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The speaker pro tempore on this vote, the yeas are 423, the nays are 4. 2 3 being in the affirmative, the rules are suspended, the motion is agreed to and without objection the motion to reconsider is laid on the table they have Unfinished Business is the volt on the motion of the gentleman from california, mr. Cook, to suspend the rules and pass h. R. 479 as amended. The clerk Union Calendar number 102, h. R. 497, a bill to direct the secretary of the interior to convey certain public lands in the San Bernardino, california to the San Bernardino Water Conservation district and to accept in return certain every nonpublished lands and for other purposes. The speaker pro tempore the question is, will the house suspend the rules and pass the bill as amended . Members will record their votes by electronic device. This is a fiveminute vote. [captioning made possible by the national captioning institute, inc. , in cooperation with the United States house of representatives. Any use of the closedcaptioned coverage of the house proceedings for political or commercial purposes is expressly prohibited by the u. S. House of representatives. ] xpressly prohibited by the u. S. House of representatives. ] the speaker pro tempore on this vote the yeas are 422. The nays are zero. 2 3 having responded in the affirmative, the rules are suspended, the bill is passed and without objection the motion to reconsider is laid on the table. The Unfinished Business is the vote on the motion of the gentleman from california, mr. Cook, to suspend the rules and pass h. R. 220 as amended on which the yeas and nays are ordered. The clerk will report the title of the bill. The clerk Union Calendar number 101, h. R. 220, a bill to authorize the expansion of an existing Hydroelectric Project and for other purposes. The speaker pro tempore the question is will the house suspend the rules and pass the bill, as amended. Members will record their votes by electronic device. This is a fiveminute vote. [captioning made possible by the national captioning institute, inc. , in cooperation with the United States house of representatives. Any use of the closedcaptioned coverage of the house proceedings for political or commercial purposes is expressly prohibited by the u. S. House of representatives. ] the speaker pro tempore on this vote, the yeas are 424, the nays are none, none recorded as the nays are 1, none railroaded records as present. Without objection, the rules are suspended and the bill is passed and without objection the motion to reconsider is laid on the table. For what purpose does the gentleman from North Carolina seek recognition . I ask unanimous consent that my name be removed as cosponsor for h. R. 60. The speaker pro tempore without objection the title of h. R. 60 s amended. The title of h. R. 497 is amended. The chair will now entertain requests for oneminute peeches. For what purpose does the gentleman from arizona seek recognition . Without objection, the gentleman is recognized for one minute. He house will come to order. The gentleman is recognized. Thank you, mr. Speaker. I rise today to honor the life of a legendary arizonan, frank koosh who passed away last week at the age of 88. Frank is best known for his career as coach of the university of arizona sun devils Football Program he won 176 games over 1 1 2 season, the most ever in sun devil history. Mr. Biggs he was named coach of the year after the 1975 season and was elected to the College Football hall of fame in 1995. Coach was not only concerned with wins and losses, he was a mentor for young men and ensured their professional and Academic Development rose above their athletic prowess. He influenced hundreds of young men in his career at arizona state. His impact is ever present in his the lives of his former players and his legacy will never be forgotten. I yield back. The speaker pro tempore for what purpose does the gentlelady from texas seek recognition . Without objection the gentlelady s recognized for one minute. Ms. Jackson lee there are a number of us who were able to go to the Childrens Hospital here washington, d. C. , and met twomy rack louse families. Children with complex, chronic diseases. But the love of their parents, one could not tell they were different from any other child but yet they had horrific and difficult medical conditions. Those parents were middle class, working families and said that without medicaid, the half a Million Dollars of health care that keeps those beautiful children alive and leads them to a pathway of a life of love would not be possible. I am glad that the Senate Trumpcare bill has been stopped in its tracks, the same bill that the c. B. O. Has said 49 million americans will lose their insurance in 2026. There is no pathway to reform this bill there is no white house meeting new york president ial cajoling and shooting deals back and forth. These are lives of americans. And as long as it take, well fight to the end to stop the demolition of the Affordable Care act which most americans, over 50 , want the Affordable Care act, stop the foolishness. I yield back. The speaker pro tempore for what purpose does the gentlelady from florida seek recognition . Ms. Roslehtinen i ask unanimous consent to address the house for one minute. The speaker pro tempore without objection, the gentlelady is recognized for one minute. Ms. Roslehtinen thank you, mr. Speaker. I rise to congratulate the National Air Traffic controllers ssociation, also known as nact a. Its worked to guide aviation policies and improve working conditions for its members with one goal in mind, to ensure that passengers arrive safely to our destination. Id also like to recognize three remarkable individuals, billy, jim, and mitch who ive met through the groups advocacy efforts. These men are committed to public service, first through their service in our armed forces and then later as air traffic controllers, ensuring that miamis skies remain safe for all. Though mitch has now retired, i know that his contributions to our nation have not stopped. Mr. Speaker, i ask my colleagues to join me in congratulating the group and its members on 30 years of outstanding public service. Thank you, mr. Speaker. The speaker pro tempore for what purpose does the gentlelady from ohio seek recognition . Without objection, the gentlelady is recognized for one minute. Ms. Kaptur i rise today as cochair of the ukrainian caucus and ask unanimous consent to submit to the record an article reporting on an act of violence thats taken place in ukraine. Yesterday a bomb exploded in the car of a highranking Ukrainian Special forces official, colonel maxine shapovo in what ukrainian authorities are calling a an act of terrorism. Shapov worked in the area where a conflict between ewe yain and russia has been going since 2014 with mainly civilians being killed. Shapovs death comes almost a year after prominent ewe yain journalist was killed by a similar explosion in kiev as he drev to work. No one has been brought to justice in that murder case. A number of other public figures have also been killed in shady circumstances in and around the area. Dennis was shot dead in central kiev in march, 2017. Awyer yuri grabovky, who represented a russian soldier found in ukraine, was shot dead this has the fingerprints of putins russia who will do nothing to blunt liberty. I call on this administration to help ukraine defend itself against these hostile acts of war against liberty. I yield back my remaining time. The speaker pro tempore for what purpose does the gentleman seek recognition . Without objection the gentleman is recognized for one minute. Mr. Speaker, i rise today to congratulate the Eden Prairie High School Girls Lacrosse team for recently winning their third consecutive state tite. The eagles showed perseverance and grit by overcoming an early deficit to the blake schools in the championship game. It was the ninth meeting between these schools two schools, in the states final in the 10year period. Eden prairie rallied back to win 1610, giving them the state tite this egirls drive for another championship led them to have a 201 overall record. The number one ranking in the state and finishing 19th in the country. Senior naomi ro fwmbings ie and sophomore Abbey Johnson both carried the team by scoring four and six goals, respectively. These student athletes work extremely hard not only on the lacrosse field but also in the classroom. Our community is proud of their hard work and dedication. Im delighted to share that these young him rose to the occasion and claimed another championship. Congratulations to the eden prairie eagles on their championship. The speaker pro tempore for what purpose does the gentlelady from new york seek recognition . Without objection, the gentlelady is recognized for one inute. Thank you, mr. Speaker. Rise today to recognize the 50th anniversary of Herkimer College. Established in 1966 as new york states 29th Community College, it opened its doors for classes in 1967. The inaugural class con sented of 221 freshmen and for the first four years it held classes on the upper floors of the old Remington Arms factory in new york. Ms. Ten nee in 197 ms. Tenney like the village of herkimer and Herkimer County, Herkimer College is proud to share its name with a revolutionary war hero, general nicholas herkimer. He valiantly fight. To hon nor the general and the countys rich history, the athletic teams are nicknamed the generals. Today, Herkimer College enrolls over ,000 students and boasts more than 20,000 graduates. It offers more than 20 degree programs and consistently ranks as a top 100 Community College in the nation. Over the course of five decades, its benefit to the local community is evidenced by over 75 million Economic Impact in Herkimer County annually. Today i recognize Herkimer College for an exceptional 50 years and offer my best wishes for many, many successful decades to come. I yield back, mr. Speaker. The speaker pro tempore the gentlelady yields. For what purpose does the gentleman from florida seek recognition . Without objection the gentleman is recognized for one minute. Today i rise to talk about something called congressionally directed spending when it comes to army corps projects. I have a bill which is called the repair act which would make a limited change to the house rules definition to allow congress to direct funding to better Water Resource Development projects of the army corps of engineers and this the bureau of reclamation. The retear act repair act does not authorize or appropriate any new funds for those project which is comprises just onehalf of one percent of our overall annual Discretionary Spending and stays exclusively within the budget cap set by congress. After several years divided government, almost every member here of congress has experienced direct correlation between our inability to provide for the these for these projects over the executive agencies, especially as it pertains to these essential public works projects. Mr. Rooney the repair act is a zero cost solution to this problem that will simply allow congress to respond to the water resource infrastructure needs of their communities. Rather than waiting for an unelected, faceless bureaucrat in the executive