Sheila Jackson Lee

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Chairman, it has been refreshing and important to listen to the many Members from all over the country discussing this important initiative and, more proudly, it is from the Judiciary Committee, which is the holder of the laws and the Constitution of this land. We are here indicating an admittance and a recognition that addiction, and opioids, and all kinds of addictions are not necessarily a crime, and that we do not come to this floor, in this bill, with mandatory minimums. So I want to follow up on some statements that I made on the floor yesterday and also in the Rules Committee concerning the contrast in the way we are dealing with the opioid crisis and the way we addressed crack cocaine in the 1980s. Many of those individuals from neighborhoods like mine, many of them still are incarcerated. And at that time, we--I was not here--Congress took action that we are still trying to rectify. At one point, more than 80 percent of the defendants sentenced for crack cocaine offenses were African Americans, despite the fact that more than 66 percent of crack users were either White or Hispanic. As we work on other legislation to address the enforcement and sentencing disparities related to crack issues, we must reexamine our approach to that and other drug issues. I think we are on the right track. I think we are being fair. This week, the House has been engaged in a comprehensive approach to addressing a serious public health crisis involving heroin and other opioids. In my earlier statement, I complimented my chairman of the full committee and my chairman of the subcommittee because we are working together. Overdoses and deaths involving heroin are on the rise. While law enforcement has an appropriate role, the bills, including H.R. 5046 before us now, reflect a broader strategy that reflects the fact that this is an addiction issue. I know that Mr. Conyers and many others who are on this floor, Mr. Davis, we come from inner-city communities, and we have watched the young people of our community die and lose their future life through crack cocaine. Accordingly, we are not raising sentences or impacting mandatory minimums, but we are funding anti-addiction mechanisms such as treatment alternatives to incarceration, and we are bringing in the police persons, the police departments. What a great idea: criminal justice and substance abuse and police persons dealing with this issue in a non-incarceration mode. We are not adding to mass incarceration with all of the related and devastating collateral consequences but, instead, we are incentivizing State and local governments to prevent, treat, and heal. That is what we should be doing, and that is what we should have done for crack and cocaine addicts. We are learning. We understand now that we have a different pathway, but it is not too late. So I am saying to my colleagues here as we are working together, we should find a way before Congress has completed its work on this legislation and send a bill to the President that applies a more comprehensive approach, or a comprehensive approach that adds to this very strong foundation, including treatment alternatives for those who may still be suffering from crack and cocaine addiction. I remember signing the sentencing, the reduction bill that we had in 2009 dealing with the crack cocaine disparities. We came together as a bipartisan group. So I know that these are things that we can do. I have had this issue and discussed it with the gentleman from Michigan (Mr. Conyers), and I hope that we can work together as we move forward and that our colleagues can work together as we move forward to look at these issues because if we walk our neighborhoods today, from one inner city to the next, and maybe our rural communities, we will find those crack cocaine addicts.

Ms. JACKSON LEE. I yield to the gentleman from Michigan.

Ms. JACKSON LEE. I thank the gentleman. I look forward to working with all of my colleagues. As I finish, let me just say that today, again, I will be introducing the recidivism--to End Infant Mortality and Reduce Recidivism bill dealing with incarcerated women. Many of those women are incarcerated because of drug addiction issues that involve the possession or sale of narcotics. What we are attempting to do, if a baby is born in prison, we are attempting to recognize that they should not be separated from that mother, and to have some postnatal nursery situation in a pilot program to examine how that works, because we know that addiction, in many instances, has caused women to be incarcerated. There are many issues that we can look at, and I hope, as we work our way through this, we will find some solutions for those who are still addicted to crack cocaine and need some of the same or similar services that this underlying legislation has. Mr. Speaker, I rise in support of H.R. 5046, the Comprehensive Opioid Abuse Reduction Act of 2016, of which I am an original cosponsor. I commend the Chairman of the Subcommittee on Crime, Jim Sensenbrenner, for his work on this bill and I also commend Chairman Goodlatte and Ranking Member Conyers for their ability to find common ground on this very important issue. I also note that I was a cosponsor of a similar bill that was the predecessor to this one, the Comprehensive Addiction and Recovery Act. I would have been happy to see the Committee pass that bill, but I am pleased that we have been able to work together to produce an alternative bill that will help address issues related to opioid abuse. I look forward to continued collaboration with my colleagues to find additional solutions to the drug crisis America now faces. We must take action because today a leading killer of Americans is drug overdose. Between 2000 and 2014, almost half a million people died from drug overdoses. Many of these deaths were preventable. In 2014 alone, more than 47,000 people died of drug overdoses. The largest percentage of overdose deaths in 2014 was attributed to opioids--like prescription painkillers, methadone, morphine, and heroin. Specifically, 28,647 people overdosed and died because of an opioid in 2014. We are experiencing an emergency that impacts citizens in every state, city, and town in this country--that is prescription painkiller and opioid abuse. This emergency is compounded due to the perilous connection between prescription painkillers and heroin. Prescription painkiller abuse is the strongest risk factor for future heroin use. Approximately three out of four new heroin users report that their use began with their abuse of prescription painkillers. Heroin use becomes appealing to those addicted to prescription painkillers because it is cheaper and easier to obtain. Due to its potency, heroin use tends to lead to addiction. Heroin addiction is often deadly, leading to overdose or other chronic diseases. The rate at which the occurrence of heroin overdose deaths increased is cause for alarm. In the four years between 2010 and 2014, heroin overdoses more than tripled. More than 10,500 people died from heroin overdoses in 2014. In 2013, more than 8,200 people died from heroin overdoses. In that same year, 11 million people admitted to improper use of prescription of painkillers. Not only were 11 million people at risk of overdosing due to their abuse of prescription painkillers, 11 million people were also at high risk of becoming addicted to heroin--with its attendant risks and dangers. This current crisis requires an immediate and comprehensive response and the bill before us today is one element of a broader strategy. This bill will establish a grant program, to be administered by the Department of Justice, to assist states and local governments, particularly by helping criminal justice agencies to tackle the opioid problem from a variety of angles. This bill encourages the development of alternatives to incarceration that provide treatment as a solution to the underlying motivation for criminal behavior or conduct associated with mental disorders. We must make our best efforts to prevent individuals from moving from painkillers to heroin by making treatment for addicts more accessible by encouraging the use of evidence-based programs, such as medication- assisted treatment. Life-saving overdose reversal drugs, like naloxone, are most valuable in the hands of trained individuals who regularly come in contact with individuals who are prone to drug overdoses. This bill will increase the use and availability of naloxone and other overdose reversal drugs to first responders. Addiction is a disease that affects the brain and eventually changes the behavior of addicts, causing them to experience mental health issues and encounter legal problems. Treatment is the most reasonable and effective approach to diverting these individuals away from homelessness and prison. There are also specific provisions in this bill that allow for a wide range of services to be offered to our veterans who tend to suffer from mental health issues and addiction. I support this bill because I believe that it will help save lives and prevent and treat opioid addiction. The approach Congress is taking with the crisis of heroin and other opioids is thoughtful and comprehensive. I hope it signals a departure from some of the failed approaches concerning other drug crises in the past. For instance, our response to the surge in crack cocaine in the 1980s was to enact draconian mandatory minimum penalties with vastly disparate treatment for crack and powder cocaine. Unfortunately, that exacerbated the disproportionate minority impact of our drug laws and their enforcement. Today, no matter who is suffering from the effects of illegal drugs, we must learn from the past and embrace new ways of addressing the problem. The bill before us today, and the approaches contained in other legislation passed by the Senate and introduced in the House, reflect our experience in dealing with drug prevention, addiction, treatment, and recovery. While there is still work to do in Congress to address the mistakes of the past with respect to mandatory minimum sentences that are unjust, unwise and financially unsustainable, I commend my colleagues for embracing drug treatment, alternatives to incarceration, and improved training to first responders and the criminal justice system on how to put substance abusers on a better path. With those considerations in mind, and a hopeful note about the progress we are making in our approach to these issues, I ask that my colleagues join me in voting in favor of this important bill. I want to follow up on my earlier statement concerning the contrast in the way we are dealing with the opioid crisis and the way we addressed crack cocaine in the 1980s. At that time, we Congress took action that we are still trying to rectify. At one point, more than 80% of the defendants sentenced for crack offenses were African American, despite the fact that more than 66% of crack users are white or Hispanic. As we work on other legislation to address the enforcement and sentencing disparities related to the crack issue, we must re-examine our approach to that and other drug issues. This week, the House has been engaged in a comprehensive approach to addressing a serious public health crisis involving heroin and other opioids. Overdoses and deaths involving heroin are on the rise. While law enforcement has an appropriate role and the bills' recognize that, the bills--including H.R. 5046 before us now--reflect a broader strategy that reflects the fact that this is an addiction issue. Accordingly, we are not raising sentences or impacting mandatory minimums but we are funding anti-addiction mechanisms such as treatment alternatives to incarceration. We are not adding to mass incarceration--with all of the related and devastating collateral consequences--but instead we are incentivizing state and local governments to prevent, treat, and heal. That is what we should be doing, and that is what we should have done for crack and cocaine addicts. But it is not too late--we should find a way, before Congress has completed its work on this legislation and sends a bill to the President, to apply this more comprehensive approach, including treatment alternatives, to those suffering from crack and cocaine addiction. I urge my colleagues to work with me to do this.

