Charles Dent

Mr. DENT

Mr. DENT. Madam Chair, just very briefly in answer to my colleague's comments, I want to say very briefly that this does not waive liability. It simply says that when care is federally mandated under EMTALA that there will be Federal liability protection provided to those who are providing the care. That's only fair. People still can bring action, but there will be Federal liability protection, as there should be, because this care is being required under Federal law. I think it's completely reasonable. At this time, I reserve the balance of my time.

Mr. DENT. The only thing I would like to say in response, once again, is this immunity protection only applies to care provided under EMPALA, and that's federally mandated care. Other activities going on in that emergency room or trauma center would not be given this exemption from liability, only federally mandated care. It can't be any more clear. I reserve the balance of my time.

Mr. DENT. Madam Chair, I rise for the purpose of offering an amendment.

Mr. DENT. Madam Chair, I'm pleased to join my colleague, Pete Sessions from Texas, on the floor this morning to support a very important amendment that we've introduced that would address the crisis in access to emergency care by extending liability coverage to on-call and emergency room physicians. The underlying bill we're debating here today is about patient access to care. Now I recognize that ideology may divide the House on the underlying bill. But common sense should unite the House on this particular amendment. Our former colleague, Bart Gordon of Tennessee, had introduced this legislation with me last year. In this session, we have bipartisan support for this concept. Mr. Matheson, Mr. Langevin, and Mr. Ruppersberger all have cosponsored this legislation that I am offering as an amendment. They cosponsored the original bill. There's a growing shortage of physicians and specialists willing to work in emergency rooms. We've seen it all over the country. A 2006 Institute of Medicine report, ``The Future of Emergency Care,'' noted that the availability of on-call specialists is an acute problem in emergency departments and trauma centers. Emergency and trauma care is delivered in an inherently challenging environment. Every day, physicians providing emergency care make life-and-death decisions with little information or time about the patients they're treating. I've spoken with surgeons who've told me they dread a Code Blue out of fear of a lawsuit. They want to serve these people who are coming into these emergency centers but are fearful for their families of a lawsuit. That's what medicine has become, unfortunately, because of this out-of-control litigation system. As a result, these physicians providing emergency and trauma care face extraordinary exposure to medical liability claims. Forty percent of hospitals say the liability situation has resulted in less physician coverage for their emergency departments. According to a report from the GAO, soaring medical liability premiums have led specialists to reduce or stop on-call services to emergency departments. This trend threatens patients' access to emergency surgical services. Neurosurgery, orthopedics, and general surgery are the most impacted. They also are the services that emergency departments most frequently require. Trauma centers across the country have closed. In my home State of Pennsylvania, this has been a very serious problem. This is an urgent issue that needs to be addressed. This amendment would protect access to emergency room care and reduce health care costs by allowing emergency and on-call physicians who deliver EMTALA- related services medical liability protections. EMTALA, the Emergency Medical Treatment and Active Labor Act, ensures that any person who seeks emergency medical care at a covered facility is guaranteed an appropriate screening exam and stabilization treatment before transfer or discharge, regardless of their ability to pay. EMTALA is a Federal mandate that protects all our citizens, the insured and the uninsured alike. This amendment will provide a backstop for the doctors who provide these critical services. Specifically, the amendment would ensure medical services furnished by a hospital, emergency department, or a physician or on-call provider under contract with a hospital or emergency department pursuant to the EMTALA mandate are provided the same liability coverage currently extended to community health centers and health professionals who provide Medicaid services at free clinics. This amendment will not impact the rights of individuals who have been harmed to seek redress. What this amendment will do is ensure medical professionals are available to provide critical, timely, lifesaving emergency and trauma medical care to all Americans when and where it is needed. Please join me and Representative Sessions in supporting this amendment. If an accident ever happened to any of us, Heaven forbid, we want to make sure that there are people in these trauma centers and those emergency rooms ready to deal with us and who have nothing on their mind but saving our lives, not worrying about lawsuits. So I urge adoption of this amendment. At this time, I reserve the balance of my time.

Mr. DENT. In conclusion, this amendment has bipartisan support. As I said, our former colleague, Bart Gordon, who was a cosponsor, introduced this bill along with me last session. Mr. Langevin is a cosponsor of the bill, Mr. Matheson, Mr. Ruppersberger. It makes sense. This is important to make sure our citizens have access to emergency care should they ever need it. At this time, I urge support of the amendment, and I yield back the balance of my time.

Mr. DENT

Mr. DENT. This medical liability crisis has had serious implications in my State of Pennsylvania. It's time we act on this issue. I live in a State where we train a lot of doctors, but we can't retain them and we can't recruit them. It's a very serious problem for us. It's time we pass this legislation. We'll say more about medical liability tomorrow in the amendment process. Support the legislation.

Mr. DENT. Madam Chairman, the bill we're considering today, H.R. 5, the Protecting Access to Healthcare Act, or PATH, is about patient access to care, plain and simple. In the months leading up to the passage of the health care law and since the law was enacted, Congress has spent countless hours talking about the need to increase access to health care. The health care law signed nearly 2 years ago was the wrong direction for our country and for our citizens, and it will negatively impact access to care. The two issues that we're going to address here today in this legislation--repealing the Independent Payment Advisory Board, or IPAB, and enacting meaningful medical liability reforms--are key to ensuring that all Americans have access to quality care. Now, as to the first piece of this legislation, the IPAB, the Independent Payment Advisory Board, let's be very clear: nothing about these advisory rulings are advisory. Good luck to anybody; good luck if you try to ignore the advice of the IPAB. It's going to be more like a medical IRS than an advisory panel. Let's be clear: the very purpose of this IPAB is to save money by restricting access to health care for Medicare beneficiaries. It will achieve these savings by ratcheting down payments to providers who are already underpaid by Medicare. This will lead to fewer doctors who are willing to see Medicare beneficiaries, and, undeniably, this will lead to delays and denials of care. This board, as has been said many times, is made up of 15 unelected bureaucrats--and unaccountable ones at that--that will wield enormous power, and there are no checks and balances in place to ensure that authority is being used appropriately. This abdicates Congress' responsibility, and it threatens care for our Nation's seniors. Make no mistake that IPAB must be repealed. We don't need a medical IRS. The second part of this legislation is going to reform our medical liability system. Across our country, our medical profession has practiced defensive medicine out of fear of frivolous lawsuits. This not only drives up health care costs, but it creates serious doctor recruitment and retention problems, especially in the so-called ``high- risk'' disciplines such as orthopedics, neurosurgery, emergency medicine, and obstetrics.