branch to move on these projects. Mr. Speaker, i urge all my colleagues to support the repair act and i yield back the balance of my time. The speaker pro tempore the gentleman yields. For what purpose does the gentleman from georgia seek recognition . I ask unanimous consent to address the house for one minute and revise and extend my remarks. The speaker pro tempore without objection, the gentleman is recognized for one minute. Mr. Speaker, i rise today to congratulate congress regation israel in savannah, georgia, as it celebrates its 284th anniversary on july 11, 2017. Mr. Carter just five months after general ogle thorpe settled the colony, jewish settlers fleeing persecution in europe arrived in georgia. They sought refuge in savannah where they were free to practice their belief. They founded their congress regation, predating our country by several decades. It set an important precedent for the jewish people. As such, wars, plagues, and religious struggles each challenged the congregation over the year, yet it has withstood the test of time and continues to be a beacon to the faithful and welcomes 380 families inside its walls. The story of the group is special to this people and has been recognized for its achievement sinence its early years. President George Washington sent a personal letter to the congregation to honor its members and wish them well. Since then, numerous president s have made similar gestures, each one act noning the congress regations longevity and importance to the jewish community. I would also like to acknowledge their importance and congratulate them on reaching this impressive milestone. I know this religious community will continue to serve, a caring will continue to serve a care, faithful, integral role in savannah, georgia. The speaker pro tempore are there any further oneminute requests . The chair lays before the house the following personal requests. The clerk leave of absence requested for mr. Stivers of ohio for today through thursday, june 29. The speaker pro tempore without objection the request is granted. Under the speakers announced policy of january 3, 2017, the gentleman from pennsylvania, mr. Murphy is recognized for 60 minutes as the designee of the majority leader. Mr. Murphy thank you, mr. Murphy thank you, mr. Speaker. Tonight im joined by a number of members here to talk about one of the most insidious problems our nation has faced in a long, long time. Its a problem of opioid abuse. We are in a crisis mode. We have now reached the point where we will have more deaths from Drug Overdoses this year than there are named on the Vietnam Memorial wall in washington. Theres almost no county, no state in america thats not affected by this. Some areas have much, much more. Places in eastern kentucky, southern West Virginia, up the ohio valley, places in new england and out west have seen this as a growing problem as death rates rise. There are things we can do about this but in order to make some discussion of what we can do about this, were going to talk about how we got to this problem and then what we can do to go beyond it. I want to start off by recognizing the chairman of energy and Commerce Committee, greg walden of oregon, to talk about what this means just in one state alone, the state of oregon. I yield to mr. Walden. Mr. Walden i thank the gentleman who chairs our oversight and investigations subcommittee and is so passionate in not only finding a solution to the Opioid Epidemic but also your great work on Mental Health reform as well as was passed into law in the 21st century cures legislation last year. As you know the energy and Commerce Committee last year or the year before also passed legislation to begin to address this issue, and we will be doing a lot of work Going Forward to look at whats working on the ground, whats not. Addiction, as you well know from your clinical experience, is an equal opportunity destroyer. Its a crisis that doesnt pick parties, it doesnt pick people because of their race, their age, their socioeconomic status. We all know someone impacted by the Opioid Epidemic. Its literally touched every corner of our country and every community in our states. The epidemic has hit home in oregon where people die more in Drug Overdoses than automobile accidents. I met with community leaders, First Responders, doctors, police officers, patients, those on the front lines of this fight against opioid addiction. At round tables throughout the Second District of oregon i heard firsthand accounts of the Opioid Epidemic and it didnt matter if i was in a rural Eastern Oregon or more area, ed city in another stories were all too familiar. Medical professionals told me about the rapid acceleration of the Opioid Epidemic in the last 20 years. They saw patient after patient fall into the trap of addiction. I heard from oregonians who struggled with the epidemic herself. A woman at our roundtable talked about how she became addicted to painkillers after a minor foot injury and she got a prescription for an opioidbased painkiller. Her decades long bat well addiction and trying to get off of this addiction, she was forced to travel more than five hours into Washington State just to find a provider who her help her with medication and help her with hear addiction. There was nobody locally could help her. I heard from a father of a High School Son who was prescribed opioids after a injury. He got addicted and he got addicted to the cheaper and more deadly drug and we know that as heroin. Sadly, this young man would not survive his addiction. He died from heroin. Devastated the family and it stole another american in the prime of his life. This story is repeated all too often. Combating the Opioid Epidemic in oregon and in every state in our union is going to require a real Bipartisan Team effort to continue from elected officials, with the input from Health Care Experts and those on the front line in this fight in our local communities. At the energy and Commerce Committee we stand shoulder to shoulder, all of us together saying, what can we do more to help in this crisis, to seize the opportunity before us, to look at the legislation that was enacted in the last congress, to make sure that the grants are getting to the ground as they are in my state and that were getting the help and that its actually working. Its one thing to pass a bill, its another to make sure its implemented correctly and that it actually works effectively. So i commend my colleague from pennsylvania, chairman murphy, for the work that hes doing on this, the compassion he has for those families who are tragically caught up in this addiction and together were going to find our way through it. So with that, mr. Chairman, i yield back. Mr. Murphy i thank the chairman and also for your passion, your hard work in the energy and Commerce Committee. We know this is life and death issue, and this is one of the things where members are coming together on both sides of the aisle to deal with. Late melee out the background here let me lay out the background here. How did we get here . 80 of addictions begin with a prescription. When we see what has happened here with this chart of heroin increased use and prescription opioids, there is something that occurred at the beginning of this millennium, where things began to take off. But on this next poster, seeing here of how this is increasing at such a rate, about 9 to 10 per year, its understandable. You look at some of the rates increasing several fold just in the last decade with increasing jumps and as fentanyl has gotten here its worse. Back in 1980, a boston doctor wrote a letter to the new england journal of medicine and he said this, out of nearly 40,000 patients who were given powerful pain drugs in a boston hospital, only four addictions were documented. Well, since he published that letter, its been cited again about 600 times, doctors, academics, pharmaceutical Companies Use this as evidence as the unlikeliness of developing addiction. But its been criticized soundly in saying, that never should have been said. In fact the new england journal of medicine took the unusual step of posting a onesentence warning over the socalled letter to the editor that the journal published in 1980 and it says, quote, readers should be aware that they have been heavily and critically cited that addiction is rare with opioid therapy. Canadian researchers focused on this letter and heres the tragedy of this. Many physicians, many pharmaceutical companies said, see, prescribe these opioids, people will be ok. And that was found to not be the case. Jump ahead to 2001 when the joint commission released their Pain Management standards and then shortly after that the American Medical Association said, lets make pain one of the vital signs. The other vital sign being blood pressure, heart rate, respiratory rate, temperature. When pain was made, doctors began asking questions about that and basically screening people on the lines of on a scale of one to 10, whats your pain level . The other Everything Else is a measure with an instrument objectively but pain is subjective. In fact, so subjective it was found that 51 of people who are on an opioid have a Mood Disorder such as depression or anxiety. Thats a huge amount there. The thing about this is, if a person fails to screen for presence of a Mood Disorder along with other aspects you really increase their risk for addiction. About 15 million americans, for example, have back pain. Of the group about 40 or so also have been found to have depression. You combine depression and opioid use, you triple or quadruple your risk for misuse, abuse and addiction. It would make since before a doctor prescribes and these cases are screen the person for Mood Disorder that is not the case. Heres another part of the problem, under Affordable Care act hospital payments are tied for patient pain satisfaction surveys which reward hospitals financially when patients give them a high rating for managing pain. And in turn the hospital gets less money if the patient says my pain was not handled. Its question 14 of the hospital assessment of Health Care Professionals survey, the hospital will do everything in your power to control your pain, doctors feared patients negative responses and was found that that probably had an impact upon increasing prescriptions. Another part of the problem is treatment access. Quite frankly, if you want to get help you cant find it. Unfortunately, getting access to high quality treatment is unlikely in the United States and of the 27 million americans suffering from addiction, less than 1 received evidencebased treatment. We have a shortage of trained providers and half the counties in america have no psychologists, no sigh i could trixes and psychiatrists and no clinical social workers. Medication treatment is a treatment method. Medication here, assisted treatment is when a person is replacing their illegal drug or things with Something Like med doan or another that chairman walden referred to. But heres part of the problem. Its supposed to be the doctor writing the prescription and patient getting treatment. It was found with medication assisted treatment just in pennsylvania alone, nearly 60 had no counseling in the year they received it. 40 were not drug tested in the year they received