Ms. JACKSON LEE. Mr. Chairman, I claim the time in opposition, although I do not oppose the amendment.

Ms. JACKSON LEE. Mr. Chairman, let me congratulate the proponents of the amendment and indicate to the gentleman from New York (Mr. Donovan) that I think many of us are on the same page. The Omnibus Crime Control and Safe Streets Act authorizes the Attorney General to make grants to State and local governments for prison-based family substance abuse treatment programs for the incarcerated parents of minor children. These programs can provide a comprehensive response to the needs of incarcerated parents of minor children, not only substance abuse treatment, but also a range of family-related services. These can include child early intervention services, family counseling, medical care, mental health services, parental skills training, pediatric care, physical therapy, and prenatal care. The importance of the value of these programs to pregnant women who find themselves incarcerated as well as to women who are already mothers is beyond dispute. We want to give our children--no matter who they are and where they are born in this country--a great and wonderful pathway to success. This amendment makes pregnant women equally eligible to participate in such programs. As indicated earlier on the floor today, I am planning to introduce the Stop Infant Mortality and Recidivism Reduction Act of 2016, which is to respond to women who have children while they are incarcerated, to provide them with some sort of support system where their babies are not separated from them. Those babies may be born addicted. I think it is important that this amendment looks at those pregnant women who may be incarcerated; and in this instance, this looks at pregnant women to provide them alternatives. It can be of tremendous benefit to these mothers-to-be as well as their children and families. This effort has my wholehearted support, and I strongly urge my colleagues to support this amendment to the underlying bill. Mr. Chairman, I yield back the balance of my time.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, it is a special privilege to be able to come to the floor and acknowledge the giants that live among us. Today I want to honor a giant in my community, the 18th Congressional District, which I have the privilege of representing. That giant's name is Carl Whitmarsh. If one were to think of those like Franklin Delano Roosevelt, John F. Kennedy, William Jefferson Clinton, President Obama, and many other leaders who invested in America, you would think of Carl Whitmarsh. He invested in the process of democracy. He invested, yes, in the Democratic Party because he was known as a democratic activist, but he had a sincere heart, being one of the members of the Texas Young Democrats. But in the course of being a democratic person and an activist, Carl worked with one of the first African Americans to integrate the Young Democrats in the name of Doris Hubbard. They worked together to say that, in this Nation, we are all equal. Yes, he was feisty. He was strong. He made us stand up and acknowledge our responsibilities of service. We lost him this past weekend. I want to thank Mr. and Mrs. Schlett for the great work that they have done to answer his need in the place he lived. I thank the Schletts for all they have done. Let me thank all of his friends for all they have done. Certainly, he was a friend of Hillary Clinton. He was a friend of mine and a friend of those who now mourn him. So among those of us who count ourselves as activists, let me simply say that he was a public servant and he believed in helping people. Let me also give my sympathy to the Oak Forest Area Democrats and all of his friends and family. Because we know that not only is a voice of democracy silenced, but we realize that a person who loved all of us and loved life and was willing to share--that person is Carl Whitmarsh. May he rest in peace. We have lost you, but not your spirit, your memory, and your legacy.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I thank Congresswoman Bonnie Watson Coleman for leading this Special Order and for bringing us together around two very important issues, not only this question of opioids, but, as well, the question of the rights of women. Let me say that this has been a week for news, news coming from the most powerful lawmaking body in the Nation. As I heard a Member say in the course of the debate on the list of opioids legislation, it is not that we needed it, for the record is established through the Congressional Record, but that we would want to have those areas that are usually filled with media really take hold of what is being done on the floor of the United States House of Representatives and, of course, the complementary legislation of the other body. Over the past 2 days, we passed legislation dealing with pregnant women, we passed legislation dealing with teenagers who lost their lives because of overdose of prescription drugs, and we passed legislation that gave a whole litany under the Judiciary Committee not of mandatory minimums and mass incarceration, but how do we bring law enforcement and substance abuse counselors together? How do we provide training for police officers to use naloxone? How do we ensure that there is training or resources for those who are addicted? How do we get parental training as it relates to individuals who are addicted and their children are addicted? How do we monitor the issuance of prescription drugs with the respect for the medical profession that we all have in doing their job? Because we do realize that this prescription journey started with the new approach to pain management that had been studied on an evidence- based basis that you would heal better if you could allow the pain not to be so devastating, then, of course, what happens are many things: the amount of prescription is more than you would need; or your children get ahold of it, or other people's children; or there is no place to dispose of it. In this discussion of opioids, I want it to be reflected that the Congress came together as Republicans and Democrats focusing on how we should address this as a sickness and an addiction and not as incarceration and punitive sentencing. We followed the beginning, in 2009, where we removed some of the disparities between crack cocaine and didn't have it in this large, unfair basis where, if you had a little bit of crack you were in prison for 400 years, if you had cocaine, you might skip by. We made that step. But now it is 2016, and we made a metamorphic change because we moved from the idea of mass incarceration to the idea of treatment. When I finished the debate on the floor on the most recent Judiciary Committee bill authored by Mr. Sensenbrenner working with Mr. Goodlatte, Mr. Conyers, many Members, and me, I indicated that we missed a period of history of the crack cocaine users. Many of them are languishing in prisons. So I am hopeful about this bipartisan spirit, as we look to sentencing reduction through H.R. 3713, for something miraculous, because it includes retroactivity. Many of those crack cocaine users are nonviolent. We will have the ability as this legislation works its way through Congress to include them in the scheme of treatment and the restoration part of what we are trying to do in the lives of people who are sick and addicted. I had someone come to me who said: Don't forget the meth users. We know that meth was an epidemic--and still is--and how destructive it is to one's physical look and body. So I am delighted to join my colleagues here to say that we did have a newsworthy great week and that we were taking a look at opioids in a different manner, that we are taking a look and working with physicians and the medical profession to be able to ensure that they do their work and that we find a way to provide a monitoring situation so that we can stem the tide of this horrific, horrible, and destructive drug addiction that destroys the lives of so many young people. I close by saying that some years ago, my late mother was in the hospital. We know how we treat our parents--but our mothers. I was flying back and forth from this House checking and determining what her condition was. She had so many moments where she was on the brink but she came on back. One of the moments that I came to the hospital, there was erratic behavior. It wasn't my mother. That is the issue that we want. We want people to be explained to as to what is going on. It was a treatment that was dealing with trying to ease her pain. I had to ask them: What is she using? Percocet. The first time that I heard that word was 6 years ago--or even later, beyond 6 years. That was 2010, so it was even earlier than that. I didn't know the ramifications of Percocet. I am a lawyer and not a doctor. But I realize that whatever it was, the cure was worse than the disease, and I asked them to take my mother off the Percocet and for me never to see that again. Now, how many families do that? She did get off of it. Thank God, she healed and walked out of that hospital. That wasn't the time that she passed. She lived for another day. But we need, in this opioid discussion, as we are moving against mass incarceration, to explain to families and physicians to talk about what these painkillers can do. Because, in essence, they are sometimes so toxic that they, in many instances, easily cause addiction, as I have heard many parents say about their youngsters who had athletic injuries. So I thank the Congresswoman for yielding to me because I think this week has been a magnificent week when we have opened the door and kicked the can not down the road, but we have kicked it to open the door to say to all of us in America that it is okay. Addiction can be cured. But we are going to work alongside of you so that you can openly seek that cure to relieve yourself of addiction, and we are not going to direct you down the path of incarceration and mandatory minimums. I want that for those who are languishing and who have been sentenced on crack cocaine, and I am looking forward to working so that legislation covers that aspect of those who are still incarcerated. With that, I thank the gentlewoman for yielding to me, and I thank the gentlewoman for her leadership.