Mr. DENT

Mr. DENT. I thank the gentleman from Pennsylvania (Mr. Thompson) for organizing this Special Order hour in order to discuss the life of Joseph Vincent Paterno. As has been said, there have been many eulogies said about Joe Paterno, and he was an extraordinary man by anyone's measure. As has been mentioned, he came to us via Brooklyn and Brown University. I believe he studied English literature, and he always took great inspiration from the books he read and the classics. In fact, he turned down a life in professional football in order to stay at Penn State and stay in this university, academic environment. He actually liked meeting with the faculty and enjoyed discussing English literature and other weighty matters. This man was quite complex. He was more than just football, although certainly that was such an important part of his life, and a big part of his life. We should also note that some of us would always watch Joe Paterno over the years. My mom is a Penn State alumna and I'm a Penn State alumnus. Our family goes back many, many decades, so we have some acquaintance with Joe Paterno. Many people fondly remember him--the guy with the thick Coke-bottle lenses and the khaki pants--flood pants-- with athletic shoes. That's how they'd see him out on the field, getting a little agitated from time to time with the officials, but he was much more complex than all that. A few things: first, if there is a theme about Joe Paterno's life, it was that he was about setting clear standards, as one of his children had told me. He has five wonderful children and a wonderful devoted wife, Sue Paterno. He often said that Joe said things like this: Take care of the little things, and the big things take care of themselves. You either get better or you get worse. You never stay the same. Most importantly, he said, Make an impact. That was the wisdom that his father passed on to him and that Joe passed on to his children--make an impact. So when you think about it, Joe Paterno's life was about making an impact, and football was just a means to that greater end for him. He and his wife, Sue, would see a need, and they would meet it one small thing at a time until the big things, a legacy of philanthropy and caring, took care of themselves. They gave a lot of their own time as well as their own money. His son said something to me, and I'm just going to read this. One of his children sent this to me. He said that, over the years, Joe attended hundreds of dinners and functions, raising billions of dollars for Penn State, for the Special Olympics--I know his wife, Sue, was particularly devoted to the Special Olympics--for the Catholic Church, and for education at all levels. He said, I once asked him why he did it, why he smiled when he signed his 30th autograph while getting a paper, and he said with that twinkle in his eye, The moment they don't care about Penn State football, we can't do the things that matter. He understood that, as a symbol and as a person, he had to let people own a piece of him to get them to buy in to the larger vision. They did, and the results were spectacular. From the Paterno Library to scholarships to what's called THON, the dance marathon where they raise so much money for children with cancer, he said, My dad helped them all. He made an impact. That's really what it was about. It has often been stated, too, that Joe Paterno really wasn't supposed to go to Penn State at all. He was supposed to go from Brown University and become an attorney, as his father had expected. Basically, he told his dad at one point, No, I'm never going to be a lawyer. He was enjoying Penn State. He enjoyed the football program. He said his father took it all right, but closed with a mandate that drove him his whole life. His dad said, It's not enough for you to be just a good football coach. You need to make an impact. So that was imparted from his father on to Joe. There are a lot of people out there who played football for him. Some of these were young men who had a lot of talent in many cases, and some of them were maybe a little bit pampered, as some athletes are at the high school level who are quite good; and Joe could be a pretty strict disciplinarian for a lot of them. In fact, one of his former players, Kenny Jackson, who attended Penn State when I did, still calls him ``teacher'' first. Hundreds of players called him a surrogate father. The lessons they learned translated across the whole spectrum of their lives, creating a living legacy, and that will make an impact decades past his passing. There are so many people who spoke of him. Since his death and just prior to his death, I spoke to some of his former players and friends who knew him well, and they often talk about the impact he made on their lives and how much they cared for him all these decades after playing for him. In fact, there was one story, too, that I want to share. I remember back in the 1980s there was a player named Bob White. He became an All-American and was on the national championship team. I think he even played in the NFL for a while. I just remember how the Paternos took him under their wing. Apparently, he was a fairly marginal student. He had some trouble reading and, in fact, wasn't very good at it. So Sue Paterno would basically give him books, and he would have to read the books and then give her a book report. I mean, this is the coach's wife taking an interest in one player who was academically not very strong at the time. Today, he is quite successful and does quite well. I just wanted to share that story. It's one of those stories you really don't hear about or about the anonymous contributions that have been made by him that have been discovered recently because people have spilled the beans, so to speak. He didn't want people to know that he was helping them. He did all of these things without any recognition. He was an extraordinary man, and he will be deeply missed. All I can say is that he was a great Pennsylvanian even if he did spend the first few years of his life in Brooklyn. He was very proud of that by the way. I just wanted to say that I'll always have very fond memories of him. The university is a better place because of what he has done throughout his life, and I think we will always remember him.

Mr. DENT. I thank the gentleman. And as we wind down this Special Order this hour, talking about Joe Paterno, we should also probably note one other thing, too. Of course Joe Paterno was about success with honor, he was about making an impact, but he was also about family. And also, I just want to say, too, that many players over the years, their children would come to the school. In some cases, three generations have played with him. It's a remarkable story. I think of a guy from my hometown, Mike Guman. Many of my colleagues from Alabama will remember Mike Guman for the famous goal-line stand, Penn State-Alabama Sugar Bowl, 1979. I wish the end result had been different. But nevertheless, Mike Guman was a running back. I had so many kind, wonderful things to say about him. And his son, too, Andy Guman, played at Penn State. That was the kind of program that I think Joe wanted. It was very family-oriented. I also wanted to mention, too, that one of the eulogies about Joe that is probably worth sharing--I believe it was given by his son Jay. He often talked about his sense of humor and that of his wife. Joe and Sue were utterly devoted to each other, very independent-minded people, but very much dependent upon one another. I am going to read an excerpt from that eulogy: Humor was a large part of my parents' marriage. My mom and dad, speaking together, was always entertaining. My mom would jump up with a smart comment when he was talking, and you'd get a glimpse of how the two of them interacted. Neither one of them took themselves too seriously. And he says: One of my favorite lines that they had was about how they stayed married so long. They had a deal--whoever leaves the marriage first had to take the children. So neither one of them ever left. And that was sort of the sense of humor they had, but they were so utterly devoted to each other, to their five children, and to their many grandchildren. That's something we don't speak much about Joe Paterno. He didn't have a whole lot of hobbies either. He was devoted to family and his football program and his university. That's what he was about. So it really speaks volumes about him. He will be deeply missed. At this time, I yield to the gentleman from Altoona, Pennsylvania (Mr. Shuster).