it. Thats important because a person may receive a prescription but still remain on heroin or the drug. 33 had between two to five different prescribers writing them prescriptions for this. Why did all those prescriptions go . This is like one of the top diverted drugs and many times the patients would simply take those drugs seldom and buy the street drugs and 24 home runs of those prescriptions didnt see a physician in the prior 30 days. So in other words, with medication assisted treatment we simply have a failure to provide treatment and lower expectation for improvement, in trade one ell addiction for another. Residential treatment is crucial for recovery but there are not enough Treatment Centers or beds and we suffer from a shortage of beds. Further, we dont have enough providers and when we do have providers they will have many times they end up overprescribing. There was a law which the United States had back in the nixon era which is called 42cfr, the consolidated federal registry and it made it so physicians could not find out in the record if a patient was on other opioids or in treatment for that or taking methadone so what happens . Someone shows up in the emergency room, theyre in pain, perhaps a doctor looks in the record, doesnt see anything there, writes a prescription. If that person was in treatment and was recovering from an addiction and at that point not taking other drugs, look at just what happened. The doctor may prescribe some opioids for that patients who was used to taking quite a few at a time have an effect. Now they have this and they are no longer thinking ill just take one or two. They may take more so you risk overdoses. The second is you risk a relapse. Perhaps that person was clean for months or years. Now they have oxycotin or some other opioid. They take it and they have a relapse. Theres a third problem that goes for that and that person may be on other drugs. Maybe respiratory suppressent. The doctor doesnt know about drug interactions. So we have this law in place which prohibits sharing of information about Substance Abuse treatment between doctors. Doctors unknowingly prescribe these for people. It causes more problems. We need to deal with this. Another level here is fentanyl. Fentanyl is a synthetic opioid which is a staggering 50 times more potent than heroin and 100 times more potent than morphine. Hypo tension for abuse and a mere two miligrams is fatal. A single packet of sweetener is a ur coffee is 1,000 miligrams. Take two of those and its fatal. Due to gaps in data collection, the number of Overdose Deaths in the u. S. Is actually much higher. Lowcost, high to look for fentanyl is relative easy to manufacture. China is a major part of this in that the illegally manufactured fentanyl shipped to the u. S. By labs in mexico, smuggled across the border and then hits our streets. One other thing i want to point out here in terms of part of this problem, if we look at what some have analyzed in terms of areas that are hot spots for Substance Abuse, you can see in here for persons on disability, look at the sections in kentucky, West Virginia, virginia, along the mississippi valley, up the ohio valley, parts out west, this isnt the only cause of factor. One of those sometimes you have people on disability and in pain and what happens they may be prescribed oipates as part of that. F you look at age adjusted drug abuse, its about the same. Out here in the mississippi, ohio valley, portions out west where you have these problems. All of these come together in terms of crime, in terms of drug cartels, in terms of fentanyl, in terms of poor access to treatment. I mentioned with the hospital beds. By the way, over half the counties in america have no psychiatrist, no psychologist, no social worker and no licensed drug treatment provider. It is no wonder we are in this mess. Well talk more about some solutions here but i wanted to recognize a number of members who might want to talk about this. Let me first go to buddy carter of georgia, representive carter is also a pharmacist and lets hear some of his perspective. I yield to you, mr. Carter. Mr. Carter i thank the gentleman for yielding and i thank the gentleman for hosting this and this is certainly a very important subject, one that im very familiar with. Indeed an epidemic in our country. Theres not a state nor district that hasnt been touched by this problem. Countless people succumbed to this issue. Thats the use of opioids and its devastating impact on our communities. Recent data showed that overdothe deaths Overdose Deaths have jumped to 50 in the decade leading up to 2015. In addition, nearly 1,300 people died in georgia from 2013 from Drug Overdoses. These are statistics that need to be urgently addressed. Weve made great progress with the compassive of the recovery act but we have an opportunity to do more. One staggering statistic last year its estimated roughly 60,000 people died from Drug Overdoses, a number thats far too high. Just this month, four people died due to opioid overdoses from falsely related drugs. That is not only troubling because it reflects pain use in our state but it represents counterfeit and fake drugs. An issue ive been working on is drug ingredients being delivered through the mail to addresses around the country. Synthetic opioids are being brought into this country and the methods by which theyre doing it, an example of one those drugs is fentanyl. Synthetic opioid thats wreaking havoc across the country. We must not only look at the types of drugs that are being used but also how people are acquiring them and ways to effectively limit that. Our enforcement personnel working with the Postal Service to curb this trend using advanced data but its a topic that needs more work. By cutting off the ability to purchasing these we may help limit this epidemic. As a lifelong pharmacist ive seen firsthand the dangers and problems associated with opioid abuse. I look forward to working with my colleagues to counter this hopes. Thank you for allowing me to speak. Mr. Murphy as a pharmacist, for example, if they want to get sudafed, a cold medication, they have to go through a special process thats behind the counter, right . Mr. Carter thats correct. Mr. Murphy are they required to have the same kind they have to show an i. D. In order to pick it up. Now the prescription itself is a c2 prescription. So as long as we if we dont recognize the pharmacy, we have to ask for the i. D. To make sure that is indeed the person who is picking it up. Mr. Carter we also have a program in georgia, the Prescription Drug Monitoring Program, that allows us to go and check a database, to see if that person is actually has actually been doctor shopping or pharmacy shopping and getting it other places. That has helped us. Its a great tool in fighting this epidemic. Mr. Murphy the gentleman knows that that has data within the state, but across state lines, that data is still not pop mr. Carter thats one of the major problems. For instance, in my practice, i practice in savannah, georgia, which is on the South Carolina line and only two hours from the Florida State line. That was a constant problem for us. I can look at my data all day long, but i wouldnt know whether they got something filled in South Carolina or in florida. Mr. Murphy i pressure this appreciate that. Thats a problem were going to have to fix to fix in our committee. Im going to call up bill johnson next from ohio. Eastern ohio. Speaking of being able to jump across state lines and have prescriptions filled, minutes away from the pennsylvaniaWest Virginia border. And also part of that the area along the ohio valley, where so much of this is occurring. I yield to mr. Johnson. Mr. Johnson i want to thank my colleague, representative murphy, for holding this special order. Its such a critically important topic. You mentioned that my district borders the state of pennsylvania and it does. Incidents so many my ngagement with constituents on the opioid addiction issue. Several of them really stick out. Representative murphy, one of those happened in pennsylvania. Occasionally because my district goes all the way up to the top into northeast ohio, occasionally i fly in and out of pennsylvania and i was there a couple of years ago. I was sitting in the lounge waiting for a flight. I happened to be on a phone call and a gentleman i in thed that he began to i noticed that he began to look my direction. He very parently waited until i got off the telephone patiently waited until i got off the telephone. He came over, introduced himself. He recognized me and he said, im not one of your constituentses but i know constituents but i know that you represent a district just across the border in ohio. He said, but i want to implore you, to beg you and your colleagues in congress, please do something about the opioid addiction. He said, our 21yearold son died of an overdose in january. He had just gotten out of a rehab. Was doing well. Ad gotten a job. He came home one friday night, said he was going out with some friends. The next morning his mother and i found him dead in his room. And i hear stories like that all of the time. I can tell you that the opioid addiction epidemic that is streaking across our country is not one that were going to be able to arrest our way out of. Its not one that were going to be able to incarcerate our way out of. Its an issue, my dear colleagues, that is going to to everybody, from the top the bottom, from the president of the United States all the way down to the family members. And im talking about local Government Officials, Law Enforcement, the judiciary. Faithbased organizations. Community organizations. This is something were going to have to all be engaged in. Weve appropriated, as you know, representative murphy, hundreds of millions of dollars. Billions in fact to attack the Opioid Epidemic. And more is needed. But were not going to be able to simply throw money at this problem. It is going to require a cultural change within our country. I have so many other stories, but i dont want to take up more time because i know i have other colleague here that want to testify on this very, very important issue. Just know that i am with you. We take this issue very, very seriously. In our district, back in ohio, were constantly reaching out to Law Enforcement, Mental Health providers, Health Care Providers , faith and communitybased organizations and families on how to attack this problem. I thank you for giving me a chance to speak on it. And i yield back. Mr. Murphy i thank the gentleman from ohio. I want to next recognize dr. Larry bucshon of indiana. Certainly he sees this issue too. As i mentioned before, one of the problems physicians have, if they do not know what kind of prescriptions that person is on, for example, medical record may show a person has an allergy to something. But you may have no idea that that patient may be taking something unless they tell you or you test for it. As a surgeon, what happens when they go to get anesthesia and the complications that is come from that, but the part of the reason why we have to make sure that you as a physician have access to these records, things we can clean up. I yield to you for three minutes. Mr. Bucshon thank you, chairman. Thank you for holding this special