope he vania ks i will be a flend and end this. And i thank the thank of gentleman for yieldic my they ime. Stafersestaferse mr. Steer, i spend to the desk two twiffled reports. The speaker pro tempore the clerk will report the title. The clerk consideration of the ill to place the oversight sight under the process to provide for reporting and Public Notice for the the other purchases ap providing for crrgs f the bill, to raise the threshold under the statement and for other purposes. Report to accompany. Consideration of the bill. 2666 to prohibit the commission the. Egulationing the speaker pro tempore referred to the house calendar and ordered printed. I would like to call on representative blure. Nd he made a number of moifingses and i would like to pl to yeed yield do to mr. Blumenauer. Mr. Blumenauer the sun is setening on our nation capitol. Many of or colleagues have returned to washington drs and they are with meeting where their convincens and i appreciate to highlight what you ave worked on so hard and each ap every american needs to address because we are all in this together. I will will a this as a chilelellingstur, i was part of the movement. It made a lot on of sense. Some ofave said, we add the conditions and some of the twreement isnt nothing we would accept today and the notion of allowing people to be helped in deinstitutionalized setting made sings. Ut we gnt do a good job. The institutionalization worked if we were wrrking. With medication, with counseling, with house ig and adly when we hit them, who followed what ms. Wasserman schultz in theory found there wewe are too many people. And we could see evidence of the stale you are some do the institutional right on the streets of every Community Large and small from coast to coast. I appreciate your efforts to help refocus the federal pardon. Here is a role for satan local governmentment but the goffed rovides a prame work and a a legal frame wrk and there eggs a Legal Framework that reflects the lessons we learned and the reality yites today. D you have been patient that carried the questions and concerns. You have tackled an area that is come plention, its controversial and there is room for give oonch take and i feel in the hours and hours that wife talked about that. We have seen jugs that. I have incrorpted this and appreciate that. And you are establishing a number of oufer colleagues that progress. Make in our community wically r call it the collaboration between four major hospitals to have a place where we can talk hep with mental problems out of Emergency Rooms ment where its costly and lies can do is stable them. And pose problems to themselves Mental Health ur sches is to be found behind boors. Its not the cost effective. We are making the maul step. And give better care to a population that is very much in need. Im hopeful that we will be fell rful and who you are working ith, that we will be able to work that partnership, than have re assistance to our communitiesies and in the experience we are a quired. Im proposeful to develop fools bre of the most erm and vented because of the Regulatory Framework we have and it shouldnt be a barrier for families to be to be the only people who know the individual who care about them who are he quipped to be a part in the. Look forward to progress and bringing to you more nore where we are going to have a discussion with concerned have u had and add vow cassie glupes and the iven put is refleeted in this. Appreciate ay say i you are being a part knee and a result. Rd being , when people look at congress m shr some will look at the issues. Thats ok. What still stands, we are able to come together with a common issue. And i never i dont know if this man is a republican, a democrat, registered to vote. I never asked a patient that in my 40 years of practicing. I do value your input on this bill. We made a number of modifications. I know that in committee, democrats offered several amendment which is i want to incorporate looking at funding. We need more psychologists and psychiatrist, we have to have them, we need more money for that we need more programs in there, we need to Bolster Community health services. We need to make sure theres oversight of what states do with those dollars to make sure they put money into appropriate programs, not frivolous ones. Im proud to say in front of the nation you have been awesome in this. I want to continue to work with you. Mr. Blumenauer i want to say, one of the areas thats most contentious deals with when people like the gentleman that you have pictured behind you are going to be compelled to have treatment. You have been open to being able to refine the protections, make sure that states, and this is something that varies across the country, to make sure that under the auspices of your bill, that we have appropriate safe gards to make sure that the rights of the individual are respected, but acknowledge the fact that in some cases, the right to for people to selfdestruct is illusory. Its dangerous to them, its dangerous to society, and its heart breaking for their families. I have appreciated our conversations on that, going back and forth, and what youve tried to do to be able to make sure that the balance is struck. And im confident before were through we can make sure that the other areas that require that give and take can in fact be met. I would like to thank you for allowing me to speak on behalf of it and look forward to the next step. Mr. Murphy i thank the gentleman. What the gentleman vevering to is assisted outpatient treatment, a program whereby 45 states and the district of columbia, maybe 46 states now have this, where someone who has a history of incarcerations, arrests, violence, when they are not in treatment, a judge, it protect theirs right and review their case in terms of saying their can be put in inpatient care but if the judge says they dont meet the standard of imminendanger to themselves or others, agisted assisted outpatient. So the judge says, youre going to continue to take your medication and see your therapist and work on this. That being the case, when new york state did this they found a reduction in incarcerations and homelessness by some 70 . It was pretty dramatic. They found satisfaction by over 80 . And they