Mr. DENT. I have to apologize for making that error. I knew you were from Everett, not from Altoona. But Blair County, the whole of Bedford, it's a wonderful area. We love it. I wanted to say one other thing my friend, Mr. Shuster, just reminded me of: how Coach Paterno, Joe Paterno, recognized that most of his players were not going to become pros, and he celebrated the accomplishments of his players off the field. In fact, I remember one fellow who went to school with me, a guy named Stu McMunn, Stewart McMunn, I think he was captain of special teams. They won the national title the year after I graduated. He talked with pride about that young man. He's not going to be a pro, but he's all of this spirit, all this fight in him, he's a smart kid, and all that. And he became a dentist. He was very proud of the fact that was one of his players. That was kind of the way he was. He wanted to see his players succeed. He wasn't so concerned about the next 5 years after graduation, but the next 15, you know, 20, 30, 50 years, to see what they're doing with their lives. So I think that's something they shouldn't lose sight of. I did read from a eulogy given at the celebration of Joe's life by one of his children, and I submit it for the Record. Again, I just want to conclude by saying that Joe Vincent Paterno, a great Pennsylvanian, a great American, a strong leader, a mentor to so many, a mentor even to many people who never met him, but he had an impact on their lives. So, Joe Paterno, you did in fact make an impact. Mom and Dad. I don't know much about Greek Mythology, so forgive me if I botch this reference. But in the past few months I've been reminded of some kind of Greek myth. Apparently, we were once one body with a male head and a female head and we were all happy. Some angry god, as punishment for some slight--sliced all of the happy two headed beings apart--forever dooming us to run around the world looking for our other half. Anyone who knows my parents also knows that they were among the lucky people who were able to find their other half: their soul mate, their best friend. We've stated over these past days just how blessed and lucky my Dad was--and he knew it. One of the stories you won't hear from a former Letterman is the time that Coach Paterno became smitten with his girlfriend and didn't ask her out. No, sneaky Joe waited until Sue realized that this player was not for her and went in for the kill. After a courtship that involved reading Albert Camus, walking on the beach, and pretending that he had money, they married and soon started their family. Over the years when my Dad would talk about retirement or getting older, he would remind me, ``You know, your mother is a young woman.'' It almost became a joke. Whenever she was late coming back from a meeting or something, I'd say ``Well you know, your mother is a young woman.'' He'd always chuckle. But he did worry about her and always wanted to make sure that she would be OK once he was gone. They were absolutely devoted to their family: my Dad was comfortable letting my Mother handle the more traditional roles of diaper changing, but he loved to bounce us around on his knee, try to teach us table manners, have discussion- filled family dinners, and take us for walks; walks that would continue into our adulthood and would be one of his primary ways of sharing his wisdom and insights with us. I shared some of dose walks in late November and I am forever grateful for having that opportunity. Their relationship was unique in some ways. Two fiercely independent and strong people, yet two people utterly devoted and dependent on each other. Best friends who challenged each other to be better, who supported each other yet reminded the other when they might be mistaken, who knew each other so well that they knew what the other was thinking before they even said it. This was a relationship that started with respect and friendship and remained strong with faith, love, and commitment to each other. They made each other better. Humor was a large part of my parents marriage. My Mom and Dad speaking together was always entertaining--my Mom would jump in with a smart comment when he was talking, and you'd get a glimpse of how the two of them interacted. Neither one of them took themselves too seriously. One of my favorite lines they had was about how they stayed married so long. They had a deal--whoever leaves the marriage first had to take the children, so neither one of them ever left. But that was really not the reason. They were devoted to each other without fail. The compassion and love they showed for each other during these past few months was indescribable. Weaker marriages may have splintered at the incredible amount of pain they endured. Yet theirs only grew stronger. My Mom's only concern these past few months was for my Dad, and my Dad's was only for my Mom. just a week ago, I was talking to him and I didn't want him to get discouraged. I said to him--Hey, you've got to keep fighting. For Mom. He barely had his voice then but he nodded and whispered back ``fight, for Mom.'' And he was. And he did until the end when we assured him that we would take care of Mom. Like my mother, we are all heartbroken at the days and years ahead when we continue our lives without being able to pop in on him for a quick visit, ask him for advice about our children. Or, in my case just to see him and be reminded of what a great father I've had. We have faith in God and his plan for all of us, and I can only be grateful that I was a witness to a beautiful marriage and that I had the best father and role model I could possibly ask for. I love you and will miss you Dad. And don't worry--we will take care of Mom. I do know that my mother is a young woman.