order tonight to talk about this really important subject on behalf of the american people. The opioid abuse disorder and drug addiction have impacted every community in our nation. The epidemic knows no boundaries. Does not discriminate base on age, gender based on age, gender, or socioeconomic status. According to the centers for Disease Control and prevention, 91 american lives are lost every day from an opioid abuse overdose. Unfortunately Drug Overdoses in indiana have increased five fold over the past decade. And Southern Indiana, in the area i represent, is bearing the brunt of this devastation. Last year in a county with a population around 108,000 citizens, authorities responded to over 16 opioid or heroininduced overdoses already this year. Another county, 182,000 citizens. Saw 29 deaths from overdose in 2016. Which is a four fold increase from the prior year. This year the county has seen 25 confirmed heroin or fentanylrelated overdoses already. But the coroner thinks its maybe more. And just this month weve seen reports of instances of opioidbase of an opioidbased drug called gray death in evansville, indiana. Were working here in congress with our states and local communities to finally bring relief to these families. But a lot of work has to be done. While we still have much to do, over the past couple of years weve made significant progress to bring hope to our communities and expand access to treatment for those who need it. I was proud to be a part of our efforts that we put into law, the landmark legislation, the comprehensive addiction and recovery act, or cara, and i had the opportunity to author a portion of cara that expanded access to medication assisted opioid use disorder treatment. Ensure patients have wider access to more comprehensive based treatment options, and help minimize the potential for diversion. As congressman murphy mentioned, the key here is ongoing therapy, counseling and monitoring. Medicationassisted treatment is not a panacea, but is a component of a more comprehensive treatment plan for each individual. Through our work in implementing the 21st century cures act, congress has provided significant funding for the states. In fact, indiana recently was granted nearly 11 million from the department of health and Human Services to help us with this epidemic. Again, most of us know someone, a family member, a friend, a neighbor, who has been impacted by this epidemic in some way. As a physician, ive seen the power of addiction up close. And it focused on shaping real policy solutions here in washington, d. C. , to improve access to treatment for patients problem ttling their every day. We all share in this fight and we cant end this epidemic through policy changes alone. Its ongoing and its going to take all of us working together as a community to meet this challenge. In that respect, i have met with and have been working with people that represent medical schools and residency programs in our country, to help better educate physicians on prescribing habits as it relates to pain. Whether thats Surgical Pain or chronic pain. So its a multifaceted approach and i commend congressman murphy for his dedication to helping this crisis in our country. I thank you for the time tonight. Mr. Murphy i thank the gentleman for his impassioned words and dedication here. Mr. Speaker, i want to recognize and yield to this crisis the ge georgia for an announcement. The speaker pro tempore for what purpose does the gentleman from georgia seek recognition . Mr. Speaker, i send to the desk two privileged reports for filing under the rule. The speaker pro tempore the clerk will report the titles. The clerk report could accompany House Resolution 414. Resolution providing for consideration of the bill, h. R. 3003, to amend the immigration and nationality act, to modify provisions relating to assistance by states and political subdivision of states in the phone ersment of federal immigration laws enforcement of federal immigration laws and for other purposes. Resolution providing for consideration of the bill, h. R. 3004, to amend the section 276 of the immigration and nationality act relating to reentry of removal aliens and providing for proceedings during the period from july 3, 2017, through july 10, 2017. The speaker pro tempore referred to the house calendar and ordered printed. The gentleman from pennsylvania is recognized. Mr. Murphy thank you, mr. Speaker. Mr. Speaker, i now want to refer back to my map here for a moment. Dr. Bucshon was referring to his district in Southern Indiana here, which in this 2014 map was already showing high mortality rates for those who have Drug Overdoses. Look here in the state of washington. Also an area nays this 2014 map, showed a lot of problems. And now a problem thats getting worse. To speak on this area, representative newhouse of the state of washington, id like to recognize you for three minutes to say your thoughts on this issue. Mr. Newhouse thank you very much. I thank the good gentleman from pennsylvania for his leadership on this important issue and for the opportunity to address the house on this very important topic. Mr. Speaker, as youve heard, our nation is facing an epidemic. Over the past two decades opioid overdoses have quadrupled. Think about that. They have quadrupled in the United States. My home state, as dr. Murphy just mentioned, has faced significant increases in Drug Overdose death rates, including a 70 increase in synthetic opioid Overdose Deaths in just the last 10 years. It is clear that this is a crisis. Which is why we in congress are committed to combating this growing epidemic. Late last Year Congress passed sweeping legislation called the 21st century cures act. It was Bipartisan Legislation. It authorized 6. 3 billion in funding to bring both our Health Care Innovation infrastructure into the 21st century. This legislation included 1 billion for opioid intervention and prevention treatment programs throughout all 50 states. The federal government began awarding those grants to confront this crisis, including 11. 7 million to the state of washington. Now, while these funds will help expand treatment options, there is still much more work to be done at the federal level which is why i cosponsored legislation like h. R. 1057, the synthetics trafficking Overdose Prevention or stop act which is designed to stop dangerous synthetic drugs like fentanyl, which you heard about. This will confront bad actors in china, in india who have been taking advantage of weaknesses in International Mail Security Standards to break u. S. Customs laws and really wreak havoc on our communities. This is just one step of the Opioid Crisis that we must address. We need to combat the illiss ildrugs coming into this country as well as equip doctors, equip nurses and First Responders with the resources they need to treat pain appropriately. We also need to support better access to care for individuals suffering from psychiatric and Substance Abuse disorders, and most importantly, we must ensure these drugs are not falling into the hands of our nations children. My colleagues in congress and i are committed to combating this epidemic from causing further harm to our nations families and communities. Again, thank you, mr. Murphy. Thank you, mr. Speaker, and i yield back. Mr. Murphy i appreciate the gentlemans comments and your dedication to helping the state of washington. I now want to recognize my colleague, justin keith rothfus, to talk about his thoughts and experience and what we should do about Substance Abuse. Mr. Rothfus i want to thank the gentleman for his lifetime work in this space. His work him with with Mental Health. Each of us can talk about our respective districts and whats been going on. In my district just over the border from my colleagues, in western p. A. Its been especially hard hit. Beaver county we saw 102 Overdose Deaths related to ioids in 2016, up from 30 in 2013. In another we lost 94 people to Overdose Deaths in 2013, a startling 62 increase from 20 in 2016, a starting 62 increase from 2015. The story of the mother who lost hair 10th child, her youngest child to this epidemic who insisted the words damn heroin be put in her sons obituary or the couple we learned about before christmas who overdose and three dates later their infant died from neglect. All three being found four days after that. Mr. Speaker, it is all habbeds on deck to address this hands on deck to address this crisis. We are coming together at the federal, state and Community Level to develop a comprehensive strategy to stop this epidemic and to share best practices at every level. Thats what a big part of our comprehensive addiction and recovery act passed last year was all about, an important first step. Another asset we have, mr. Speaker, is the office of National Drug control policy. This week i led a Bipartisan Group of my colleagues in a letter to President Trump requesting that the director of the office of National Drug control policy be reelevated to cabinet level position. Since its inception, this office has played a central and Critical Role in fighting Drug Trafficking and drug addiction. Both the office of National Drug control policy and its director have played and should continue to play a central effort a central role in this effort. The office was created in 1988 with the antidrug abuse act. The mission is to fight the nations drug problem through three areas prevention, Addiction Recovery and enforcement. The offices director, commonly referred to as the drug czar, was elevated to the cabinet in 1993 by president clinton who wanted to raise the offices profile in order to coordinate and emphasize legislative efforts on the hill. More importantly he wanted to focus and emphasize efforts within the administration for the antidrug efforts of the department of justice, the Drug Enforcement administration, department of education and department of health and Human Services. The Obama Administration removed the office from the position it had in the cabinet. When it comes to drug addiction as well as to the illicit drug trade occurring across our southern border, the challenges have never been greater. This is no time to retreat in our efforts, and it is time to restore the office of National Drug control policy to the cabinet. The office is very important. Its a very important part of the fight against the Opioid Epidemic, particularly because it plays a crucial role in coordinating efforts at various levels of government. In addition to the legislation we are passing here in congress, the administration has a crucial role to play as do leaders at the state and local level. We all want to end this crisis, and this common cause unites us. Perhaps more than any other issue across party and partisan lines. Again, i thank my colleague from pennsylvania for giving me this time. I thank him for his work in this area, and i yield back my time. Mr. Murphy i thank my colleague and my friend for his dedication on this issue and, yes, youre right. We have to Cross Party Lines and work on this together. Now want to recognize another friend, steve chabot of ohio who has seen these problems in his district and knows full well how these problems have. Rged well into the ohio area now recognize the gentleman from ohio. Mr. Chabot i thank the