Ms. JACKSON LEE. Mr. Speaker, as I listened to Congresswoman Maloney, I heard her mention the Constitution and the importance of the Equal Rights Amendment and I am reminded of the constitutional amendment that was needed in 1920 to allow women the right to vote. If you took a broad assessment of the American people, they might allude to women have the right to vote. But what I would offer to say to them is that every time we wanted to be sure of a right given to a left-out group, we had to add to the Bill of Rights. The Bill of Rights includes the Fifth Amendment, which is the protection of our property and due process. It includes the 13th, 14th, and 15th Amendments, which codify, constitutionally, the wrongness of slavery and the concept of equal protection under the law. But in all of that, it has not protected women in their rightful place in this society to have a legal basis to object to unequal pay. It did not provide the cover for Lilly Ledbetter, who went to protest the fact that she was paid less and was not given any respect by the employer who felt that there were no laws that protected her. I believe that, in all of my tenure in Congress, I have supported the Equal Rights Amendment legislation. So I just answer today, for those who may be querying ``here they come again'' or ``they already have a Bill of Rights'' or ``they have the amendment allowing them to vote,'' yes, we have sectors of rights--the right to vote--and maybe we join in and have the right to due process. What the Equal Rights Amendment does is it pierces the veil of governmental leadership and governance, and it says to the 50 States: you must adhere to the Constitution as it is related to women and that, with every aspect of governmental action that impacts women, without discrimination against men, you must put them on an equal footing. We have title VII and we have title IX; but, Mr. Speaker, in spite of those statutes, women are still discriminated against because you can't section off their rights and expect all of their rights to be protected. Discrimination under title VII fits one box, and title IX, with athletics, fits another box. Then, for some reason, we have all of these different aspects that seem either not to prevail under lawsuits under title VII or not to prevail under lawsuits under title IX, but women are still discriminated against. If there were an amendment that would cover all aspects of governance that States had to adhere to, that counties had to adhere to, that cities had to adhere to, and that, certainly, the Federal Government had to adhere to, because the Constitution is the Constitution of the United States for all people, then we would see the lifting of those issues that impact women and that are not clarified through the statutory process. I rise today again to support the movement of this bill through the Judiciary Committee, to the floor of the House, and, ultimately, through the Senate. For my colleagues, many of you know that there is a constitutional process that would engage the States. Then, ultimately, that would become an amendment to the United States Constitution. What better process of engaging the people of the United States in determining whether they want and recognize the importance of an Equal Rights Amendment than the process of amending the Constitution of the United States. I finish by saying we are doing what is right, and I am hoping that its conclusion will be in short order on behalf of the women and the men and the families of this great United States of America.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4843, the ``Improving Safe Care for the Prevention of Infant Abuse and Neglect Act,'' approved by the Education and the Workforce Committee. In the past decade and a half, the growth in the number of physicians prescribing opioids to help patients deal with pain from surgeries, dental work and chronic conditions has resulted in an increasing number of patients becoming dependent on the powerful and highly addictive painkillers--with patients not only abusing the use of those painkillers but often turning to heroin once their opioid prescription ended. The Centers for Disease Control and Prevention reports that nearly 259 million opioid prescriptions were written in 2012, more than enough for every adult in the United States, and it is estimated that in 2013 nearly 4.5 million people in the United States without a valid medical need were using prescription painkillers. The Health and Human Services Department estimates that the number of unintentional overdose deaths from prescription painkillers almost quadrupled between 1999 and 2013 and that abuse of prescription opioids now kills nearly 30,000 Americans each year. The ``Child Abuse Prevention and Treatment Act'' (CAPTA; PL 93-247) was enacted in 1974 to coordinate federal and state efforts to prevent and respond to child abuse and neglect. The law provides states with federal funds to improve their child protective services systems; however, to receive the funds, states are supposed to implement certain child welfare policies. CAPTA was amended in 2003 by the ``Keeping Children and Families Safe Act,'' (PL 108-36) that requires health care providers to notify child protective services agencies when a child is born with prenatal substance exposure or addiction. The protective services agencies are supposed to develop a ``safe care plan'' to protect the babies. The law explicitly states that it is meant to protect drug-dependent newborns and not to punish mothers who are dealing with addiction. In December 2015, Reuters published the first in a series of articles documenting the failure of health care providers and state child protective services to help these infants. Based on information from 2013, the latest year for which data are available, there were 27,000 cases of drug-dependent babies born that year, up from 5,000 in 2003 when CAPTA's notification requirements were enacted. However, more than 30 states do not require doctors to report cases of infants born with addictions. Some states have interpreted the law to mean that only addiction to illegal substances need be reported. This means that if the mother is taking prescribed drugs, even if the infant is born with an addiction, they do not require that the addiction be reported. In addition, even in states where infants born with drug dependencies must be reported to child protective services agencies, these agencies often take no steps toward developing a safe care plan for these infants. As a result, infants die because of neglect or abuse in their homes. Reuters identified 110 fatalities since 2010 of babies and toddlers whose mother used opioids during pregnancy and who later died from causes that could have been prevented. I recognize that infant mortality is at unprecedentedly high rates in our nation. Seeking to right the same wrongs as H.R. 4843, the ``Improving Safe Care for the Prevention of Infant Abuse and Neglect Act,'' I introduced the ``Stop Infant Mortality and Recidivism Reduction Act of 2016,'' or the ``SIMARRA Act,'' which will help the Federal Bureau of Prisons to improve the effectiveness and efficiency of the Federal prison system for pregnant offenders, by establishing a pilot program of critical- stage, developmental nurseries in Federal prisons for children born to inmates. It is time that our nation recognizes a long-persistent need to break the cycle of generational, institutional incarceration amongst mothers serving time for non-violent crimes and the children they birth behind prison bars. H.R. 5130, the ``SIMARRA Act of 2016,'' gives those infants born to incarcerated mothers a chance to succeed in life. ``SIMARRA'' is not merely yet another second chance program, demanding leniency from the criminal justice system. Instead, H.R. 5130 asks our national criminal justice system what it can do for those young Americans born and relegated to a life of nearly impossible odds of survival. ``SIMARRA'' provides that first chance--a first chance for American infants--that many of their mothers, born themselves to mothers behind bars, never received. H.R. 4843 requires the Health and Human Services Department (HHS) to review and confirm that states have enacted and implemented the child protection policies required by the Child Abuse and Treatment Act, including the requirement that addicted newborns are cared for. Specifically, in order to receive a grant for its child protective services system, a state must certify that it has a law or statewide program for child abuse and neglect that includes a safe care plan for an infant born with substance addiction after the infant is released from the care of health care providers. HHS must monitor the compliance of each state that receives a grant. Under the measure, states must also develop and implement monitoring systems to follow the safe care plans and determine whether local entities are providing referrals to, and delivery of, appropriate services for the infant and the affected family or caregiver. States must include in their annual data reports the total number of affected infants for whom a safe care plan was developed and for whom there were referrals to appropriate services, including services for the affected family or caregiver. The bill requires HHS to maintain and disseminate information regarding the requirements and best practices relating to the development of safe care plans for infants born with substance addiction. H.R. 4843, the ``Improving Safe Care for the Prevention of Infant Abuse and Neglect Act,'' is a valuable piece of legislation that I encourage my colleagues to support. Additionally, I urge my colleagues to join me in sponsoring and supporting all legislation targeting the improvement of care for the prevention of infant abuse and neglect, such as H.R. 5130, the ``Stop Infant Mortality and Recidivism Reduction Act of 2016'' or the ``SIMARRA Act.''