Mr. DENT

Mr. DENT. I certainly appreciate the support of Mr. Pitts and Mr. Pallone for their leadership on this issue. It's deeply appreciated. This issue of synthetic or designer drugs was first brought to my attention by a woman, a mother in my district whose son had been abusing legal substitutes for marijuana. These synthetic cannabinoids, as they're referred to, or synthetic marijuana, affect the brain in a manner similar to marijuana, but can actually be even much more harmful. Synthetic marijuana, or cannabinoids, are just one category of designer drugs. Even more potent substances have properties similar to cocaine, methamphetamine, LSD, and other hard street drugs. These substances are marketed as innocent products like bath salts, plant food, incense, and they're sold under brand names familiar to their users, such as K2 Spice, Vanilla Sky, or Ivory Wave. However, these are total misnomers designed to facilitate their legal sale. These drugs have no legitimate purpose, period. H.R. 1254, the Synthetic Drug Control Act, drafted in consultation with Federal law enforcement, has three principal components: First, a prohibition of broad structural classes of synthetic marijuana or the cannabinoids; Two, a prohibition of synthetic stimulants and other designer drugs, such as bath salts, mephedrone, MDPV, C2E, et cetera, several of those; Third, an expansion of the DEA's existing authority to temporarily ban a new substance from 1\1/2\ to 3 years. Under current law, if the DEA and Department of Health and Human Services can prove that a substance is, one, dangerous and, two, lacking legitimate value while it is temporarily banned, the prohibition will become permanent. Over the past year there's been a sharp increase in the number of new reports detailing horrific stories of individuals high on synthetic drugs. A man in Scranton, Pennsylvania, stabbed a priest, and another jumped out a three-story window, both high on bath salts. Several deaths from West Virginia to Florida to Pennsylvania to Iowa have been attributed to abuse of synthetic drugs. Senator Chuck Grassley of Iowa has introduced a companion bill with provisions very similar to H.R. 1254, named after one of his young constituents who tragically took his own life while high on synthetic marijuana. A man in my district was arrested this past May for firing a gun out of his window in a university neighborhood. Police charges indicate that he injected himself with bath salts, and he later told police he thought there were people on the roof watching him. Finally, I was approached by another distraught mother from my district whose son was hospitalized for over 2 weeks after suffering liver failure and other complications after injecting himself with bath salts. These substances pose a substantial risk, both to the physical health of the user as well as to the safety of those around them when these drugs contribute to dangerous, psychotic behavior, suicide, and public endangerment. The fact that these drugs are legal in many States contributes to the misconception that they are safe. And the use of easily recognizable brand names and logos on the packaging promotes the concept of a consistent product. Significant variations of potency from one unit to the next have led recurrent users to inadvertently overdose. One of the major difficulties in combating these designer drugs is the ability of the producers to skirt the law with different chemical variations. By modifying the formula in some minor way, producers can generate a new compound which circumvents legal prohibitions but has similar narcotic events. DEA needs enhanced authority to temporarily schedule new variations when they hit the market, and they usually hit Europe first, and then they enter the United States. A growing number of States, including Pennsylvania, have enacted bans on many forms of synthetic drugs, but Federal action is necessary to prevent these drugs from being obtained by simply crossing State lines or, increasingly, ordering them over the Internet. I believe over 30 States have passed bans, if my memory serves me correctly. State-by-State differences in which individual substances are controlled and how strongly makes for a confusing legal patchwork, and Federal legislation certainly will facilitate enforcement. The U.S. Department of Justice announced its support of H.R. 1254 as amended by the House Judiciary Committee in a letter dated September 30, 2011, and I would submit that for the Record. I also want to point out, too, that the American College of Emergency Physicians, which notes the devastating physical and psychotic effects of these drugs, has also endorsed this bill, and I think that's quite significant as well. Finally, go to a hospital like Children's Hospital of Philadelphia-- they'll tell you they get a case every day with individuals who are suffering from these particular drugs. A year ago at this time, they probably got no calls. And now every day, and that's not just typical in Philadelphia but throughout the country. I urge my colleagues to support this legislation. You will also hear some folks here today who might actually argue that medical research will somehow be impeded. Nothing could be further from the truth. This legislation does not in any way impede medical research. I would be happy to get into that at some point. U.S. Department of Justice, Office of Legislative Affairs, Washington, DC, September 30, 2011. Hon. F. James Sensenbrenner, Jr., Subcommittee on Crime, Terrorism, and Homeland Security, Committee on the Judiciary, House of Representatives, Washington, DC. Dear Mr. Chairman. This letter provides the Department of Justice's views on H.R. 1254, as amended by the Committee on Energy and Commerce, titled the ``Synthetic Drug Control Act of 2011.'' The bill would amend the Controlled Substances Act (CSA) to address the growing use and misuse of synthetic drugs by placing a number of substances in schedule I and by extending the length of time that a drug may be temporarily placed in schedule I. We support the bill as drafted, but believe it can be strengthened with the addition of the ``2C family'' of drugs listed in an appendix to this letter and in S. 839. The Department also supports the goals of S. 605, Dangerous Synthetic Drug Control Act of 2011 or the ``David Mitchell Rozga Act''; S. 839, Combating Designer Drugs Act of 2011; and S. 409, Combating Dangerous Synthetic Stimulants Act of 2011. H.R. 1254 already contains many provisions included in S. 605 and S. 409, and we urge that the bill be expanded to include the provisions of S. 839. The Threat of Synthetic Drugs In recent years, a growing number of dangerous products have been introduced into the U.S. marketplace. Products labeled as ``herbal incense'' have become increasingly popular, especially among teens and young adults. These products consist of plant materials laced with synthetic cannabinoids which, when smoked, mimic the deleterious effects of delta-9- tetrahydrocannabinols (THC), the principal psychoactive constituent in marijuana. To underscore the scope and breadth of the synthetic cannabinoid problem, a recent report prepared by the United Nations Office on Drugs and Crime (UNODC) notes that more than 100 such substances have been synthesized and identified to date.'' There is also growing evidence demonstrating the abuse of a number of substances labeled as ``bath salts'' or ``plant foods'' which, when ingested, snorted, smoked, inhaled, or injected, produce stimulant and other psychoactive effects. These synthetic stimulants are based on a variety of compounds and are purported to be alternatives to the controlled substances cocaine, amphetamine, and Ecstasy (MDMA). These drugs have been distributed and abused in Europe for several years and have since appeared here in the United States. According to a recent National Drug Intelligence Center report, poison control centers and medical professionals around the country have reported an increase in the number of individuals suffering adverse physical effects associated with abuse of these drugs. There are other newly developed drugs that also pose a significant threat to the public. This includes the ``2C family'' of drugs (dimethoxyphenethylamines), which are generally referred to as synthetic psychedelic/hallucinogens. Recently, a 19-year-old male in Minnesota died of cardiac arrest after allegedly ingesting 2C-E, one of the substances within this class of drugs. We note that the 2C substances listed in the attached Appendix are included in the list of substances covered by S. 839. The Department supports the addition of the 2C family of substances listed in the Appendix to H.R. 1254. Products containing synthetic drugs are dangerous and represent a growing challenge to law enforcement. Apart from the wide array of harmful or even lethal side effects of many of the listed substances, neither the products nor their active ingredients have been approved by the Food and Drug Administration for use in medical treatment, and manufacturers and retailers of the products containing these substances do not disclose that there are synthetic drugs in their products. Synthetic drug abusers may endanger not only themselves but others: some become violent when under the influence of these substances, and abusers who operate motor vehicles after using synthetic drugs likely present similar dangers as those under the influence of controlled substances. With the exception of the five substances recently controlled by the Drug Enforcement Administration (DEA) pursuant to its temporary scheduling authority, the listed synthetic cannabinoids and synthetic stimulants are not currently in any schedule under the CSA. Efforts to control Synthetic Drugs Congress created an interagency process for placing new and emerging drugs into one of five schedules of the CSA (21 U.S.C. 811 et seq.). One such mechanism, temporary scheduling (21 U.S.C. 811(h)), was specifically designed to enable the Department to act in an expeditious manner if such action is necessary to avoid an imminent hazard to the public safety. In response to the growing threat posed by known synthetic cannabinoids, on March 1, 2011, the DEA temporarily placed the following five synthetic cannabinoids in schedule I: JWH- 018, JWH-073, JWH-200, CP-47, 497, and CP-47, 497 C8 homologue. The DEA is currently gathering scientific data and other information about synthetic cathinones as well as evaluating their psychoactive effects to support administrative action to schedule these substances under the CSA. To temporarily schedule these stimulants, the DEA must find that placement in schedule I is necessary to avoid an imminent hazard to the public safety, a finding that requires the DEA to consider the following three factors: history and current pattern of abuse; the scope, duration, and significance of abuse; and what, if any, risk there is to the public health, including actual abuse; diversion from legitimate channels; and clandestine importation, manufacture, or distribution. Once data have been gathered to meet the statutory criteria to temporarily schedule these cathinones, the Department will initiate an action to temporarily place them into schedule 1. In fact, on September 8, 2011, the DEA published a notice of intent in the Federal Register (21 FR 55616) to temporarily place mephedrone, methylone and MDPV in schedule I. Unfortunately, however, the distribution and abuse of synthetic drugs cannot be fully addressed by temporary scheduling because as law enforcement investigates, researches, and develops evidence to support such action, illicit drug makers create new synthetic drugs for the purpose of evading federal law. Scheduling via legislation is an additional tool to promote public health and safety. Purpose of Legislation Placing synthetic carnnabinoid and synthetic stimulant substances in schedule I would expose those who manufacture, distribute, possess, import, and export synthetic drugs without proper authority to the full spectrum of criminal, civil, and administrative penalties, sanctions, and regulatory controls. Unless authorized by the DEA, the manufacture and distribution of these substances, and possession with intent to manufacture or distribute them, would be a violation of the CSA and/or the Controlled Substances Import and Export Act. H.R. 1254, as well as S. 409, would amend the CSA by expanding the list of substances in schedule I of the CSA (21 U.S.C. 812(c)). To address synthetic cannabinoid abuse, the bill names 15 unique substances that would be placed in schedule I; this list includes those temporarily scheduled by the DEA. Additionally, the bill creates five structural classes of substances collectively referred to as ``cannabimimetic agents.'' In order for a substance to be a cannabimimetic agent, the substance must: (1) bind to the CB1 receptor; and (2) meet any of the definitions for those structural classes. If both criteria are met, that substance will be a schedule I cannabimimetic agent controlled substance. To address emerging synthetic stimulant abuse, H.R. 1254 names 17 unique substances that would be placed in schedule I. These substances have either been encountered by law enforcement here in the United States or are most likely to be encountered by law enforcement in the United States based on their use and misuse in Europe, which is likely where the use and misuse originated. Finally, the bill seeks to double the amount of time allowed for the Department to temporarily schedule new and emerging drugs by amending 21 U.S.C. 811(h). In this regard, the bill seeks to enhance the tools available to the Department to combat the abuse of new drugs that will appear in the future. For these reasons, the Justice Department supports H.R. 1254 and recommends that the Committee consider strengthening it in the ways we have proposed. Thank you for the opportunity to present our views. The Office of Management and Budget has advised us that from the perspective of the Administration's program, there is no objection to the submission of this letter. Sincerely, Ronald Weich, Assistant Attorney General. Appendix Additional Synthetic Drugs for Inclusion in section 202(c) of the Controlled Substances Act (21 U.S.C. 812(c)): Redline of H.R. 1254, as amended by Energy and Commerce on July 28, 2011-- ``(35) 2-(2,5-Dimethoxy-4-ethylphenyl) ethanamine (2C-E). (36) 2-(2,5-Dimethoxy-4-methylphenyl) ethanamine (2C-D). (37) 2-(4-Chloro-2,5-dimethoxyphenyl) ethanamine (2C-C). (38) 2-(4-lodo-2,5-dimethoxyphenyl) ethanamine (2C-I). (39) 2-[4-(Ethylthio)-2,5-dimethoxyphenyl] ethanamine (2C-T-2). (40) 2-[4-(lsopropylthio)-2,5-dimethoxyphenyl -[ethanamine (2C-T-4). (41) 2-(2,5-Dimethoxyphenyl)ethanamine (2C-H). (42) 2-(2,5-Dimethoxy-4-nitro-phenyl) ethanamine (2C-N). (43) 2-(2.5-Dimethoxy-4-(n)-propylphenyl) ethanamine (2C-P).''