gentleman for yielding and for his leadership in this most important area. Mr. Speaker, the heroin and opioid scourge is running this country into the ground. And unfortunately, the problem appears to be getting worse, not better. That grim reality is particularly true in my district in cincinnati where during a single week last summer City Health Officials reported 174 overdoses in one week. Deaths caused by opioids have doubled in my district where during the first four months in 2017, the Hamilton County core nors office had Coroners Office had logged hundreds and hundreds of opioid overdoses. Heartbreaking numbers, but numbers only tell part of the story. The spike in overdoses can and at time is horrifying. A couple months back in cincinnati, a 9yearold girl called 911 about both her parents who overdosed on heroin in their s. U. V. She told the dispatcher she was scared and that her parents wouldnt wake up. The girl didnt know where she was or what was wrong with her parents but she fortunately knew how to call 911. That called saved her parents lives but no little girl or little boy, for that matter, should ever be placed in that situation for their parents or anyone. This is becoming common. Opioids can kill anyone in any neighborhood. Every day there are more headlines about how heroin and other opioids are basically taking over the country. The simple fact is nearly every member of congress could come to the floor today and share a similar story from their own district, and thats why, mr. Speaker, its imperative that we Work Together to find new and more successful ways to combat the Opioid Epidemic. We need to put politics aside and help people in need. Last year we came together in a bipartisan manner to pass the comprehensive addiction and recovery act, or cara, and i think its a good chance that the expanded treatment and Recovery Options that legislation created will help some of those suffering from addiction to turn their lives around. While cara will give local Law Enforcement and Health Care Officials more resources to fight opioid addiction, we need additional legislation to help combat the importation into the United States of extremely dangerous synthetic drugs like fentanyl and cartfentanyl which many blamed for the spike of heroin overdoses. According to the d. E. A. , much of the supply of these two dangerous drugs on our streets originates overseas, particularly from china and india. The Bipartisan Legislation that by ed its being led representative tiberi and senator portman, is the stop act. It would update the customs process to require that advanced electronic notice of all packages, large or small, be provided to customs officials. Providing this information to customs before the packages arrive will help them help them, meaning the customs agency, to intercept more illegal shipments and prevent these dangerous drugs from reaching drug traffickers within our borders. Im hopeful this legislation will be embraced with the same bipartisan enthusiasm that we saw with cara. Because the heroin and opioid problem in this country is too serious, too significant and too widespread for us not to Work Together at every level of government to find a solution to this epidemic. Its way overdue. We need to Work Together in a bipartisan manner about this. I, again, want to thank the gentleman from pennsylvania for his leadership in this area and i yield back. Mr. Murphy i thank the gentleman from ohio. I point also on this map here, the cincinnati area and southern ohio which is one of the hot spots in 2014 has continued to grow as a problem. We recognize its both a local problem and nationwide problem. I want to tell a story here. Last december when the president was signing into law 21st century cures act, which included my legislation of the helping families and Mental Health crisis act, former state senator from West Virginia took the stage to introduce it. David grubb talked about his daughter, jesse, who herself had been in rehappen, in a treatment Something Like three or four times, had had several Drug Overdose incidents and had been revised. What happened to her also is part of what they called the loaded gun that never should have happened. She went into hospital for some surgery but the doctors and nurses never told her discharging doctor that she was in recovery for heroin addiction. Point made before the list there or the 42cfr blocks information from going into the medical record. While someone was out to protect her privacy, they didnt protect her from death. She was given a prescription of 50 opioid painkillers. Remember i said before when a person is given this prescription they run the risk of relapse, overdose or bad drug interactions. In her case, it was an overdose that finally took her life. Another important reason why we have to deal with this 42cfr and get rid of that arcane and quite frankly deadly law. Let me talk about some other recommendations where i believe congress can help. The references made before with dr. Bucshon and others about the Prescription Drug Monitoring Program, also, buddy carter of georgia said, where pharmacists and physicians can say, is this person on other opioids, have they jumped across the border, have the same four, five physicians for some opioids . By having a better Prescription Drug Monitoring Program or the national all schedules prescription electronic reporting program, we have to make sure all states use the same system, that it collects data from across borders so doctors can easily see this. But part of this, too, in dealing with the 42cfr, is understanding the federal law prohibits methadone in the pdmps. How absurd and how cruel that is that a doctor would not even be able to know that a patient is one of those prescriptions. Some of these drugs can be a respiratory suppressent and when a person takes another medication can add to further complications. Another aspect, too, which we must be further engaged with is vigorous Public Education programs across all age groups. Beginning with early elementary school. When schools have some of these programs and we will bring forth some models in a future hearing i will be holding in the oversight and investigation subcommittee, these are very important to help students early on to understand the dangers of this. This is not just recreation but its so easy to slip into this and given that 80 of prescription of drug abuse begins with a prescription, whether its a student athlete, perhaps a Football Player that injured their leg and is given these things, its essential. The family be counseled understanding the concerns and dangers of continuing these on. We also have to have drug takeback programs and Public Education programs, stressing the importance of proper disposal of unused oipiates and prescriptions from being stolen and misuse. For example, if a family is having selling their home and theyre having an open house and strangers come into the house and while theyre there they say, can we use their restroom, dont be surprised that person has no intention of buying a house but checking a medicine cabinet and finding medication and taking it. Also, when teens come over to the house for parties or socializing, dont be surprised if they also go into medicine cabinet, look in drawers in other places of the house which they will take and sell. We have to make sure we have vigorous patient Education Programs about doctorprescribed opioids to make sure people know about that before the addiction takes foot. Taking one of these prescriptions may only take a few weeks before the problems start to kick in. I know myself back in 2005 i was in a rollover accident in iraq. Our vehicle rolled and in that, ended up, myself, having a mild concussion, snapping my neck. Temporary paralysis. But a great deal of pain. Battlefield medicine is one that get you out of the area, stops bleeding, stops pain and ships you off to some other hospital. That was the case for me. Everywhere i landed in a helicopter and amend ambulance, appropriately so the physicians would ask me a number of questions and say, are you in pain and the scale of one to 10, how much pain are you in . When i proceeded to say that number, immediately, as they would do more many other people, administering more even if or other pain relief to move you on from there. Returning to the United States, where pain continued for me, i was prescribed some pills for that pain, but also prescribed fentanyl. Never once was i ever was it ever described to me, be careful with this, this is highly addictive, this is a problem. After a few weeks on this, recognizing it was hard to even do my job, i couldnt keep my head clear, i said, thats it, im not taking this anymore. But at that point my body had already begun to develop tolerance for this. When i stopped taking it, i had some reaction. Granted, it was not as severe as some of of those who have been taking these drugs at a higher dosage and longer. I could feel myself saying, i understand what people mean when they say their skin feels like its peeling off of them and they feel a sense of nausea and other problems as well. I cant even imagine when its like for someone who has taken higher dosage for longer periods of time. Its extremely important that every time that prescription is written, pharmacists have an opportunity to counsel patients and doctors are also doing more than simply passing on a prescription. Pharmacists should have what buddy carter was saying before. Make sure they have the person showing a photo i. D. Is this indeed a prescription they are picking up for themselves or claiming they have it for someone else, perhaps that prescription was stolen from someone. We have to make sure there are also theres also an understanding of this. For those trying to legalize marijuana, i caution you. Because this marijuana that is out there on the streets or being presented in many areas, it can cause tremendous problems with psychiatric problems for those who are already at risk for them or the longer youre on some types of marijuana, the greater risk you have for things like delusional behavior. We have to make sure we also eliminate medicaid payments for responses i ed referenced before about pain. In the area of treatment and recovery, we have to expand the Mental Health work force. As i said before, half the counties in america have no psychiatrist, no psychologist, no social workers, no drug and alcohol counselors. And those out there likely have their schedules so filled they dont even have room to treat someone. And not all of them even know how to treat addictive disorders. The fact that a majority of people who may have an addiction disorder also have a concurring Mental Health disorder is another reason why we have to increase this work force by tens of thousands. And adolescent psychologists alone, we need tens of thousands of those. Its important that the schools of med sib, schools of psychologist, schools of social work are graduating more people with these degrees and getting them into our work force. Ive had legislation before, weve passed some things in the cures bill, in my Mental Health crisis bill, to provide more funding for more of these folks to continue with their education. It is essential, its like trying to fight a war without soldiers. To try and fight