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 3680 the ``Co-Prescribing To Reduce Overdoses Act of 2015.'' This bill requires the Department of Health and Human Services (HHS) to establish a grant program to support prescribing opioid overdose reversal drugs, such as naloxone, for patients at an elevated risk of overdose, including patients prescribed an opioid. Opioids are drugs with effects similar to opium, such as heroin and certain pain medications. The Centers for Disease Control and Prevention reports that nearly 259 million opioid prescriptions were written in 2012, more than enough for every adult in the United States. In 2013 nearly 4.5 million people in the United States without a valid medical need were using prescription painkillers. Both states and the federal government have begun responding to this growing public health crisis. The Obama administration has awarded $94 million to community health centers to improve and expand the delivery of substance abuse services. H.R. 3680 would encourage and train health care providers to prescribe lifesaving overdose reversal drugs. Enacting this legislation will help reduce drug overdoses across the country by giving at-risk patients better access to lifesaving overdose reversal drugs. The plague of opioid overdose deaths across the nation is disturbing, but there are ways to combat this trend. H.R. 3680 is supported by the American Medical Association, the American Society of Addiction Medicine and the Harm Reduction Coalition. A party, or organization receiving a grant under this legislation will use the grant for the following reasons: 1. To establish a program for co-prescribing opioid overdose reversal drugs. 2. To train and provide resources for health care providers and pharmacists on the co-prescribing of opioid reversal drugs. 3. To establish mechanisms and processes for tracking patients participating in the program. 4. To purchase opioid overdose reversal drugs for distribution. 5. To offset the copays and other cost sharing associated with opioid overdose reversal drugs to ensure that cost is not a limiting factor for eligible patients. 6. To conduct community outreach, in conduction with community based organizations, designed to raise awareness of co-prescribing practices and the availability of opioid overdose reversal drugs. 7. To establish protocols to connect patients who have experienced a drug overdose with appropriate treatment, including medications assisted treatment and appropriate counseling and behavioral therapies. Mr. Speaker, the mounting number of people adversely affected and the over 25,000 lives lost expressly demonstrates the need for this type of legislation. H.R. 3680 is a positive step in the right direction and I urge all members to support this important legislation.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4978, the ``Nurturing & Supporting Healthy Babies Act,'' approved by the Energy and Commerce Committee. In the past decade and a half, the growth in the number of physicians prescribing opioids to help patients deal with pain from surgeries, dental work and chronic conditions has resulted in an increasing number of patients becoming dependent on the powerful and highly addictive painkillers--with patients not only abusing the use of those painkillers but often turning to heroin once their opioid prescription ended. The Centers for Disease Control and Prevention reports that nearly 259 million opioid prescriptions were written in 2012, more than enough for every adult in the United States. It is estimated that in 2013 nearly 4.5 million people in the United States without a valid medical need were using prescription painkillers. The Health and Human Services Department estimates that the number of unintentional overdose deaths from prescription painkillers almost quadrupled between 1999 and 2013 and that abuse of prescription opioids now kills nearly 30,000 Americans each year. Both states and the federal government have begun responding to this growing public health crisis, with many states moving to make anti- overdose drugs more available and shield first-responders from liability in administering those drugs. President Obama, meanwhile, has updated prescribing guidelines to encourage doctors to be more cautious when prescribing opioid painkillers and to emphasize non-opioid therapies for certain conditions. Additionally, the Obama administration has awarded $94 million to community health centers to improve and expand the delivery of substance abuse services. In the president's FY 2017 budget the administration proposed $1.1 billion to combat drug addiction and is also considering modifying certain rules to improve treatment. Our counterparts in the Senate, on March 10, 2016, passed S. 524, an antiopioid abuse bill that would authorize grants for opioid treatment services and first-responder training in using anti-overdose drug by a 94-1 vote, as well as create a task force to review and update best practices for prescribing pain medication. S. 524 also mandates investigations into heroin distribution and unlawful distribution of prescription opioids, and requires the creation of a national drug awareness campaign that takes into account the association between prescription opioid abuse and heroin use. The science indicates that opioids can have particularly harrowing effects on infants whose mothers took the drugs during pregnancy, including medical issues stemming from drug withdrawal known as neonatal abstinence syndrome. Advocacy groups note that the incidence of neonatal abstinence syndrome almost tripled from 1.20 per 1,000 hospital births in 2000 to 3.39 per 1,000 hospital births in 2009. In conjunction with H.R. 4978, the ``Nurturing & Supporting Healthy Babies Act,'' the Congressional Budget Office (CBO) has estimated that 45 percent of births in the United States are now covered by the joint federal-state Medicaid program. This bill directs the Government Accountability Office (GAO) to report to Congress on neonatal abstinence syndrome among children covered by Medicaid, including any federal barriers to treating such infants. The GAO must also provide recommendations for improvements that will ensure access to treatment for infants with neonatal abstinence syndrome under state Medicaid programs. Additionally, the measure modifies Medicaid to provide incentives for the development of abuse-deterrent formulations of prescription drugs and to prevent disclosure of Medicaid anti-fraud algorithms. The bill requires that GAO's report identify the prevalence of neonatal abstinence syndrome in the United States, including the proportion of affected children who are eligible for Medicaid at birth and the costs associated with neonatal abstinence syndrome. GAO will also be required to examine Medicaid-eligible services that are available for treatment of infants with neonatal abstinence syndrome, settings for such treatment, related reimbursement methodologies and costs, and the utilization of various care settings under state Medicaid programs for such treatment. This GAO's report must be submitted to Congress within one year of the bill's enactment. Seeking to right the same wrongs as H.R. 4978, the ``Nurturing And Supporting Healthy Babies Act,'' I introduced the, ``Stop Infant Mortality and Recidivism Reduction Act of 2016,'' or the ``SIMARRA Act,'' which will help the Federal Bureau of Prisons to improve the effectiveness and efficiency of the Federal prison system for pregnant offenders, by establishing a pilot program of critical-stage, developmental nurseries in Federal prisons for children born to inmates. It is time that our nation recognizes a long-persistent need to break the cycle of generational, institutional incarceration amongst mothers serving time for non-violent crimes and the children they birth behind prison bars. H.R. 5130, the, ``SIMARRA Act of 2016,'' gives those infants born to incarcerated mothers a chance to succeed in life. ``SIMARRA'' is not merely yet another second chance program, demanding leniency from the criminal justice system. Instead, H.R. 5130 asks our national criminal justice system what it can do for those young Americans born and relegated to a life of nearly impossible odds of survival. ``SIMARRA'' provides that first chance--a first chance for American infants--that many of their mothers, born themselves to mothers behind bars, never received. The bill excludes abuse-deterrent formulations of prescription drugs from Medicaid's additional rebate requirement for new prescription drug formulations, which is intended to encourage the development of these drugs by allowing drug companies to reduce the rebates they otherwise must pay to Medicaid. The measure also limits disclosure of predictive modeling and other analytics technologies that are used to identify and prevent waste, fraud and abuse in Medicaid, including by exempting covered program integrity algorithms from the Freedom of Information Act (FOIA) and requiring state Medicaid and Children's Health Insurance Program (CHIP) agencies to have adequate data security policies to ensure the security of covered algorithms. Finally, the measure makes $5 million available to the Medicaid Improvement Fund for expenditures for FY 2021 and beyond. CBO estimates that enacting H.R. 4978 would not, on net, change direct spending over the 2017-2026 period. While opponents argue that some provisions of the bill will increase direct spending by $80 million over that period, I point out that other provisions would decrease direct spending by the same amount balancing the total cost. Enacting the legislation would affect direct spending, rather than revenues. Under current law, pharmaceutical manufacturers are required to pay rebates to states for prescription drugs provided through Medicaid. The formula which determines rebate amounts in the Medicaid program has several components, with some components generating rebates that are paid to states and shared with the federal government, and others generating rebates that are paid to states and subsequently transferred in their entirety to the federal government. Abuse deterrent formulation, or ADF, is a new technology that is being implemented by the pharmaceutical industry to prevent the abuse of prescription pain medications. For example, some ADFs make it more difficult for an individual to crush, break, or dissolve a drug to inappropriately extract and use its active ingredient. Under the bill, the component of the rebate formula that would no longer apply to ADFs of brand-name drugs is one that is paid to states and transferred in full to the federal government. Therefore, states would not be directly affected by this section of the bill. CBO estimates that this section would increase federal Medicaid costs by about $75 million over the 2017-2026 period by reducing rebates. CBO anticipates that an increasing number of ADFs of brand name drugs will launch over time; therefore, the component of the rebate affected by H.R. 4978 would also grow over time. CBO estimates that enacting the legislation would not increase net direct spending or on-budget deficits by more than $5 billion in any of the four consecutive 10-year periods beginning in 2026. H.R. 4978 contains no intergovernmental or private-sector mandate as defined in UMRA and would impose no costs on state, local, or tribal governments. In sum, H.R. 4978, the ``Nurturing & Supporting Healthy Babies Act,'' is a valuable piece of legislation that I encourage my colleagues to support. Additionally, I urge my colleagues to join me in sponsoring and supporting all legislation targeting the improvement of care for the prevention of infant abuse and neglect, such as H.R. 5130, the, ``Stop Infant Mortality and Recidivism Reduction Act of 2016'' or the ``SIMARRA Act.''