Mr. DENT. I do want to address a few of the statements I heard on the floor from my friends from Tennessee and Virginia. My friend from Tennessee made some comments, but I want to be very clear, these drugs are dangerous, have a high potential for abuse and no accepted medical use, which is why they belong on Schedule I. Schedules II and V are reserved for drugs used in legitimate medical procedures. So we're talking about Schedule I here, not Schedules II through V. Let me be very clear on that point. Second, the FDA has stated that the drugs listed in H.R. 1254 have no medical use, and there are no INDs--that is, investigational new drug applications--for these substances pending with the FDA. This is from the FDA. H.R. 1254 will not prevent further research into synthetic drugs. It's simply false to say that it will. DEA has a routine, well-established procedure in place to facilitate scientific study of Schedule I drugs, including marijuana, cocaine, and heroin. Currently the DEA has licensed nearly 4,000 individuals and other entities, including universities, manufacturers, researchers, and labs to handle Schedule I drugs for scientific and investigational purposes. These are facts. I also want to point out, my friend from Virginia made some comments about I guess eight compounds having been found in the United States. Actually, dozens of compounds have been found in the United States. Many bath salt chemicals currently are in the United States, but only three synthetic stimulants and five synthetic cannabinoids have been emergency scheduled by the DEA because they have to go chemical by chemical in order to act on this matter. They have to deal with this on a chemical- by-chemical basis. We need Congress to give the DEA authority to be more effective and get ahead of this problem. We know that these drugs are coming into this country from Europe. That's where they're coming from, these compounds. There are some in Europe right now. Our goal is to get out in front of this before they have a chance to be exported into the U.S. Another comment I heard about 325 researchers, well, 325 researchers because that's all who have applied to do this type of research. DEA is not in the business of turning researchers away, so I want to be clear on these points. There's so much more that can be said on this. But again, research will not be impeded in any way. There is a mechanism, there is a process in place to do research on these Schedule I drugs. It's well established. This has nothing to do with the medical marijuana debate. I heard that argued earlier, too. We're talking about synthetic marijuana and synthetic cocaine. This stuff is dangerous. And, in fact, some would argue worse than the real stuff, so let's get to it. This is about public safety. This is about the health of our constituents. We know what's going on. In fact, somebody pointed out to me today that a store in Washington, D.C., a few blocks from the Capitol, somebody is selling this stuff. My State and over 30 other States have seen this problem. They know what's happening across this country. We need to do something about it. DEA is alarmed by this. Justice is on board. DEA is on board. Let's do something for the good of the American people. Please pass H.R. 1254, the Synthetic Drug Control Act of 2011. It's in the best interest of the American people, and the best interest of our children. We're doing the right thing.