this war, which is killing more people every year than the entire war in vietnam. But we do not have the solders to fight this. We have to also make sure that with regard to the governmentsponsored medication assistance treatment i referred to before, we cannot simply rely on synthetic opioid maintenance alone. We have to make sure there are requirements to have that person in counseling and treatment. Ive heard from some persons that go to some of those treatment programs, they have no counseling at all and some have great counseling. In some cases, sitting in the waiting room, perhaps a nurse or someone checks up on them, how are you doing, whats life . Thats considered and written down as group therapy. That is not acceptable in any way, shape or form. We need 14u7b,000 more inpatient psychiatric bed and we need to mike sthaur Insurance Companies recognize that an addictive disorder is a chronic disorder. Giving someone a weekend or a few days for withdrawal and put them back on streets is not an answer. Thats why we have to encourage private Insurance Companies and medicaid and medicare, i say medicare because a large number of people who are having some of these problems are also the elderly. We have to make sure that we increase the availability of opiate blockers for First Responders. But lets keep this in mind. If some cases we hear of some of those pushers of these drugs who also give an accompanied dosage of nar can, recognizing that it will bring that person to a near death experience. We have heard from First Responders and others, Law Enforcement, where someone may have a party where someone will remain there expecting that someone will have an overdose and die. Bring them back to life. Thats how some of these people are seeking some of those experiences. We have to make sure that those who that states review their laws that some arent doing. If you take one of these oprah ats and do you have that near death experience, perhaps that should be treated the same as a suicide attempt. That person is in imminent danger of harming themselves or someone else. And perhaps determine if they need in patient psychiatric stay. We have to make sure we have supportive ploist employment for those in recovery to break the cycle of recovery and reexposure. Many times persons who have who are trying to stay clean, because they cant get a job hat deals with that cant pass the drug test, they neighbor a job that exposure to other people who end up with Substance Abuse. We have to make sure they have Higher Standards and increased accountability for payment models and require evidencebased treatments in Halfway Houses and residential treatment facilities. We have to deploy certified addiction counselors to emergency rooms. When we know a person comes to an emergency room, if they see an addictions counselor, they are not simply given a Business Card and say, call someone next week, we hope you get treatment. If they see an addiction counselor in the emergency room, they increase their chances of followup by 50 , according to a michigan study. We must make sure the f. D. A. Is working with companies to find alternatives to opioids. And that, again, medicaid and other physicians are educated on some of those aspects. Physician training has to also be rarped up. Require them to have ramped up. Require them to have opioid training practices. And prescribing limited dosage instead of dosages for a month, perhaps just a couple days. Many in cases are not adequately trained in alternatives to opioids and the potential harms of overprescribing. We have to increase training requirements for Health Care Providers who deliver this medication assisted treatment. Right now in many cases they only have a few hours of training and then they can go and prescribe this and have very little if any training at all in addictions counseling. Before doctors write a prescription, we can make it that they have to make sure theyre looking at the lists. In the area of Law Enforcement, its critical that what is called the high intensity drug traffic areas are made more available with access to things around the country. Mr. Speaker, do you know how much time we have left in our segment here . The speaker pro tempore the gentleman has seven minutes remaining. Mr. Murphy thank you. We have to make sure we have more Border Security so were intercepting these as they come across the border. We need funding for the post offices. Because in many cases the letter carriers are the ones who are carrying delivering to peoples homes fentanyl and other drugs. In the incarceration system. We have to make sure were testing inmates for the presence of drugs in their system during their incarceration. We can offer for them medications which upon discharge would block any effects of some of these drugs. So that they medicaid and other Insurance Companies make sure that immediately upon release from incarceration, they take some of these drugs. That they are get their medicaid returned to them so they dont simply relapse into finding ways of selling drugs. We also need to make sure we have solid data collection. When we show these charts about death rates around the country, these may be grossly inaccurate. Medicaid, First Responders and paramedics, coroners do not keep accurate data on these rates. The persons themselves may not even be tested to see if they died from a Drug Overdose. These are several items in here, of what we can be doing as a nation. And theres many more. The point is, we have fallen short and we have seen some problems with this. Theres more that we can do and we must do in order to save lives. I know i just have about three minutes left, mr. Speaker. Am i correct . The speaker pro tempore the gentleman has five minutes remaining. Mr. Murphy id like to yield three minutes to my friend from ohio, ms. Kaptur, to talk about some issues dealing with Substance Abuse. Ms. Kaptur i thank you so much, congressman murphy, for doing this and for your incredible leadership on this important topic. And for holding this special order this evening. I can tell you the citizens of the state of ohio are paying attention. The Opioid Epidemic continues to intensify with over two Million People addicted to prescription opioids and more than half a million addicted to heroin in 2015 alone. According to an estimate from the new york times, Drug Overdoses from are now the leading cause of death for americans under 50, and drug overcoasts are the leading cause overdoses are the leading cause of accidental death in our country, with prescription opioids responsible for more than 20,000 deaths in the United States just in 2015, according to the American Society of addiction medicine. I have to mention that medicaid plays an Important Role in addressing this epidemic. Because it is a life line program, providing coverage to over 650,000 nonelderly adults with opioid addiction and covering a range of treatment services. Ohio tragically leads the nation in opioid overdoses in 2014. Sadly deaths have continued to rise with increased use of heroin and fentanyl. Many states have expanded medicaid, including ohio, to cover adults who make a modest 16,000 a year per individual. By broadening coverage of adults, the medicaid he can pangs reaches many lowincome adults with opioid addiction, who were previously ineligible for coverage and facilitated access to treatment. The Opioid Epidemic is so bad that even librarians are learning how to treat overdoses for individuals who come in to libraries. Mental health can be comorbid with opioid abuse and those suffering from that dulet are truly an american tragedy. For an addict to complete rehab and recovery successfully, they need to work in concert. And over half of uninsured, nonelderly adults with an opioid addiction had a Mental Illness in the past year with over one a seriouserating with Mental Illness, such as depression, bipolar disorder, or skets friendia. To address the sketsfreenia. To address the gravity of the challenge, i want to put on the record what my home county is doing with their dart program which engages hospitals, Mental Health centers and businesses in the community. Believe it or not, according to a sheriff, the dart program has helped nearly 2,300 overdose victims and has a 74 success rate of getting people into detox and treatment programs. At a total cost of about 370 per individual. This is truly an amazing record. I wish to submit for the record the information about other counties in the district that i represent. And again yield back the time to the gentleman. Mr. Murphy id like to recognize the gentleman from wisconsin for one minute. I thank the gentleman for yielding and his leadership on this critical issue. As you lay out, communities across this country, communities like mine in northeast wisconsin, are in the midst of a Public Health crisis. Its not a republican or democrat issue. Its an american issue. One that should bring us all together. Opioid abuse is wreaking havoc on our homes, our schools, our churches. Its devastating effects are destroying its devastating effectses are destroying our families and lives. As you pointed out, more americans will have died of Drug Overdoses in 2017 than there are names on the vietnam war memorial. That should put it into sharp relief. Asthma are inveteran, im acutely aware that Service Members are more susceptible than the average person to addiction. Veterans die from accidental Drug Overdoses at a 33 higher rate than the rest of the population. Something must be done to reverse this trend. I commend law makers in wisconsin who are doing agrissive work on this front and commend you, sir, and everyone else who has spoken out and i look forward to working with you. Because headline after headline reminds us of the tragic loss of life that has resulted from our nations growing opioid and addiction risk and we have to step up. We to take action. Mr. Speaker, i yield the balance of my time. Mr. Murphy i yield 30 seconds to mr. Blumenauer of oregon. Mr. Blumenauer thank you, congressman. I deeply appreciate your sent kontos convenienting us this evening your convening us this evening. Your focus. Its been fun working with you in the past on creative, bipartisan efforts to try to make sure the federal government is a better partner on this. I look forward to working with you on legislation that will make it easier to be able to have the Information Available that people need for integrated treatment. And your commitment to trying to bring people together to understand the problem and the fact that we are agreed more than we are divided on these things. And look forward to working with you on some progress in the months ahead. Mr. Murphy i thank my friend from oregon. I thank all the members speaking here tonight. Mr. Speaker, i want to say, this was a Bipartisan Coalition of members. Were much better working off off working hand in hand, than standing next to each other as paul bearers. With that with some hope that we can pass this legislation and ave some lives, i yield back. The speaker pro tempore under the speakers announced policy of january 3, 2017, the chair recognizes the gentleman from texas, mr. Gohmert, for five minutes. Mr. Gohmert thank you, mr. Speaker. I just want to thank all my fellow members speaking up on this very important