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, let me congratulate the gentleman from Texas for his leadership and the gentleman from New Mexico for his outstanding leadership on this important legislation and his concern and passion. Let me thank my friends who are managing the legislation and let the American people know and our colleagues know that we are continuing our commitment on dealing with the issues of addiction, in this instance, opioid. And, of course, we know that there are other forms of addiction, from alcohol, to crack, to cocaine, but we are moving forward. I rise to support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015. It is clear that this is an issue that has plagued both the woman and as well the newborn baby. Let me offer to say that President Obama has updated that guideline to encourage doctors to be more cautious when prescribing opioid painkillers and to emphasize nonopioid therapies for certain conditions. Many times women who are pregnant are under treatment. Additionally, the Obama administration has awarded $94 million to community health centers to improve and expand the delivery of substance abuse services. In the President's FY 2017 budget, the administration proposed $1.1 billion to combat drug addition considering modifying certain rules to improve treatment. As misuse of opioids have increased over the past decade, so has the incidence of neonatal abstinence syndrome, referring to the medical effects on newborn infants suffering from drug withdrawal because their mothers were drug addicts. The GAO report found that a lack of available treatment programs for pregnant women and newborns with neonatal abstinence syndrome, including the availability of comprehensive care and enabling services, such as transportation and child care, has hampered Federal efforts to address the issue. I am glad that this bill, which is why I rise to support it, reauthorizes residential treatment grant programs for pregnant and postpartum women who have substance abuse problems--programs that are administered by the Health and Human Service Department's Center for Substance Abuse Treatment, increasing the authorized funding level by 6 percent. This gives me an opportunity to say that, with regard to all of these bills, I know that we will all join together to make sure the right funding is available for these bills to really work. I join in support of this legislation and add to it legislation that I have introduced, Improving Safe Care for the Prevention of Infant Abuse and Neglect Act, and, which I introduced recently, the Stop Infant Mortality and Recidivism Reduction Act of 2016, which will help the Federal Bureau of Prisons to improve the effectiveness and efficiency of the Federal prison system for pregnant offenders by establishing a pilot program of critical stage development nurseries in Federal prisons for children born to inmates. Likewise, at that time, one may discover the concerns that are being expressed here today. However, the Improving Treatment for Pregnant and Postpartum Women Act of 2016, also establishes a pilot program to provide grants to State substance abuse agencies to promote innovative service delivery models for pregnant women who have a substance use disorder, such as opioid addiction, including for family-based services in nonresidential settings. This is a good bill because it is more than the adult who is being treated here. It is a good bill because we are concerned about the newborn, the innocent baby who needs to have a start in life. In this instance, this legislation will both treat the mother and provide assistance--residential and nonresidential care--so that these individuals can have the starts in life that they need. Let us be reminded of the fact that this addiction of these drugs becomes an illness. We have seen overdoses that cause the loss of life. Let us be part of stemming the tide, but, more importantly, let us help those who are trying to hang onto life and to start a new life. This legislation does that, and I ask my colleagues to support it. Again, I thank the gentleman from Texas for his leadership, and I thank him for yielding to me. Mr. Speaker, I rise in support of H.R. 3691, the ``Improving Treatment for Pregnant & Postpartum Women Act of 2015,'' that was approved by the Energy and Commerce Committee. In the past decade and a half, the growth in the number of physicians prescribing opioids to help patients deal with pain from surgeries, dental work and chronic conditions has resulted in an increasing number of patients becoming dependent on the powerful and highly addictive painkillers--with patients not only abusing the use of those painkillers but often turning to heroin once their opioid prescription ended. The Centers for Disease Control and Prevention reports that nearly 259 million opioid prescriptions were written in 2012, more than enough for every adult in the United States. It is estimated that in 2013 nearly 4.5 million people in the United States without a valid medical need were using prescription painkillers. The Health and Human Services Department estimates that the number of unintentional overdose deaths from prescription painkillers almost quadrupled between 1999 and 2013. Abuse of prescription opioids now kills nearly 30,000 Americans each year. Both states and the federal government have begun responding to this growing public health crisis, with many states moving to make anti- overdose drugs more available and shield first-responders from liability in administering those drugs. President Obama, meanwhile, has updated prescribing guidelines to encourage doctors to be more cautious when prescribing opioid painkillers and to emphasize non-opioid therapies for certain conditions. Additionally, the Obama administration has awarded $94 million to community health centers to improve and expand the delivery of substance abuse services. In the president's FY 2017 budget the administration proposed $1.1 billion to combat drug addiction, considering modifying certain rules to improve treatment. As misuse of opioids has increased over the past decade, so has the incidence of neonatal abstinence syndrome, referring to the medical effects on newborn infants suffering from drug withdrawal because their mothers were drug addicts. A 2015 Government Accountability Office (GAO) report found that a lack of available treatment programs for pregnant women and newborns with neonatal abstinence syndrome, including the availability of comprehensive care and enabling services such as transportation and child care, has hampered federal efforts to address the issue. This bill reauthorizes residential treatment grant programs for pregnant and postpartum women who have substance abuse problems that are administered by the Health and Human Services (HHS) Department's Center for Substance Abuse Treatment, increasing the authorized funding level by 6%. Seeking to right the same wrongs as H.R. 4843, the ``Improving Safe Care for the Prevention of Infant Abuse and Neglect Act,'' I introduced the, ``Stop Infant Mortality and Recidivism Reduction Act of 2016,'' or the ``SIMARRA Act,'' which will help the Federal Bureau of Prisons to improve the effectiveness and efficiency of the Federal prison system for pregnant offenders, by establishing a pilot program of critical- stage, developmental nurseries in Federal prisons for children born to inmates. It is time that our nation recognizes a long-persistent need to break the cycle of generational, institutional incarceration amongst mothers serving time for non-violent crimes and the children they birth behind prison bars. H.R. 5130, the, ``SIMARRA Act of 2016,'' gives those infants born to incarcerated mothers a chance to succeed in life. ``SIMARRA'' is not merely yet another second chance program, demanding leniency from the criminal justice system. Instead, H.R. 5130 asks our national criminal justice system what it can do for those young Americans born and relegated to a life of nearly impossible odds of survival. ``SIMARRA'' provides that first chance--a first chance for American infants--that many of their mothers, born themselves to mothers behind bars, never received. The ``Improving Treatment for Pregnant & Postpartum Women Act of 2015,'' also establishes a pilot program to provide grants to state substance abuse agencies to promote innovative service delivery models for pregnant women who have a substance use disorder, such as opioid addiction, including for family-based services in nonresidential settings. Of the amounts appropriated for the HHS residential treatment program, up to 25% would be available to carry out the pilot program. No funds would be made available to carry out the pilot program for a fiscal year, however, unless the amount made available to carry out the residential treatment program for the fiscal year is more than the comparable amount made available for FY 2016. The Senate on March 10, 2016, passed by a 94-1 vote, S 524, an antiopioid abuse bill that would authorize grants for opioid treatment services and first-responder training in using anti-overdose drugs, as well as create a task force to review and update best practices for prescribing pain medication. The measure offsets the increased authorization through a $5 million reduction in the existing FY 2017 authorization for Centers for Disease Control (CDC) public health capability enhancement activities. Under current law, $138.3 million is authorized for those activities each year through FY 2018. The Congressional Budget Office (CBO) has not yet released a cost estimate for the bill. H.R. 3691 would also mandate investigations into heroin distribution and unlawful distribution of prescription opioids, and require the creation of a national drug awareness campaign that takes into account the association between prescription opioid abuse and heroin use. This week we are scheduled to consider a series of more than a dozen bills that address the opioid abuse problem facing America. This measure reauthorizes grants from HHS's Center for Substance Abuse Treatment to public and nonprofit private entities that provide residential substance abuse treatment for pregnant and postpartum women, authorizing $16.9 million each year through FY 2021--$1 million (6%) more than the current $15.9 million authorization. Under the pilot grant program, proposed services for eligible pregnant and postpartum women would not have to be provided solely to women who reside in facilities. However, the center must specify a minimum set of services, including substance abuse counseling, and it must solicit stakeholder input. The bill directs HHS's Center for Behavioral Health Statistics and Quality to fund an evaluation of the pilot program at the conclusion of the first grant cycle. Under the program, grant recipients are required to provide an individualized plan of services for each participating woman that includes substance abuse counseling and certain supplemental services, such as pediatric health care for the woman's children. The measure directs the Center for Substance Abuse Treatment to carry out a five-year pilot grant program to help state substance abuse agencies address identified gaps in the services that are furnished to pregnant and postpartum women with substance abuse issues, and encourage new approaches and models of service delivery. H.R. 3691, the ``Improving Treatment for Pregnant & Postpartum Women Act of 2015,'' is a valuable piece of legislation that I encourage my colleagues to support. Additionally, I urge my colleagues to join me in sponsoring and supporting all legislation targeting the improvement of care for the prevention of infant abuse and neglect, such as H.R. 5130, the, ``Stop Infant Mortality and Recidivism Reduction Act of 2016'' or the ``SIMARRA Act.''