Mr. DENT

Mr. DENT. Mr. Chairman, I appreciate this opportunity to speak on this bill. First, I am the co-chair of the Cement Caucus, along with Congressman Mike Ross of Arkansas. My district is the largest cement producing district in America. I have a town in my district called Cementon. I have a high school team called the Konkrete Kids. This is what we do in my district in large part. I have five cement plants, Lafarge, Buzzi, Keystone, Essroc, Heidleberg-Hanson, Lehigh Portland cements. I have a company that manufactures and constructs cement plants, FLSmidth-Fuller. This is a big business where I live. It's an important business, the basic industry and the manufacturing to the industrial sector of this country. These three rules that we are dealing with are going to have a dramatically negative impact on cement production in America. Foreign imports currently make up more than 20 percent of total U.S. cement sales, and that number is going to grow if these regulations are implemented. Many of these foreign producers, as has been pointed out by some of the previous speakers, do not operate with anything close to the types of regulations that we are talking about here today, whether they be in Europe or Mexico, China or elsewhere. And as has been stated previously, close to 20 percent of all cement production facilities in this country are likely to close as a result of these three rules. What are they? It's NESHAP rule, which cobbles together a whole range of different performance characteristics for different pollutants without determining if it is possible for any single cement plant to comply with all the various standards simultaneously. Also one called CISWI--and I won't read the acronym--but that is going to have an impact on the ability to use solid waste in the form of tires, waste plastics, and other materials that we use in cement plants. This material would be land-filled. We'd have unsightly tire piles all over America, breeding grounds for mosquitos and West Nile virus. We burn them in cement plants. They have high Btu content. This will make it much more difficult, these rules, if they are implemented. So we have to stop it. So what this bill does, it scraps its three existing rules and requires the EPA administrator to develop and propose more realistic and achievable regulations within 15 months. This is completely reasonable. Support this. This is about protecting American jobs. I urge a ``yes'' vote.

Mr. DENT. Madam Chairman, I move to strike the last word.

Mr. DENT. I rise with strong reservations about this amendment, but I also want to talk about the underlying legislation. I think, really, what we have to be focused on here is jobs. Again, as I stated earlier during floor debate, I represent the largest cement-producing district in America. We have five cement plants in my district. Those five cement plants produce more cement than did the 50 plants that preceded them. We used to have 50 plants in my district, and now those five plants that are remaining produce more than the 50. The point is that the industry has become much more productive in many respects, including being environmentally more productive and sensitive. That said, these new rules, these three rules in particular, will restrict the industry's ability to remain competitive with foreign producers. These foreign imports currently make up more than 20 percent of the total U.S. cement sales. If these three rules are implemented, we will see less domestic cement production. To add insult to injury with respect to what the EPA is doing with their regulatory assault on the cement industry as well as on the coal industry, what they are doing here is just unfair to basic industry--to manufacturing, to industrial America. When you look at the stimulus law that was enacted a couple of years ago, look at what happened. Our stimulus dollars, Federal dollars, are being used to finance a cement importation terminal in New York City for the purpose of bringing in Peruvian cement. No, I am not making that up; that's real. And I've talked about this issue before on the House floor. Because this regulatory assault on domestic cement and our own Federal Government, another arm of the Federal Government, trying to basically subsidize the importation of foreign cement, it's going to have a very negative impact on my congressional district, which is, again, the largest cement producing district in America. And it's been stated before these NESHAP rules just cobble together a range of different performance characteristics for different pollutants without determining if it is possible for any single cement company to comply with all these standards simultaneously. There are two other rules, the CISWI rule and the nonhazardous solid waste rule, that will deal with issues like tires. And many modern cement plants here, as well as in Europe, use alternative fuel sources with high Btu content. They use tires. They use waste plastics ground up. Many of these materials and waste would be otherwise, ordinarily, landfill. We burn them in cement kilns with a high Btu content, and that replaces other fuels like coal. So this is very important. It's a great reuse of these materials. If we leave those unsightly tire piles out and about, what will happen is we'll see another situation like we saw in Philadelphia years ago where the tire pile ignited and melted the I-95 bridge in Philadelphia. That's when many people started to realize that there was a better use for tires than letting them sit in these piles under interstate freeways and use them in cement kilns. It makes great sense, and these new rules will imperil our ability to use those types of waste fuel oils, waste tires and ground-up plastics. So this is something I think we really have to focus on as we deal with this issue. Finally, I wanted to mention a couple of other things about what's occurring here. By scrapping these three existing rules and requiring the EPA administrator to develop and propose more realistic and achievable regulations within 15 months, we are going to provide more time for the industry to prepare for full implementation and compliance. We are going to require that the EPA administrator establish compliance dates and requirements after considering compliance costs, non-air quality health and environmental impacts, energy requirements, the feasibility of implementation, the availability of equipment suppliers and labor, and the potential net employment impacts. That means jobs. As has been pointed out at various points here, the industry today employs about 17,000 Americans, and we have lost more than 4,000 jobs in the cement industry since 2008. As I pointed out, in a district like mine where we have five cement plants that are operating, and operating effectively--and not only the cement plants, but we also have ancillary industries, like the FLSmidth Company, formerly the Fuller Company, where they actually make cement equipment and build cement plants. These types of jobs are good-paying jobs, are essential to America's industrial base, to our basic industry. We have to stop this regulatory assault on these types of manufacturing jobs. We can make things in America if our government will just allow us. So, once again, I want to express my concerns regarding the underlying amendment but, at the same time, expressing my strong and unreserved support for the underlying legislation, which is much overdue. Again, cement is a critical industry to our Nation, and it's time that we adopt this very important Cement MACT legislation. I yield back the balance of my time.