issue. Appreciate dr. Murphy taking lead. It is something thats not gotten enough attention. We continue to have people need to deal with the issue. It is interesting. Me people find great hope in heir religious beliefs throughout americas history. Christianity has been an important foundation. No, you didnt have to be a christian to participate in government, to be a founder, franklin said we know because he wrote out the speech in his own handwriting immediately afterwards as quested so often teachers teach that hes deiist as so many of the founders were told deist. Said at the conventional continental convention, a few years away from meeting his maker, severe gout, arthritis, overweight, trouble getting up and down but he said, i lived, sir, a long time. E lonner i live the more convincing proof i see of this longer i live the more convincing proof i see of this, if a sparrow fall to the ground without notice is it possible an empower could rise without his aid . Franklin said, we have been and by the way, that is viously a reference to jesus comment about the sparrow. God seeing the sparrow, watching the sparrow. And he makes it very clear as his own words indicate. He said, we have been assured, sir, in the sacred writing that unless the word build a house they labor in vain that build it, again, rmping scripture. Those are referencing scripture. Those are not the words of a diest. Teachers have been miseducating people for so long. I know they were just passing on what they were taught. Theres been so much miseducation for so long. And regardless of what else, and we dont try to force our religious beliefs on anyone. Thats not what the house of representatives is for, but since it formed such an important part of our founding and a part of the discussion for most of our nations history its important to point out that those scriptures that ben franklin referenced at the constitutional convention, the scriptures that have been quoted so often. We know the bible is the number ne far away most quoted book in the house of representatives and the senate. Nothing else anywhere even close. And it has brought hope to people that had no hope. So its interesting that as our nation moves further and further away from the source of of our hope for so much nations history and for those who lived through that part of our nations history, the hope that Franklin Roosevelt brought to the microphone when he read the famous prayer on dday as american soldiers were fighting, as he said, against hose forces of evil. Was from country that used to peace that were fighting forces of evil but they had hope. That hope in prayer that Franklin Roosevelt gave over the microphone for several so es now is condemned by any. That hope that served as the foundation, the Building Blocks for the beliefs of sam adams and so many around in those being an redit as important foundational Building Block for the revolution, for the new nation. And were arriving at a time when record numbers of people are dying. We heard today in our judiciary 144 ng, i believe it was americans each day are dying of Drug Overdoses. Who dies of a Drug Overdose . People without hope. People who are drawn to drugs to provide a good feeling, a warm feeling. We have more military members killing themselves than in any time probably in any nations history. I dont know that for sure. Its just hard to imagine a time in any nations history when so many of its veterans re taking their own lives. The time when so many of our active military have taken their own lives. Those obviously, as people have said over the years, that is a permanent solution to a temporary problem. And it is the act of someone ithout hope. So we know, regardless of whether people accepted christian beliefs or not, christianity throughout our nations founding, provided. Ope, the bible provided hope for those who were slaves in , so many , 1800s were christians, and it was the bible, those wonderful spirituals, it was scripture that gave them hope to endure, t through the horrors of slavery. Though Abraham Lincoln bragged in his early 20s about being an infidel and not believing in Steve Mansfield in his book in the last five years or so about lincolns struggle with god documents his going from being an infidel to a point where as president he read scripture constantly. Ctor spears, a brilliant history professor at the university of oklahoma, asked me once, do you know why lincolns speeches are so god and touch our hearts . And i said, i dont know. Theyre just really wellworded. Theyre great speeches. He said, no, he was reading so much scripture by that point in his life, like the gettysburg address, he wrote his speeches as if they were scripture. His words provided hope because e referenced scripture so much. Nd those, whether aethist, agnostic, muslim, buddhist, so many have a general knowledge of what christians believe and its very basic. God, according to genesis, the Old Testament, he created the world, created the universe, eated man and woman, and basically we got the bible as n Owners Manual giving us important history so that we ould get a good look at what works and what doesnt and what we wner expects and how can live the most joyous and hopeful life even through terrible, perilous times. Hristianity goes on and in the to the ament points belief that the Old Testament, as we refer to it, points to the messiah coming, be born in many of the prophecies about the messiah to come even if one believes jesus was not the messiah, incredible that he could fulfill those prophecies the way he did. And christians, as people of most religions understand, believe what john 3 16, so god loved the world that he gave his own begotten son. Then who soffer believeth in him would not perish but have everlasting life. O clearly christian religion is based completely on love, that god so loved the world hat he gave his only son who was perfect, unblemished, with since of the earth and only something, someone unblemished could take away the sins of the world. And the additional exclamation point that makes clear that christianity is a religion based on love, it was made clear by jesus himself when he was asked by a lawyer, naturally, whats the greatest commandment . He said, love god, and the others like it. Love each other. On those two commands, hang all the law in the prophets. Someone, if you were to go about outlining the 10 commandments, they easily fall under those two headings, love od, love each other. , t then jesus also made clear greater love no one than this than a man lay down his life for friends. And jesus knew whether you believe he was the fulfillment of all the prophecies from the Old Testament or not, he could have escaped. He made no effort. He gave himself. Out of love. Hes a liar or a lunatic or hes exactly what he said, but his acts were based on love. He gave his life for a world that needed an unblemished lamb. So with that background, mr. Speaker, and of course the Supreme Court outlined it much more thoroughly in the late 1800s, as it came to the conclusion, well after the , the case of dred scott and made clear, determined, pronounced, you know, even though everyone in the United States is not a christian, this is a christian nation. And everything that the court calls in to view in their decision testify to that fact. As the court pronounced. So why am i going into this . Its because weve hit what may be as low a point as weve ever hit in congress. He was being questioned on the same day another person named comey was testified here on capitol hill, Russell Brock was being questioned by senators so they could determine how they wanted to vote on whether or not he could fill a role in the administration. This low point in our nations history has to rank down there as one of our low points when so much throughout our history has testified to the fact that christianity was such an important part of our foundation , of everything thats been good in america, the ending of slavery, driven, guided by churches. Sure there were some atheists involved. The revolution. Following the great awakening. 1730s and 1740s. Ded up yielding a revolution that produced the greatest country in the history of the world by virtue of the opportunities, by virtue of the protections for freedomloving people around the world, by virtue of, you know, the opportunities and the assets and that a country would ultimately arise, the Number One Health problem for the nations poor was obesity. The more opportunities, more assets, more freedoms, even than solomons israel. An incredible country. With many religions celebrated here in the United States. But as general jay garner was told when he was in iraq after Saddam Hussein was driven out, hes told me twice, actually, three times, said it when i heard him speaking back in 2004, i called him and reiterated it, he told me again last september, it was i remember it correctly. He talked to a direct descendant mohammed in iraq about what kind of government the u. S. Should help iraq have. I would contend we shouldnt be about nation building but that was his order and thats what he was doing. And he said that this descendant of mohammed, with a black turban, said he was going to explain in his native tongue because they were recording it and then after he finished he said, let me just give you in a nutshell what i told you we need here for a government in iraq. By ed a government formed iraqis, a government composed of iraqis. And a government based on a constitution which is based on the teachings of jesus. The descendant of mohammed told jay garner the best hope for a country was a constitution based on the teachings of jesus. Because basically, those teachings of jesus are the only can allow h a nation freedom of religion. No matter which other religion or agnosticism, atheism, whatever other religion not going to be able to truly allow freedom of religion unless its based on the teachings of jesus. Thats what this insightful descendant of mohammed in iraq told retired general jay garner. We get to 2017, hearing on the , this comey testified appointee, nominee, by President Trump, Russell Brock, great man his christian twisted, intoted, something that was represented to be hateful. The religion based on the love of love of god and the love of his son that would give his life for others. Senator sanders said, and im quoting, let me get to this issue thats bothered me and bothered many other people and that is in the piece that i referred to that you wrote for the publication called resurgent, you wrote, quote, muslims should not simply have a deficient theology. They do not know god because they have rejected jesus christ his son and they stand condemned, unquote. Senator sanders then went on and said, do you believe that statement is islam phobic . Islamaphobic . He replied, no, im a christian, i believe in christian principles. That post, as i stated in the questionnaire to this committee was to defend my alma mater, Wheaton College a Christian School that has a statement of faith that includes the centrality of jesus christ for salvation and senator sanders interrupts. I apologize, forgive me, we dont have a lot of time. Do you believe people in the muslim religion stand condemned, is that your view . He replayed, again, senator, im a christian. And i wrote that