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 1818, the ``Veteran Emergency Medical Technician Support Act of 2015,'' which emphasizes the necessity to add requirements and procedures that assist veterans with military EMT training to meet state EMT certification, licensure, and other requirements. I support this legislation, because it benefits states with a shortage of emergency medical technicians. H.R. 1818 allows veterans to reenter society and assist the helpless within the emergency medical community. The bill enables the Public Health Service Act to direct the Department of Health and Human Services in an efficient approach for veteran assistance. Specifically, H.R. 1818 requires the secretary to establish a program consisting of awarding demonstration grants to states to streamline state requirements and procedures. H.R. 1818 determines the extent to which the requirements for education, training, and skill level of emergency medical technicians are equivalent to the requirements for military emergency medical technicians. The bill identifies methods to facilitate the attainment of state requirements for military emergency medical technicians. For proper usage of the grant provided by the bill, a state shall demonstrate its shortage of emergency medical technicians. This bill introduces a feasible alternative for veterans within the community. With consistent experience in high pressure situations and emergency environments, veterans are the appropriate choice for this profession. This is a comprehensive bill that will simultaneously provide opportunity for veterans while alleviating the shortage of staff in a medical specialty involving care for undifferentiated and unscheduled patients with illnesses or injuries requiring immediate medical attention. I urge all Members to join me in support of H.R. 1818.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 4969, the ``John Thomas Decker Act of 2016.'' Our nation values the importance of transparency and availability of public information regarding prescription drugs. This bill amends the Public Health Service Act to require the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention to report on the availability of information regarding prescription of opioids after youth sports injury. This report includes the information on opioid use and misuse, injury treatments that do not involve opioids, and treatment for opioid addiction. The report must determine the extent this information is available to teenagers and adolescents who play youth sports, their families, youth sports groups, and health care providers. Opioids are drugs with effects similar to opium, such as heroin and certain pain medications. In addition to stimulants and central nervous system (CNS) depressants, prescription opioids are one of the three main broad categories of medications that present abuse liability. Due to prescription opioids' similarity to heroin and morphine, they present an intrinsic abuse and addiction liability for non-medical purposes. Opioid, heroin, and morphine act on the same brain systems. In an effort to increase their euphoric effects, the ``high'', people tend to take them in their most dangerous and addictive methods. Understanding the dangers of these addictive drugs highlight the importance of John Thomas Decker Act, which increases awareness and educating the youth people of the adverse effects of opioids. H.R. 4969 also allows for public transparency in making available public reports, informational materials, and resources are available to teenagers, their families, and health professionals. Our country has acknowledged the importance of preventive healthcare and education within our nation. Providing education to those directly or indirectly associated with opioid usage enables them to have control over their thoughts and actions, offsetting the potential for drug abuse. I support this legislation because it will help protect the integrity of consumers through implementation of effective preventative strategies. H.R. 4969 provides the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention with specific responsibilities for dissemination. H.R. 4969 is a positive step in the right direction and I urge my colleagues to join me in supporting its passage.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4586, also known as Lali's Law. Sadly, Lali's Law was named after Alex Laliberte: a Buffalo Grove, Illinois resident who tragically passed away seven years ago from a drug overdose. Alex was a good kid. He was an athlete during high school, and also did well academically. During his sophomore year in college, he began being hospitalized for a mysterious illness. Unknown to his friends and family, Alex soon developed an addiction to the prescription drugs and was being hospitalized for withdrawal. He would stay in the hospital until his symptoms subsided only to leave the hospital and repeat the cycle. Alex continued this cycle until he died of an opioid overdose a few days before his final exams. He was only 20 years old. Our lack of education on opioids and harm reduction contributed to Alex's early death, and we must act to prevent a repeat of this tragedy. Lali's Law is an important piece of legislation that would authorize grants to states to develop standing orders and educate health care professionals about the dispensing of opioid overdose reversal medication without person-specific prescriptions. In addition, this bill would encourage pharmacies to dispense opioid overdose reversal medication pursuant to a standing order. According to the National Institute on Drug Abuse, 2.1 million people nationwide abuse opioids. Mr. Speaker, Lali's Law is instrumental in helping these victims reverse their addiction. Lali's Law would also implement the following guidelines and practices for those people authorized to prescribe the medication: Only prescribe opioids for chronic pain Opioid overdose reversal medication must be co-prescribed with opioids; and the purpose and administration of opioid overdose reversal medication must be discussed with the patients. Furthermore, H.R. 4586 would require the development and adaptation of training materials and methods for the people authorized to prescribe or dispense the medication to use in educating the public, which includes: When and how to administer opioid overdose reversal medication, and The steps that should be taken after administering the opioid overdose reversal medication. Lastly, Lali's Law would educate the public regarding the health benefits of the opioid reversal medication and the availability of the medication without a person-specific prescription. In 2014, rates of opioid overdose deaths jumped significantly, from 7.9 per 100,000 in 2013 to 9.0 per 100,000, which is a 14 percent increase. Mr. Speaker, I join my colleagues in support of H.R. 4586. This legislation is vital for reducing opioid-related deaths across our nation, protecting the lives of those at risk to opioid abuse. It is our job to make sure that Alex's lasting legacy includes helping others get a second chance at recovery and a second chance at life.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4599 the ``Reducing Unused Medication Act of 2016''. This bill is an important measure that will decrease the number of unused medications available for misuse to the public by setting limitations on the most frequent avenues used to secure unused medication. As we know, many times patients are prescribed medication far beyond their needs. Unused prescription medication creates a lethal danger to households and communities across America, and failing to properly dispose of unfinished medications can have dire consequences on the environment and our ecosystem. According to a new study conducted by Geisinger Health System and published in the Journal of the American Pharmacists Association just 11 percent of unused prescription drugs were disposed of via drug take- back programs, while 55 percent were left in the medicine cabinet, 14 percent were thrown in the trash, and 9 percent were flushed down the toilet. As we have heard many unfortunate stories as we bring greater awareness to this issue, we know that abuse of medicine among teenagers is a growing problem. Easy access to parents' and grandparents' leftover medications is just throwing gasoline on the fire. Meanwhile, more than 60,000 young children are taken to the emergency room each year after ingesting a family member's medication. With respect to the environment, the FDA no longer recommends flushing drugs down the toiler because sewage treatment plants lack the capacity to remove pharmaceuticals and personal care products' residue. H.R. 4599 will amend the Controlled Substances Act to permit certain fillings of prescriptions--such that a prescription for a controlled substance may be partially filled if: It is not prohibited by state law; The prescription is written and filled in accordance with the Controlled Substances Act, regulations prescribed by the Attorney General, and State law; The partial fill is requested by the patient or the practitioner that wrote the prescription; and The total quantity dispensed in all partial fillings does not exceed the total quantity prescribed. Mr. Speaker, enacting this legislation will work to not only combat a number of prescription drug abuses, but also deal a debilitating blow to the mounting opioid abuse epidemic.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4981 the ``Opioid Use Disorder Treatment Expansion and Modernization Act''. This bill highlights the abuse of opioids that has become a public health epidemic. Opioids are drugs with effects similar to opium, such as heroin and certain pain medications. H.R. 4981 would encourage and train health care providers to prescribe overdose reversal drugs, such as Naloxone, when they prescribe common opioids-like pain medication to patients at risk of addiction. The plague of opioid overdose deaths across the nation is disturbing, but there are ways to combat this trend. Any party receiving treatment assessments under this legislation will be privy to the following. 1. A treatment plan and periodic assessments. 2. Will also be subject to medication adherence and substance use monitoring. 3. Treatment options, including all drugs approved by the Food and Drug Administration for the treatment of opioid use disorder, including their potential risks and benefits. 4. Receiving regular counseling services is critical to recovery. The Centers for Disease Control and Prevention reports that nearly 259 million opioid prescriptions were written in 2012, more than enough for every adult in the United States. Enacting this legislation will implement a diversion control plan that contains specific measures to reduce the likelihood of the diversion of controlled substances prescribed by the physician for the treatment of opioid use disorder. In 2013 nearly 4.5 million people in the United States without a valid medical need were using prescription painkillers. Both states and the federal government have begun responding to this growing public health crisis. The Obama administration has awarded $94 million to community health centers to improve and expand the delivery of substance abuse services. Mr. Speaker, the mounting number of people adversely affected and the over 25,000 lives lost expressly demonstrates the need for this type of legislation. H.R. 4981 is a positive step in the right direction and I urge all members to support this important legislation.