Mr. DENT

Mr. DENT. I have an amendment at the desk.

Mr. DENT. Thank you, Mr. Chairman. This amendment simply adds the National Emission Standards for Hazardous Air Pollutants, NESHAP or Cement MACT, to the covered rules within H.R. 2401. Reasonable efforts to limit the emissions of hazardous pollutants by cement manufacturing facilities are most certainly appropriate, but EPA has failed to craft effective and efficient regulations. These NESHAP standards will be very, very difficult and extremely costly for domestic cement manufacturers to meet, severely jeopardizing the ability of an essential American basic industry to remain competitive with foreign importers. Including NESHAP and H.R. 2401 will allow the loss of American jobs and the weakening of domestic manufacturers' global competitiveness to become key considerations during the completion of the rulemaking process. We must understand the impacts of these rules on jobs and our manufacturing competitiveness. Here now are some simple, basic facts about the American cement industry, and I represent the largest cement- producing district in America. I'm cochair of the Cement Caucus along with cosponsor Mike Ross of Arkansas. This industry employs about 13,000 Americans. Four thousand of those jobs have been lost since 2008. There are 97 cement plants in America producing today, and there's a presence in nearly every State as well, I might add. Cement is an absolutely essential basic industry in American manufacturing. It plays a major role in the development of our Nation's infrastructure. I think we need to better understand some of this background, too, regarding these NESHAP rules. NESHAP, of course, amends EPA's maximum achievable control technology, or MACT, and performance standards for cement kilns. And this is utilizing an unrealistic pollutant-by-pollutant approach for application of MACT. MACT requirements are designed to direct industries toward the pollution control technology used by the best performers in a certain industry sector. It cobbles together a range of different performance characteristics applicable to different pollutants without determining if it is feasible or even possible for any one kiln to comply with all of these standards. The truth is there is not a single cement manufacturing plant in America that can comply with all of these standards simultaneously. The chemical composition, too, of key cement inputs, such as limestone, vary from region to region. Consequently, NESHAP will have disproportionate impacts on different manufacturing locations across the country simply based on the type of limestone being used in the process of manufacturing cement. We should talk, too, about the impacts on the domestic cement industry: $2.2 billion worth of compliance costs, and that's an EPA estimate; $3.4 billion in compliance costs, and that's the industry estimate. So there's a lot of cost here. We're in the billions. There are numerous plants. There are estimates that from 12 to 18 of these plants across the country may be idle or permanently shut down. And these are massive facilities with tremendous capital investment. And we believe that the national price for Portland cement may increase by 5.4 percent. Domestic production will fall by 11 percent. Thousands of high-quality jobs could or would be lost. One major domestic cement producer has already publicly announced that, due to other regulatory uncertainties of this NESHAP and other pending regulations, it is halting construction of a new state-of-the- art cement kiln, suspending over $350 million in new investment and the creation of over 1,500 construction jobs. With respect to global emissions, what will this mean? The reduction of domestic production of cement will naturally lead to an increase in our Nation's reliance on foreign cement. And I can assure you those foreign producers are not going to be complying with the NESHAP rules. So this is going to shift overseas production and will likely increase global greenhouse emissions in two ways: First, transporting cement to the U.S. from international markets will require tremendous amounts of fossil fuels, substantially increasing the amount of carbon emitted per unit of cement used; and Second, foreign suppliers will be manufacturing in countries with little or no environmental protections. So it's critically important that EPA produce realistic and achievable regulations. Including NESHAP in H.R. 2401 will help EPA take into account the economic impact of its flawed regulations, and a more thorough economic analysis will lead to a better final rule. Finally, I wanted to say one thing. The Federal stimulus law is actually helping to finance the construction of a cement importation terminal in Staten Island, New York City, designed to displace many cement workers in my district and all across the northeastern United States, using Federal money to create a handful of jobs while displacing many in basic industry and manufacturing. That's got to stop. Pass this amendment, and then pass the underlying bill. I reserve the balance of my time.

Mr. DENT

Mr. DENT. Mr. Speaker, I too rise in support of this continuing resolution. It will fund the government through November 18. It takes care of many of our disaster needs. As you heard from my colleague so eloquently, Mr. Marino of Pennsylvania, you heard about the plight of so many people in towns like Shickshinny and West Pittston who are living in the front yard in the cars. People are broken. Communities have been ruined, and so we need to pass this bill. I urge you to support this bill. I've heard a lot of talk tonight about manufacturing. My dad's family spent 100 years making industrial hardware in Pennsylvania. If you really care about manufacturing, some of you might have considered voting for a bill last week to allow the Nation's largest exporter to open up a billion-dollar facility in the State of South Carolina to hire a thousand people to make aircraft. If you really want to help manufacturing, you should've voted for that bill. You can also help us in stopping EPA's assault on the coal industry and on the cement industry. I represent the largest cement-producing district in America. These industries are in trouble, and they're under assault by this EPA. Help us. There'll be measures considered here to deal with them. If you are truly concerned about manufacturing, innovation and research, you wouldn't have slapped a 2.3 percent tax on medical devices. It's going to kill tens of thousands of jobs in this country. We make a lot of devices in my part of the world, in Pennsylvania and New Jersey. We need help. Our manufacturers need help. So rather than defending a company out in California that just wasted $500 million, down the drain, taxpayer dollars, 1,100 people out of work, let's do something to help manufacturers. And most importantly, let's pass this bill tonight to help so many people who are struggling throughout this country in Pennsylvania; New Jersey; New York; Vermont; the people of the South; Joplin, Missouri; and elsewhere who have been affected by these horrible natural disasters. Please, stand up, do the right thing and vote for this continuing resolution.

