We are live of the Greenbrier Resort in West Virginia today. Our continuing coverage of the National GovernorsAssociation Annual summer meeting being held this year at greenbrier. The association is composed of executives from the states territories, and districts of the u. S. It is chaired by governor hickenlooper of colorado and the vice chair is governor herbert of utah. The form that is about to get started focuses on state efforts to combat drug use. Steve bashir is chairing the session. But Coverage Today on cspan. If i could have your attention, lets take our seats so we can get the joint session started. First of all, good morning, welcome. I am governor steve bashir from kentucky. I chaired the health and Human Services committee. We will call this meeting to order. Welcome all the governors who are here. This is a joint session of the health and Human Services committee and the Homeland Security and Public Safety committee. Joining me as vice chair of our committee is vice chair governor bill haslam of tennessee. I am pleased that we have been able to come together with the Homeland Security and Public Safety committee for todays discussion regarding the nations opiate crisis. I want to thank the leadership of the other committee governor, rick snyder of michigan and for partnering with us on this important topic. There are a few administrative tasks to perform. The briefing books were sent in advance, including the speaker bios and updates. The proceedings of this meeting are open to the press and all meeting attendees, please violence your cell phone please silence your cell phones. Sitting at the table are Melinda Baker and justin stevens, you can see them after the session if you need details about any of the issues we discussed today. Before we go into our formal presentations, i want to turn to heather, the staff director of health and Human Services and the Homeland Security and Public Safety committees. Heather and her nga colleagues will provide key updates on key state issues. From the health and Human Services perspective, we advocated actively for an extension of the Childrens HealthInsurance Program which congress s did extend in april for two years as a part of a larger deal to overhaul medicaid payments. That extension maintains existing programs, flexibility, and planned levels for states. That was a key priority that we were able to conflict. One of the other things that aj just committee has been engaged in its efforts to reform the childrens welfare system. At the same time the Homeland Security and Public Safety committee has been working with congress to maintain National Guard personnel and prevent the further transfer of apache helicopters until after congress has time to consider the recommendations of the Army Commission currently doing its work. Currently be house and senate are conferencing their bill they planned to have a final bill in the fall. Nga has been in advocating that the bill which would event the further transfer of apache helicopters be included in that bill. In addition to National Guard matters, the committee has been working to promote the states role in Cyber Security and foster greater collaboration with the government and the private sector. Those are the two main parties that i wanted to cover on the federal relations perspective. I will pause quickly to see of there any questions before we proceed. Ive happy to answer anything afterwards. I now turn to my colleagues from the nga center of best practices. Good morning, governors. I just want to give you a very brief update on how the work in the Health Division is going. We continue to be very busy. We have over 20 projects going on around the country. There are two products i wanted to highlight for you this morning. The first is medicaid transformation policy academy. This is a very intensive work with alabama washington, and nevada where we are working handinhand with the states to negotiate broad new authorities. These are authorities that we never had before that will allow governors to have a lot more flexibility in the way they pay for and deliver services in medicaid. We are very very close to agreement with at least one state, and in addition, we are working hard to negotiate in some cases billions of dollars of of front investment for the federal government from the federal government for the state and medicaid and medicare dollars. It is very powerful work. We plan on inviting you with a fake torillas report out victorious report out. In addition, we will allow all of you to use a new process to get to use with medicaid waivers much more quickly. It is a big project, we are excited about it. We are also launching, in two days, i next round of work that is aimed at the highest cost, highest spending medicaid patients. These people are spending millions and millions of dollars and have terrible outcomes. Several states around the table, your leadership staff, will be working with is on those projects. That is for the next year and a half. It is the second part. I just way to highlight, in that project in particular, Prescription Drug abuse has come to light as a very strong component to the reasons that these folks abusing services and costing a lot of money on having