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, this is an emotional night for me. I thank the gentlewoman from Massachusetts (Ms. Clark) for guiding us. I also thank Representatives Guinta and Kuster. I am so moved by the fact that we are here on a bipartisan statement. As I spoke to Ms. Kuster and indicated, as a ranking member of the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations count me in, as she began to expand the tragic window of the impact of drug addiction, particularly opioids. Let me speak very quickly because I have a lot to say. This is an epidemic that has gone beyond reason. Between 2000 and 2014, almost half a million people died from drug overdoses. In 2014 alone, more than 47,000 people died of drug overdoses. The largest percentage of overdose deaths in 2014 were attributed to opioids like prescription painkillers, methadone, morphine, and heroin. Today in the Rules Committee, we made it clear that we want to work with doctors and law enforcement. We also said that we understand the use of painkillers during end of life. We understand that, so we are not here to condemn. We are here to help. I am so glad that the Judiciary Committee will have on the floor this Comprehensive Addiction and Recovery Act that responds to this crisis. It is a treatment bill where we will bring together law enforcement and substance abuse treatment persons. This emergency is compounded due to the perilous connection between prescription painkillers and heroin. Approximately three out of four new heroin users report that their use began with their abuse of prescription drugs. Not only were 11 million people at risk of overdosing due to their abuse of prescription painkillers, 11 million people were also at risk of becoming addicted to heroin with its attendant risks. We have heard the stories, and let me share some with you very quickly. I read one on the plane as I came up. It was a very painful story. A woman was detained in a fatal car wreck. In that car was her little 2-year-old and a little 7-year-old. She was on hydrocodone. She sideswiped two cars and then killed a person on a motorcycle. That person's family does not have them anymore. This woman will be subjected possibly to life imprisonment. Those children will not have a mother. What about the situation in Ohio? We don't know what the circumstances were, but eight persons of a family were killed execution style. Drugs were behind it. What about this mother who supplied hydrocodone and alcohol to her son and his date on prom night? There is an epidemic that we must confront. There are those who would do wrong, but those who are addicted. This is evidenced by a study, ``How the Heroin Epidemic Differs in Communities of Color.'' It is important, as I stand here and look at the suburban and rural areas, that we, again, remember how it has doubled among African Americans, Latinos, and Native Americans and that we look to the kind of resources that would include all. In conclusion, let me share these numbers with you that I think are so very important. They are startling. The increase in overdose by rates: 267 percent by the White population from 2010 to 2014. 213 percent by African Americans from to 2010 to 2014. 137 percent by Hispanic. And Native Americans, 236 percent. Not one person can be counted out that needs to be included in our work here on the floor of the House. I am glad that we are making this statement today and next week because now America knows the Congress is speaking, the bully pulpit will be heard, and I hope we can save lives. I am pleased to join my colleagues of the Bipartisan Task Force to Combat the Heroin Epidemic to speak on this important issue impacting all Americans. I want to thank Congressman Frank Guinta (R-NH) for his leadership in elevating this issue to a national forum that has drawn unprecedented attention and concern. We must take action because today a leading killer of Americans is drug overdose. Between 2000 and 2014, almost half a million people died from drug overdoses. Many of these deaths were preventable. In 2014 alone, more than 47,000 people died of drug overdoses. The largest percentage of overdose deaths in 2014 was attributed to opioids--like prescription painkillers, methadone, morphine, and heroin. Specifically, 28,647 people overdosed and died because of an opioid in 2014. We are experiencing an emergency that impacts citizens in every state, city, and town in this country--that is prescription painkiller and opioid abuse. This emergency is compounded due to the perilous connection between prescription painkillers and heroin. Prescription painkiller abuse is the strongest risk factor for future heroin use. Approximately three out of four new heroin users report that their use began with their abuse of prescription painkillers. Heroin use becomes appealing to those addicted to prescription painkillers because it is cheaper and easier to obtain. Due to its potency, heroin use tends to lead to addiction. Heroin addiction is often deadly, leading to overdose or other chronic diseases. The rate at which the occurrence of heroin overdose deaths increased is cause for alarm. In the four years between 2010 and 2014, heroin overdoses more than tripled. More than 10,500 people died from heroin overdoses in 2014. In 2013, more than 8,200 people died from heroin overdoses. In that same year, 11 million people admitted to improper use of prescription painkillers. Not only were 11 million people at risk of overdosing due to their abuse of prescription painkillers, 11 million people were also at high risk of becoming addicted to heroin--with its attendant risks and dangers. This current crisis requires an immediate and comprehensive response and the bill before us today is one element of a broader strategy. I am proud to say that I have worked with my colleagues on the Judiciary Committee and with members of the Heroin Task Force to introduce and cosponsor legislation that help combat this deadly epidemic. Legislation Supported by Jackson Lee 1. Bipartisan Comprehensive Legislation: H.R. 953--Comprehensive Addiction and Recovery Act of 2015; Representative Sensenbrenner, F. James, Jr. [R-WI-5] (Introduced 2/12/ 15); 124 Cosponsors (84 Dems--including SJL, 40 Reps); * No Sentencing Enhancements or Penalties. H.R. 3719--``Stop the Overdose Problem Already Becoming a Universal Substance Epidemic Act of 2015'' or the ``STOP ABUSE Act of 2015''; Representative Guinta, Frank C. [R-NH-1] (Introduced 10/08/2015); 8 Cosponsors (4 Dems, 4 Reps); * No Sentencing Enhancements or Penalties. H.R. 4697--Prevent Drug Addiction Act of 2016; Representative Esty, Elizabeth H. [D-CT-5] (Introduced 03/03/2016); 2 Cosponsors (Reps); * No Sentencing Enhancements or Penalties. 2. Legislation to Improve Pain Management Practices: H.R. 4499--the ``Promoting Responsible Opioid Prescribing Act of 2016'' and as the ``PROP Act of 2016''; Representative Mooney, Alexander X. [R-WV-2] (Introduced 02/09/2016); 31 Cosponsors (18 Rep, 13 Dem); * No Sentencing Enhancements or Penalties. H.R. 2805--Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015; Representative Brooks, Susan W. [R-IN-5] (Introduced 06/17/2015); 41 Cosponsors (23 Reps, 18 Dems); * No Sentencing Enhancements or Penalties. H.R. 1821--Opioid Overdose Reduction Act of 2015; Representative Neal, Richard E. [D-MA-1] (Introduced 04/15/2015); 6 Cosponsors (4 Reps, 2 Dems); * No Sentencing Enhancements or Penalties. H.R. 2335--Stop Tampering of Prescription Pills Act of 2015; Representative Keating, William R. [D-MA-9] (Introduced 05/14/2015); 9 Cosponsors (5 Dems, 4 Reps); * No Sentencing Enhancements or Penalties. H.R. 4599--Reducing Unused Medications Act of 2016; Representative Clark, Katherine M. [D-MA-5] (Introduced 02/24/2016); 14 Cosponsors (10 Dems, 4 Reps); * No Sentencing Enhancements or Penalties. H.R. 4063--Jason Simcakoski PROMISE Act; Representative Bilirakis, Gus M. [R-FL-12] (Introduced 11/18/2015); 30 Cosponsors (17 Reps, 13 Dems); * No Sentencing Enhancements or Penalties. 3. Legislation to Improve Treatment: H.R. 2536--``Recovery Enhancement for Addiction Treatment Act'' or the ``TREAT Act''; Representative Higgins, Brian [D-NY-26] (Introduced 05/21/2015); 25 Cosponsors (18 Dems--including SJL, 7 Reps); * No Sentencing Enhancements or Penalties. H.R. 4076--The Reforming and Expanding Access to Treatment Act or the ``TREAT Act''; Representative Turner, Michael R. [R-OH-10] (Introduced 11/18/2015); 6 Cosponsors (all Dems); * No Sentencing Enhancements or Penalties. H.R. 3865--Cradle Act; Representative Jenkins, Evan H. [R-WV-3] (Introduced 10/29/2015); 38 Cosponsors (30 Reps, 8 Dems--including SJL); * No Sentencing Enhancements or Penalties. H.R. 4586--Lali's Law; Representative Dold, Robert J. [R-IL-10] (Introduced 02/23/2016); 3 Cosponsors (2 Dems, 1 Rep); * No Sentencing Enhancements or Penalties. H.R. 2872--Opioid Addiction Treatment Modernization Act; Representative Bucshon, Larry [R-IN-8] (Introduced 06/24/2015); 5 Cosponsors (4 Reps, 1 Dem); * No Sentencing Enhancements or Penalties. Sentencing Reform Legislation: H.R. 3713--Sentencing Reform Act of 2015; Representative Goodlatte, Bob [R-VA-6] (Introduced 10/08/2015); 65 Cosponsors (48 Dems--including SJL original, 17 Reps) We must make our best efforts to prevent individuals from moving from painkillers to heroin by making treatment for addicts more accessible by encouraging the use of evidence-based programs, such as medication- assisted treatment. Life-saving overdose reversal drugs, like naloxone, are most valuable in the hands of trained individuals who regularly come in contact with individuals who are prone to drug overdoses. It is important that we support these measures that will increase the use and availability of naloxone and other overdose reversal drugs to first responders. Addiction is a disease that affects the brain and eventually changes the behavior of addicts, causing them to experience mental health issues and encounter legal problems. Treatment is the most reasonable and effective approach to diverting these individuals away from homelessness and prison. [From WETA FRONTLINE, Feb. 23, 2016] How the Heroin Epidemic Differs in Communities of Color (By Sarah Childress) Most of the media attention in the current nationwide heroin epidemic has focused on the uptick in overdose deaths among suburban, white, middle-class users--many of whom turned to the drug after experimenting with prescription painkillers. And it's among whites where the most dramatic effect has been seen--a rise of more than 260 percent in the last five years, according to the Centers for Disease Control. But the epidemic has also been seeping into communities of color, where heroin overdose death rates have more than doubled among African Americans, Latinos and Native Americans, but gone largely overlooked by the media. People develop addictions for a variety of reasons, which makes it difficult to gather concrete data on what's happening in each community, said Dr. Wilson Compton, deputy director at the National Institute of Health's National Institute on Drug Abuse. ``To a certain extent, these are hidden behaviors, and we only notice people at the end of their lives sometimes,'' he said. ``So we don't always know all of the pathways that lead to this.'' FRONTLINE spoke to experts and community outreach workers around the country to try to understand the differences. While some have followed a similar trajectory as the white community, a closer look at the epidemic in some communities of color reveals a different story. And outreach workers in several cities say that while funds and attention have been directed to aid white opioid and heroin users in the suburbs, they are still struggling to get the resources they need to support minorities who are dealing with the same addiction. ``Our job is to help those services really make it deep into the community,'' said Jacqueline Robarge, founder and director of Baltimore-based Power Inside, which serves drug users who are mainly African-American women. ``And if they aren't going to arrive, we want to have an accounting that these people have been suffering for decades. It really is disingenuous if the resources are only going to be directed at the suburbs and the counties where, basically, the white folks are getting high.''