found costs go down by 50 . So it is something that we as Congress Need to continue to work, we did pass legislation which puts money in the appropriations of 15 million to help states do that but we have a long way to go. And its a long way to go based 1,820,000 said some people so far have commented, have seen this on my facebook page. I want to give some more comment, some heartbreaking lessons people are saying. A woman by the name of Carrie Butler wrote on my facebook page, theyre falling through the cracks. Its easier tow put them in jail with high bail. They dont take medication, for people like him, for my nephews, one is in jail now since november, no release until august, mostly because he didnt follow up and prosecutors did a mental evaluation to see if he could withstand court and concluded he could but something is not right here. Hes assaulted officers, been tazed three times and not affect. Five Police Officers it took to get him in the back of the car. They tazed him in walmart once in front of the whole store. And on it goes. There are many people with Mental Illness out there and this person writes, i dont believe Public Servants have been trained properly to treat Mental Illness. I dont know what to do to help people get the help they need to be productive. You might say one aspect of our bill is to provide training for Police Officers. Whats called emergency treatment for them. When Police Officers have been trained in that, we see and Police Officers like this too, they can identify if this is a mentally ill person in crisis, what they can to to deescalate the crisis and prevent it becoming harmful or deadly. Heres another comment. I worked inside a Mental Institution and saw firsthand what it was like. Depending on where i was, the people were not getting their needs met or being ignored. I saw where a man was waiting for 15 minutes for two Staff Members to stop talking about football just to ask for some ice he never got his ice because he lashed out for being ignored and of course he was restrained in a chair for an hour for getting angry. Marion says work regard to cody miller, talk to him. Our Mental Health system is shameful. I know as i work daily with this population, many times their treatment is inhumane. Someone with dementia or alzheimers wouldnt be treated this way if they had a break with reality. Its a sad commentary on our lack of knowledge of dealing with serious Mental Illness. Heres some more stories. Andy writes, my 13yearold daughter morgan was in Police Custody for 19 months before she finally received treatment for schizophrenia. We had to pursue a civil commitment to make it happen. Now shes back in juvenile detention. But she has no access to the outdoors and is not allowed to have physical contact with her family them treatment of the seriously mentally ill by the criminal Justice System is appallingly inhumane. Fred writes, two weeks ago, a stranger that ive been married to for years came into my home, sprayed me with pepper spray, took a knife out in front of my two kids and thrittond cut his throat. The police took him away and put him in a Mental Health hold. I chose not to press charges and requested he get help. The hold was supposed to be for seven days. Four days later he got out im sure because he had a plane ticket out of state he convinced someone out there i was a threat and deny fered having a knife. I received abusive texts before i changed my phone number. I only wish he could get the help he desperately needs, wherever he is. But because of the unchecked Mental Illness, i now have two beautiful girls without their father and both needed their observe mental hell counseling. How do we help our system . Another woman writes if you want people like this young man to get help we all need to be ok with pay manager taxes and closing privatized prisons. The prison system has become the dumping ground for the pervasive mentally ill. Another one writes, my uncle has skits fen skits friend ark he disappears for months schizophrenia. He was living 15 miles away in the woods in a camper and was threat witness stand a gun by a neighbor because he was walking to fields talking to be things only he can see. Cops were called, showed up with weapons drawn. They took him away and locked him up for a month. Police assumed he was on drugs. He was having a psychotic episode. Theres not enough education in the judicial system about Mental Illness. And innocent people are being killed through ignorance. Another woman writes, my question is this, as the mom where should we direct young people with constituents yeen schizophrenia . Hospital care is effective but seems temporary. Six months in, two years out, repeat. Has anyone found or used or heard of successful treatment going on . The answer is yes. Actually one of the programs in h. R. 2646, the helping families in Mental Health crisis act is for something called raise, response after initial schizophrenic episode. If you get to someone early, low dose medication with proper evidencebased treatment, the prognosis is much, much better. But when we dont treat someone, every time someone has what the lay public call asner vouse break dunn or psychotic break or crisis, we have to understand these lead to neurological damage. These are not harmless episodes. This is not just someone getting upset. This is a real psychiatric disorder that comes from the brain and leads to problems. And thats why we see these problems grow. Heres someone who doesnt quite understand the problem, a woman by the name of julie writes. Im very much against the families with mentally ill patients to have the power of putting loved one a ones away against their will. Let the doctors determine if a patient is a problem. Often family doesnt want to deal with the illness so they want the person to go away. Someone by the name of robin duffy write, julie, you dont know what youre talking about. There are more of us that do care but because of the Mental Health laws we are unable to make decisions for very sick family members. People with schizophrenia dont realize theyre sick. They think their hallucinations are real along with the voices they hear. How can they make the logical decision to get the help they need . The answer is they cant. The doctors