terrible outcomes. Todays discussion is very relevant, both from a cost and quality perspective. If we can tackle this problem it will be one of the biggest facing state governments and budgets. Now we will turn to the director of the center on Public Safety. Good morning, governors. My division has worked in close collaboration with frederick division. We close to policy academys edwards with 13 states. Governor hickenlooper cochaired the first academy. Through the academies, states have passed legislation and passed Public Service campaigns and improved coordination across state agencies and with stakeholders. To provide guidance for the states on how to address this problem, we have put out a few products. We put out a brief a few years ago on strategies that states can adopt to battle Prescription Drug abuse. Currently, we are partnering with the urban institute to provide a guide on evaluation. Through evaluation, states can better assess what they have implemented and ensure that the and divisions are having their intended effect. Certainly, the problem of Prescription Drug abuse has been grabbing headlines but Substance Abuse is a serious problem across the country. This is especially true for children in the Child Welfare system. Later this year, we will be launching a new policy academy on improving child safety and preventing child fatalities. In addition, my division will be working again with frederick and his team to build on the success of the policy academysies and the momentum that i think there is nationally on this issue around the use of haireroin. According to the center for Disease Control and prevention three out of four users started on prescription pain pills. Since 2010, the rate of death involving heroin have tripled. Our speakers today will be talking about this issue in more depth, but to the extent that frederick or i can be of assistance to you, dont hesitate to reach out. Thank you. Jeff, frederick, and i will stick around afterwards. Governor beshear, back to you. Governor beshear thank you. Lets turn to the topic of todays joint the many meeting. That is over the opiate abuse. We know it is a Major Health Crisis that affects all of our communities and every one of our states. Because of the rise in prescription. Use and heroine abuse, Prescription Drug use and hair when abuse, Drug Overdose deaths now surpassed Motor Vehicle accidents as the leading cause of death in the United States. Hair when deaths heroin deaths at triple between 2010 at 2013. Kentucky has its problems in this area. We have long been plagued with high rates of drug addiction both Prescription Drugs and Illegal Drugs like heroin. Over the past two years, two things have happened that are giving us more hope and confidence in the future. One, we passed and implemented programs that attacks the problem from every angle including treatment Law Enforcement, and health care. Secondly, what we are fighting is that our stakeholders are working together like never before, both inside and outside of our state. Back in 2012, we passed what we call house no one, which targeted Prescription Drug use and misuse. We tightened the regulation of pain clinics and ran a bunch of pill mills out of the state. We required our medical professionals to use our statewide electronic monitoring system, and we allowed for a better sharing of records among agencies in kentucky and other state. Earlier this year you know this addiction situation is akin to the gain of whack a mole. You attack it on one level and it pops up somewhere else. After two dozen 12, we became pretty successful in the brisket drug abuse area and really crackdown, and have seen tremendous progress, but now heroin is raising its ugly head and killing even more people than Prescription Drug abuse did. Earlier this year, we took a similar approach and a legislator on heroin. We passed senate bill 192. Among other things, this bill increased prison sentences for heroin traffickers, but also allows us to identify addicts. I think we have figured out that we cannot incarcerate ourselves out of this problem. We have expanded addiction treatment. We have allowed local option Needle Exchange programs. We have increased the abil availability of a clock glocsome. Last month i announced the allocation of 10 million for programs aimed at fighting drug abuse, including programs to help inmates pregnant mothers improve prosecutorss of joe drug dealers. Governors across the country are leading similar efforts to address the crisis bringing together lawenforcement criminal justice Professionals Health agencies, providers, and other Key Stakeholders in order to implement ct the committee has since maintain a focus on Prescription Drug abuse, bringing Lessons Learned from states to inform policymaking at the federal level. At the most recent nga winter meeting, governors approved a new policy that calls on the federal government to work with the states in a National Response to drug abuse. Todays discussion reflects the reality that we are no longer confronting an epidemic of research and drug abuse by itself. But, andn alarming resurgence of the use of harewood. Studies show that there is a link between use of heroin and perception drug abuse. Next