Mr. DENT

Mr. DENT. Mr. Speaker, I rise today in support of the Budget Control Act. First and foremost, we, the United States House of Representatives, have an obligation to govern. We have a tremendous responsibility to the American people to consider this plan that ensures our Nation does not default on our Nation's commitments while at the same time places this country on a sustainable fiscal path. Let me be clear: Defaulting on America's obligations to our creditors, to our seniors, disabled veterans, activity military personnel, college students, and many others is not an option. This bill prevents a default and it pays our bills. Congress must act swiftly to deter a ratings downgrade of our U.S. Government, a downgrade that will affect families and small businesses across the country. Only a sound, credible plan that places us on that sustainable trajectory will prevent that downgrade, driven in part by an unprecedented spending binge by this administration which has blown up the fiscal balance sheet. A previous speaker said a few moments ago that we're playing games. I can assure you this is no game. This is serious stuff. And speaking of serious, the White House has still refused to offer a serious specific plan in writing that we can review. In fact, in a stinging rebuke of the administration, the nonpartisan Director of the CBO, Doug Elmendorf, said, ``We don't estimate speeches.'' The Senate has dug in its heels, too. It would be nice if they passed the bill, any bill. It's been 800 days since there's been a budget. It's time for them to act and to move to prevent this type of a fiscal calamity that many have predicted. Again, I ask my colleagues to support this legislation. It's a step forward. It may not be the final product, but it moves this process forward. I encourage the Senate to take it up. Most importantly, we have a sacred duty and a solemn obligation to lead and to act. We do have that affirmative obligation to govern for the benefit of our country and for the American people. The world is watching. Americans are watching. It's time for us to lead and demonstrate American exceptionalism.

Mr. DENT

Mr. DENT. I rise tonight in support of the Dicks-Fitzpatrick amendment. I voted for this same language in the Appropriations Committee markup a few weeks ago, and we have all heard some pretty compelling arguments here tonight about some challenges with the Endangered Species Act. And as has been previously stated by Mr. Thompson and others here tonight, I agree with those who said that the proper venue for this discussion is in the authorizing committee. I have great confidence in Chairman Hastings, that he would take a thoughtful and sincere look at the act to make reforms that I think many people would agree are needed. But again, I don't think this is the right place to do it. Again, I support the underlying bill. I think overall this legislation, this Interior bill, while it is not everything to everybody, and certainly the funding levels might not be where some people would like, Chairman Simpson has done a commendable job putting a bill together. But I think this language in the underlying bill should be stricken as proposed by Mr. Dicks and Mr. Fitzpatrick, and so I urge my colleagues to support the amendment. I yield back the balance of my time.

Mr. DENT. I move to strike the last word, Mr. Chair.

Mr. DENT. Mr. Chairman, I do rise in support of the Tonko amendment. Mr. Tonko and I have offered this amendment for consideration by the House. We are the cochairs of the Heritage Corridor Caucus. I represent the areas of the Delaware-Lehigh Heritage Corridor as well as the Schuylkill Valley Corridor in eastern Pennsylvania, and we have seen a great deal of positive activity as a result of these heritage areas. Specifically, as Mr. Tonko conveyed, a great deal of tourism activity, recreational opportunities, as well as economic development occurs as a result of this. Also, significant community development activities have been the result of our efforts and investment in these heritage areas. Obviously money is very tight, and this program is taking about a 50 percent reduction under the underlying bill. The amendment before us will simply restore about $8.4 million to the heritage area, to the heritage partnership program; and we'll be taking that money, substituting it from the National Park Service, where we believe they have sufficient funds to operate. I support the underlying legislation. I know Chairman Simpson has put a lot of effort into this. I think he has really done a great deal, given the numbers he has had to work with. So I do support the underlying bill. But I think that this amendment strikes a proper balance and preserves and protects these heritage areas that are making a real impact across the country. I guess there are 49 of these heritage areas currently in existence, and most of them, I believe, are receiving under $1 million of support through the Interior Department. So I just think this is a program that is worthy of our support. We're just simply, in these tough economic times, trying to bring this program back to neutral. I know the administration did not, in their budget proposal, cut this program as well. But I think this might be one way this amendment could help us bring this program back to a level that will be sufficient in supporting these heritage areas. Again, as was stated by Mr. Tonko, these communities are benefiting. We are seeing so much tourist activity. We are seeing increased recreational opportunities. I know in my community, we are all of a sudden doing things on our rivers and discovering our rivers and the natural beauty of them that many of us had not really noticed before, and it's really as a result of this. Again, it brought the rivers back to life, economic life, community life, and it has become really, once again, the center of our existence. And a lot of this would not have been possible but for the efforts of these heritage areas. So, again, I rise in support of the Tonko-Dent amendment and would urge the House to adopt this. I yield back the balance of my time.

Mr. DENT. Mr. Chairman, I move to strike the last word.

Mr. DENT

Mr. DENT. Mr. Speaker, on rollcall No. 601 and 602: I regret that I was unavoidably absent on Monday, July 18, 2011, due to a family obligation. Had I been present for the two votes which occurred, I would have voted ``aye'' on H.R. 33, rollcall No. 601 and ``aye'' on Approving the Journal, rollcall No. 602.

Mr. DENT

Mr. DENT. I too rise today to urge the Senate to take up this year's Homeland Security appropriations bill. The Senate has a bad habit of waiting to do just about anything. It's bad enough that the Senate has refused to even take up a budget. It's been hundreds of days before they considered to do one. But now they're derelict in their duties by failing to deal with the Homeland Security appropriations bill. We need to fund ICE, we need to fund CBP, we need to fund the Coast Guard, and many other critical functions of this Department. Of course, FEMA has great needs right now with the floods in Missouri, and elsewhere, and all the tragedies we've seen with the tornadoes across the country. It's important now that we get this funding, which was appropriated out of the House, through the Senate. Mr. Speaker, with the 10th anniversary of 9/11 and those horrific attacks just weeks away and disasters occurring all over the country, I certainly urge today that the Senate move forward. There can be no further delay. The motto of the Senate simply can't be: do nothing, do nothing, do nothing; start slow and then wind down from there. That's what we seem to be getting. But not on this bill. Move the House appropriations bill on Homeland Security immediately.