piece in accordance with the statement of faith at Wheaton College. Enator sanders i understand that. I dont know how many muslims there are in america, maybe a couple million, are you suggesting all those people stand condemned . What about jews . Do they stand condemned too . He replays, im a christian. Senator sanders at this point is shouting, i understand youre a christian but this country are made of people who are not just i understand christianity is the majority religion but there are people of different religions in this country and around the world and in your judgment do you think people who are not christians are going to be condemned . He said, thank you for probing on that question. As a christian i believe that all individuals are made in the image of god and are worthy of dignity and respect regardless of their religious beliefs. I believe that as a christian thats how i should treat all individuals. Senator sanders responded, you think your statement that you put into that publication, they do not know god because they rejected jesus christ his son and they stand condemned, do you think thats respectful of other religions . Mr. He said, senator, i wrote a post based on being a christian and attending a Christian School that has a statement of faith that speaks clearly in regard to the centrality of jesus christ in salvation. Senator sanders said, i would simply say, mr. Chairman, this is that this nominee is really not someone who this country is supposed to be about. That came from quotes came from article in National Review quoting from the hearing itself. Thats why i say, mr. Speaker, for may be the low point hope in america. Condemns ting senator someone who is simply quoting from the teachings of jesus. Teachings that even a descendant of mohammed knew was helpful in creating a great nation. Weve come a long way from the within the ounded founders of this country, within the hope of those who fought to bring about the end of the horrendous, hideous practice of slavery. Where human beings treated brothers and sister human beings with chains and bondage. And now weve come to a point that i feared and i brought up when hate crime legislation was discussed, that the day would religion of the world based on the love of god and the love of jesus christ would be twisted to the point that it would be called hateful. Am the way, the truth, the light. No one goes to the father except through me. Hes either a liar or a lunatic or hes exactly who he said he was. But thats not hateful. Its not hateful to believe in religion where you want to share the joy and the hope that comes from it. Results, maybe its t a result, but more of a an unfortunate unfortunate situation that exists when you take away the hope of the christian religion, condemn people for believing jesus is the hope as he said he was, or r friend, the lake Chuck Coleson pointed out, our hope going to arrive on air force one he believed the hope was in jesus. And now we have some we have someone who has declared who is declared totally inappropriate to be a Government Official because he believes the teachings of jesus. It is not hateful to believe the teachings of jesus. In fact, someone i know jewish friends who have asked, i thought christians blamed jews for killing jesus . The truth is, anyone who is a true christian, they blame jews or anyone else for the death of jesus, theyre not a christian. They dont understand the belief that jesus died for me, for anyone who has done wrong in this life. So its a sad day, its a sad week. Its a sad month. To look how far we have come from the hope that was once so prevalent and now were in a society where suicide is rampant, 144 Drug Overdoses a day, and that doesnt count all of the suicides by veterans and ctive duty military. Christianity is a religion of love. And may god grant which is come to any senator who thinks otherwise. I yield back. The speaker pro tempore the the gentleman yields back the balance of his time. The chair lays before the house a communication. The clerk the honorable, speaker, house of representatives, sir, under mr. Robert designate reesks deputy clerk to sign and all parties and do acts under the name of the clerk of the house which they would be authorized to do by virtue of this designation except as provided by statute in case of my absence or disability. This shall remain in effect for the 115th congress. Karen l. Haas, clerk of the house. The speaker pro tempore for what purpose does the gentleman from texas seek recognition . Mr. Gohmert i move that we do adjourn. The speaker pro tempore the question is on the motion to adjourn. Those in favor say aye. Those opposed, no. The ayes have it. The motion is adopted. The house stands adjourned until 10 00 a. M. Tomorrow for morning hour debate. For more on the Health Care Legislation we spoke earlier today with a capitol hill reporter. Host the day began with an insistence that there would be a vote so walk us through the days developments. Guest republicans were down five votes on the procedural motion but they wanted to have the vote today or on wednesday. A couple of hours ago, senators say they wont hold the vote this week. They dont have enough senators on board to get there. And you know, we have some inklings of this, we have the announced senators who are no, we suspected there were more who were privately a no. When we tried to go to them they wouldnt say where they were, they wouldnt say if they were a yes or no. At some point Republican Leaders made the decision they cant vote this week, at least not successfully so theyll try to move forward, try to get a deal to come together. Host i want to follow up on that in a moment but we heard from the senator from West Virginia and the senator from ohio opposed to the bill of the current in the current form. The list had been gring over the day who else have you been keeping an eye on . Guest senator moran of kansas said he was a no. They didnt make the announcement until after the vote was pulled so they at least publicly were not opposed until a vote was no longer a realistic option so they could have told mcconnell this privately, to try to shore up the negotiating room. We had the senator conservatives were already public with their opposition. And these moderates, senators portman and capitoing were clearly not public. But weve always known theres opposition to the bill on both sides, both the conservative side and the moderate side. Its up to leader mcconnell to try to bridge the gap between both sides. This is like a balloon you push one side to get some votes and lose on the other side. The question is going to be, can mcconnell find that, you know, perfectly shaped balloon that gets 50 of his 52 republicans to vote for it. Host one of the arguments, we talk about this in past day is the longer you wait for a vote, the more time it gives the opponents of the legislation to build up some sort of campaign. So now we have the july 4 recess. What will happen on both sides . Both for the Republican Leadership who want to see the bill pass and opponents who want to see it scuttled . Guest immediately after the vote was announced as not going to happenmark democratic activists and groups announced they are going to go to senators barbecues, fourth of july parades and pushing them to oppose the bill. I think there are a will the of republican senators who are nervous about that i spoke to several republicans who said privately this makes them nervous. They know the longer this is out there, the more pressure theyre going to get. There are some critics who say its going to smell even worse than it does right now. If leader mcdonell doesnt have the votes now its hard to see how that changes unless the bill changes significantly and as we were saying, you know, thats going to be hard to do to find those changes that get enough folks on board. Host your story today Available Online at politico. Com points out maybe the president wants to see the Affordable Care act collapse and then act on it. Walk us through that . Guest republicans have made the argument that the Affordable Care act is collapsing, its in a death spiral and will fall apart because it was not well built. Supporters argue thats not the case and republicans are letting it collapse through neglect. The republican argument here which President Donald Trump has tweeted about several times over the last several months is that if the law collapses democrats have to come to the table and hes really using it as a negotiating ploy. The issue is the law doesnt really collapse. As long as subsidies roll out, insurance premiums can go up dramatically and subsidies will keep going. The issue will be if insurers decide not to participate in the markets next year. Weve seen some states where insurers dont want to offer coverage, they fell its too expensive, too much risk to offer coverage there. In those state its a dire situation. If people cant get buy insurance policies, the Affordable Care act is worthless. But so far, you know, we havent seen any kind of bipartisan negotiation. Senator collins, the most moderate republican in the senate, has tried to bring folks to the table. She held a meeting with some moderate democrats but everyone kind of left the meeting saying its nice to have a discussion but they dont see it really going anywhere. Unless to this republican bill actually fails one day. And even then i dont see how seven years of such partisan conversation on both sides of the aisle can really bring, you know, together a bipartisan compromise. Host bottom line, the president and Administration Officials meeting earlier this afternoon with e with the republican senators inside the white house, what happens next . Can they reach a deal in the coming weeks . Guest Mitch Mcconnells strategy now is to try to get a deal on a plan by the end of the week. He would use the fourth of july recess to get a new c. B. O. Score and the senate would vote right after the fourth of july break that seems like an ambitious goal because of the problems facing the legislation an it is hard to see congress coming back from a recess and voting right away. As you know, congress doesnt really vote on things until they have a recess right in front of them but mcconnell wants to keep the train going. He feel he is has some momentum right now, getting additional senators on board, as he hopes to do. As soon as he gets to 50 hes going to want to hold that vote. And i think the moment he gets to 50 hes going to try to hold that vote right away. We will look for you reporting online at politico. Com. Jennifer joins us on capitol hill she covers the health care beat. Thank you for being with us. Guest thank you. Cspans washington jounl live every day with news and policy issues that impact you. Coming up wednesday morning, Kaiser Health news correspondents marry agnes carey and julie rogner discuss the senate the postponed health care bill. Join the discussion. Next a discussion about the United States global image. A new Pew Research Study examined the fluctuation and Favorability Ratings in countries around the world including mexico, rush and israel. This is held by the brookings institution, its an hour and 40 minutes. Good morning, everyone. Welcome to brookings. My

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