have to follow the laws in place which is they cannot recommend committing a person unless they are an immediate threat or danger to someone or themselves. Yes, julie, there are some families that dont want to be bothered, but i was not one of them. I highly recommend you do research on the subject before you spout your ideas. Read the federal and state laws. Indeed, that is what were trying to do with h. R. 2646. There are a couple thousand more comments on my facebook page, mr. Speaker. And i certainly ask people to go and read them. They are heartbreaking. They are horrifying. They are tragic. They are true. And they go on and on because our nation refuses to acknowledge this. So what we will probably do again until we pass this bill and start making changes, we can predict it. There will be in the time that i have been speaking here, there have been several more suicides. There have been more homicides. There have been more mentally ill people which we abandoned, people who got chronic illness and died. People with serious Mental Illness for multiple reasons tend to die 20 to 25 years sooner than the rest of the population because of the fact that 75 of those with Mental Illness have at least one chronic illness. 50 have at least two chronic illnesses. A third have at least threefment things like heart disease, diabetes, other diseases. Often theyre not treated, dont seek treatment we feel let them go in in in this slow motion death spiral and ignore them. We closed the hospitals, put them in prisons, theyre out of control and the police bring them into an emergency room theres no beds available they tie them down to the gurney where they may wait for days or weeks in some cases, perhaps given some sedative. A chemical straitjacket if you will, to calm them down. That is not treatment. That is abusive. That is our nation doing it and congress is culpable of this. Because we refuse to act system of once again therell be a tragedy somewhere, i shudder to think and i hope its not anybody here thats injured. But someone swr out in america today, this is going to happen. Once again, well gather for a moment of violence and the gavel will come down and well go back to our regular order business. It is sad and it disgusts me but thats what we face. All this closing of hospitals and not opening up to community Mental Health, medicaid saying you cant see two doctors in the same day. Medicaid saying you cant go to a hospital with more than 16 beds, h. S. S. Saying we cant tell parents anything so theyre left in the dark. The Substance Abuse and Mental HealthService Agency that funds programs that teach people to make collages, to go interpret to do interpretive dances to get off their medication, to make masks and things that have nothing to do with serious Mental Illness. We need to change the system and thats what h. R. 2646 does. It takes the office of sahmsa and changes it so the director of it is the director of Mental Health and Substance Abuse and that person needs to be a doctor, someone who understands the field not just someone say, lets do these other feel good programs. The city of new york just did this too, where the mayor put up hundreds of millions of dollar farce program supposedly for the mentally ill. It wasnt at all of it was parks and bike track to help people with sadness. Not deal with depression and serious Mental Illness. How long can we continue to fool ourselves . But this whole idea that says leave it up to them if they want to choose. Dont provide them the help. Make it the most difficult for those who have the most difficulty. All of this, mr. Speaker, is more commentary and evidence that the grand experiment of stopping all treatment under the misguided selfcentered and projected belief that all people who are mentally ill are fully capable of deciding their own fate and direction regardless of their disease and that they have the right to selfdecay and selfdestruction which overrides their right to be healthy. The most fundamental, dangerous, and destructive hidden undercurrent of prejudice is low expectation. That your disability is as good as it gets. The shift to consider changes in how we treat severe Mental Illness is the pendulum that eeds to swing the other way. The grand experiment has failed. Closing down all the institutions and care and stopping all treatment and not allowing community Mental Health. Its a principle that operated under the misguided selfsent selfcentered believe that people are always fallly capable of deciding their own fate regardless ofer that deficits and disease and the right to selfdecay and selfdestruction overrides the right to health. As i said. In so doing, weve come to abdicate our responsibility to action and live under this perverse redefinition of the most compassionate, compassion is to do nothing at all. It further bolstered the most evil of prejudices that the person with disabilities deserves no more than what they are. And under that approach, no dreams, no aspirations, no goals to be better than even exist. Indeed, to help a person heal is a head on collision with the bigotted belief that the severery mentally ill have no right to be better than what they are. We have no obligation to help them. This is the corrupt evil of the hands off and thaw per version of the thought is to you live a life of paranoia and trum president s and the better life. This is the towards the stigma and let them be particular. As blame and ed lives of others or maybe our own fear. Et they are way, it is the same. , we can have moments of sealens. And i hope the Committee Takes this up. And i hope members will sign on h. R. 26. Law ay that is signed into it will save lives and all the lives, theo down the oling on this bill and politicians and vote for it. My concern is will america wake up and say when we had a chance , did we act or once again just caught up. Just jefferson, god is and just ties cannot speak forever. We are in that position now. We have the courage. And i hope chamber tanges umh r. 2 and with that, i yield back. The speaker pro tempore the gentleman yields back the balance of his time. Under the speakers announced poll, mr. Garamendi is cognized mr. Garamendi thank you, mr. Speaker. My col owing, just finished a very good resuetation of