week in kentucky, we expect to hear positive news from an evaluation on our efforts to change the landscape of Prescription Drug abuse. We still have a long way to go to fully address the opiode problem and the recent spike in heroin. I look forward to todays discussion and hearing from our panelists on additional strategies that we might be able to implement in kentucky. Im turned out to Governor Snyder and if you would like to make some opening remarks and introduce our guests. Governor snyder thank you. I would like to start by thanking you and the Committee Members for the great work you have been doing on this through the health and Human Services com committe. It is important. Thank you for your effort and perspective. I would like to recognize governor mcauliffe. We have worked well together on a number of issues, including several security, but this is another issue that is important to us as governors and citizens. This is a great venue to have a discussion. I would like to thank everyone for coming today, in terms of the other governors, the audience, and a paneli the pa the panelists. In michigan, we found it to be a tremendously growing problem. To give you some perspective, as i travel michigan, i often ask people what is the Biggest Issue you face . I was in rural michigan and two different shares pointed out that their greatest problem was Prescription Drug abuse. That is the starting point of all of this. We need to do more. Im proud to say that last year we passed a bill dealing with opiate antagonists where we have our ems people carry something with them in order to address the problem. However, if you have to use that, it is much later than it should be. We need to do more for prevention and treatment and on the Public Safety side. With that, lets get to a distinct panelists and learn from them. I look forward to this because in michigan i have created a task force that is reporting this fall on legislative and other actions to be taken. This could not be more timely to hear from people who are experts. With that, i am proud to say that we havent established panel. I am proud to introduce congresswoman mary bona. From 1998 to 2013, she represented californias inland empire region. She founded the Prescription Drug abuse caucus and cochair of the treatment caucus. A cofounder of the collaborativ opiate policy she maintains a commitment to recovery. Thank you for being with us. Also with us as dr. Debra howery , director of the National Center for injury prevention and control. In that role she leaves the cdcs efforts to preventing Drug Overdose deaths, working closely with states. Just prior to joining cbc in 2014, she served as vice chair and associate professor in an emergency medicine at emory school of medicine, as well as associate professor at emory school of Public Health. Thank you for joining us, doctor. Finally, i would like to welcome someone from the Law Enforcement agency, id active of the a detective of the Massachusetts Police department. He has spoken about his Program Throughout the country. In 2013, he received the white house advocates for action award for bringing Law Enforcement and Public Health together to disrupt the use of drugs and recidivism. Thank you. Again, welcome to our panelists, and im looking forward to the discussion. Governor beshear lets start off with congresswoman bono. Congresswoman bon thank you. It is great to see my former colleagues. If i remember, i was really kind to you, and a hope you will do the same to me. My gavel was very light that day. I am without a gavel now. I am honored to be here to share with you my thoughts on the opiate crisis. I applied you for focusing on the deadly epidemic, and i encourage you to throw everything cute you can add at it. I here with you today as both a former elected official who spent almost a decade. E focused on Prescription Drug use, by am also a passionate parent. Just like far too many parents, my introduction to this problem started in my own home. As a fulltime working mom, a member of congress, and i knew my amazing son was grappling with issues, by did not understand what they were and what he was going through. Whone day i received a call from my son who said, mom, i need your help, i have become addicted to pills. You can imagine how this felt. I still think for that colin consider myself to be one of the lucky ones to receive such a call, but i grieve with the many parents who are not as lucky as i w. It was a journey that we made public by doing National Television and print interviews. After that my office and i became somewhat of a begin for parents going to the grief of losing a child or for parents simply looking for help. To this day, i credit my son for speaking out, and allowing me to do the same. I have developed a very special passion for our youth, their suspected susceptibility to the powerful drugs that we have all seen happen too often. Shortly thereafter, it congress man from kentucky and i created a caucus. Many solid strategies are emerging to deal with this crisis, and is not one that i have read about that i disagree with. There are widely agreedupon strategies on Monitoring Programs, Access Research into personalized medicine, and Good Samaritan laws