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise to salute a caring mayor, the mayor of the city of Houston, Mayor Sylvester Turner. Over the last couple of months, which is the first of his term, many challenges have confronted his administration, one of which was the terrible, devastating floods of mid-April when so many thousands, many of them mothers and children, were displaced in my congressional district. Because of those terrible storms, $400 million of cars were lost, people lost their jobs, and businesses were destroyed. Mayor Turner continued to be that caring, steady hand working across political lines, working with the county judge, working with council members, and the Federal Government. One thing that he steadily did was listen to the council and the advice of his staff as I sat in meetings, taking ideas, establishing a relief fund, joining now with the Osteens in Lakewood, and having this wonderful concert to continue to provide relief, but yet showing the caring and loving nurturing of a father. In the midst of all of this, he lost a dear brother, a Vietnam vet. But steady, strong, and determined, he continued to nurture those who could not help themselves. What a pleasure to be able to work with a mayor, one who is ready to listen and to be able to answer the concerns of a constituency, but make hard decisions. I salute you, Mayor Turner, as someone who cares about our city, and works with all of us to make their lives better and our city the best.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of S. 2755, the ``Fallen Heroes Flag Act of 2016,'' which allows Members and Senators, at the request of an immediate family member of a fallen emergency responder, to have a flag flown above the United States Capitol in their memory. As a senior member of the House Committee on Homeland Security, I am intimately aware, as are my colleagues, of the great sacrifices made by our emergency responders. This is why I am proud that earlier this Congress the House passed H.R. 2795, the FRIENDS Act, which I introduced. I introduced the FRIENDS Act because it embodied the important and fundamental idea that we have an obligation to ensure that the first responders who protect our loved ones in emergencies, have the peace of mind that comes from knowing that their loved ones are safe while they do their duty. S. 2755 and the FRIENDS Act embody the spirit of bipartisanship that is needed in this Congress. These brave men and women who risk everything by running towards danger should be honored by this Congress by streamlining the process to have a flag flown above the U.S. Capitol in their memory. Let us not forget the 15 brave volunteer firefighters who perished in the city of West, Texas, in 2013 when a fertilizer plant exploded. This tragedy serves as a reminder of the risks and dangers undertaken each day by our firefighters and other first responders to keep us safe. Since 1996 in the city of Houston there have been 20 firefighters that have lost their lives protecting others. They are District Chief Ruben Lopez, Firefighter Steven C. Mayfield, Firefighter Lewis E. Mayo III, Firefighter Kimberly A. Smith, Captain Jay Paul Jahnke, Probationary Firefighter Kevin Wayne Kulow, Captain Grady Don Burke, Assistant Chief David Louis Moore, Captain James Arthur Harlow Sr., Captain Damion Jon Hobbs, Cadet Firefighter Cohnway Matthew Johnson, Captain Thomas William Dillion, Engineer Operator Robert Ryan Bebee, Firefighter/EMT Robert Herman Garner, IV, Captain Matthew Rena Renaud, Firefighter Anne McCormick Sullivan, Firefighter Daniel D Groover, Captain Dwight ``B.B.'' W Bazile, Firefighter Richard J Cano, and Cadet Steven Whitfield II. Since 1860, 109 Houston Police officers have fallen in the line of duty. In 2015 officer Richard K. Martin was killed when he was intentionally struck with a car when he was laying down spike strips during a pursuit. I have on many occasions requested that U.S. Flags be flown above the Capitol in the memory of fallen first responders and presented them to the family members. First responders are called to serve and few outside of their ranks can understand why they do the work that they do each day placing their lives in harm's way to save a stranger. The greatest example of the selflessness of first responders was the hundreds of fire fighters, law enforcement officers, emergency management service personnel, port authority workers, and federal officers and agents who rushed into the Twin Towers on September 11th 2001, to save lives. On that terrible day 366 first responders sacrificed their lives so others may live. Mr. Speaker, I support S. 2755 because this bill streamlines the process to have a flag flown in the memory of the fallen emergency responders in this country.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 4063, the ``Promise Act.'' H.R. 4063 directs the Department of Veterans Affairs (VA) and the Department of Defense (DOD) to jointly update their respective clinical practice guidelines. The practice guideline pertains to the management of Opioid Therapy for Chronic Pain. The guidelines spell out procedures for: (1) prescribing opioids for outpatient treatment, (2) (con-tra-in-di-ca-tions) contraindications for opioid therapy, (3) treatment of patients with post-traumatic stress disorder, (4) psychiatric disorders, or a history of substance abuse or addiction, (5) and management transitioning patients. The guidelines also prescribe routine and random urine drug tests, as well as treatment options to augment opioid therapy designed to minimize opioid dependence. This bill examines the VA's evidence-based therapy treatment model for treating veterans' mental health conditions. The Department of Veterans Affairs (VA) will be expected to update safety measures for opioid therapy, expand the use of alternative medicine, and conduct audits of the VA health care system through a nongovernment entity. The VA will be required to request documentation of medical license violations during the past 20 years and any settlement agreements for medical-related disciplinary charges from the medical board, of each state. All VA medical facilities will implement the opioid safety initiative and train employees to effectively dispense pain management techniques through the establishment of pain management teams. Enhancing national oversight, the VA is also expected to track and monitor opioid use and access to state program information, increase the availability of Food and Drug Administration-approved opioid receptor antagonists, and modify the computerized patient record system, as well as internal audits. Adjusting the computerized patient record system will ensure that health care providers accessing veterans' records are notified of their use of opioid therapy. This system also informs health care providers of substance use disorder or opioid abuse histories. The Promise Act of 2016 institutes pilot programs within the VA to evaluate the feasibility of wellness programs complementing veteran pain management and related health care services. I support this legislation because it will promote safety measures for opioid therapy and alternative medicine. H.R. 4063 is a positive step in the right direction and I urge my colleagues to join me in supporting its passage.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I thank the chairman and the ranking member for capturing what we in the Committee on the Judiciary have been doing over the last couple months. We have been working in a very effective, bipartisan manner to deal with the whole scheme, if you will, of criminal justice reform. We have been extensively involved in what has become a major epidemic across this Nation. I listened to a number of legislative initiatives, one dealing with a veteran who died from a drug overdose that was just debated here on the floor of the House. As I was flying in today, we knew there was an incident in my district where a motorcyclist was killed by a driver, a young woman who was under the influence of opioids. We know that this Transnational Drug Trafficking Act is an important act, and we want to continue in our bipartisan effort. It is important for me to note a concern that I do not believe the sponsors intended, but which I believe must be addressed. This bill is intended to help us do more to combat the importation of illegal drugs into our country, but it could also subject more people to mandatory minimum sentencing, an unfortunate feature of our criminal justice system that we must address. The United States has been suffering from the damaging effects of illicit drug trafficking for decades. The majority of the drugs wreaking havoc in the United States originate in foreign countries, moving from one country to the next under the direction of powerful and wealthy drug kingpins. I think all of my adult life, Mr. Speaker, we have heard the words ``drug kingpins''--you cannot live in urban America without hearing about them; you cannot live in Texas without hearing about them--many of whom never see or touch the drugs or enter the boundaries of this country themselves. Foreign drug kingpins in Colombia, Ecuador, and Peru are leading producers of cocaine imported into the United States. These kingpins lead operations which sell to traffickers in Mexico, who receive the drugs from Central America, South America, or Mexico and then smuggle the drugs into the United States. Certainly, drugs come from all over. The Obama administration reported instances of Afghan drug trafficking working with West African drug trafficking organizations to smuggle heroin into the United States. It is around the world. I support the idea that these drug kingpins are dangerous, but S. 32 is intended to help Federal prosecutors successfully prosecute foreign drug traffickers whose criminal activity outside the U.S. threatens the health, safety, and security of Americans at home. Section 959 makes it a crime to manufacture or distribute controlled substances or certain chemicals used to make controlled substances intended or knowing that the substance or chemical will ultimately be brought illegally into the U.S. or within 12 miles of the coast of the U.S. In recent years, Federal prosecutors reported difficulties enforcing this statute in some instances. Some drug traffickers are aware of the methods used to charge and then extradite foreign criminals into the U.S. for prosecution. Drug traffickers simply avoid any discussion of the destination of the drug shipments. S. 32 would amend section 959, making it easier for prosecutors to obtain a conviction against drug traffickers who operate in other countries. That is certainly an important mission. I am troubled, however, that lowering the intent requirement in the statute without limiting its use to leaders and organizers would expose even low-level offenders to mandatory minimum sentences. We are working now to stop that tide so that we can restore the criminal justice system to be just and fair. This would happen, depending on the quantity of drugs involved. Historically, mandatory minimums created in the late 1980s to target kingpins have been largely applied to low-level, nonviolent offenders. Mandatory minimums have led to unwarranted and unfair sentences and overincarceration. As the ranking member of the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations, I am engaged with colleagues on both sides of the aisle to address the problem of mandatory minimum sentencing. I am concerned that S. 32 may make matters worse. In the Committee on the Judiciary, Ranking Member Conyers proposed a very thoughtful amendment to H.R. 3380, the House companion to this bill, to specify that the reduced intent standard would only apply to leaders and organizers of foreign drug trafficking organizations. The amendment would have made certain that the substantial resources, time, and money necessary to extradite foreign criminals will be expended only on those individuals whose prosecution would disrupt the chain, the pipeline, or dismantle drug trafficking networks. If this bill was amended as recommended, it would be a useful tool to help target leaders of transnational organized crime from Africa to Afghanistan, to South and Central America and beyond, networks in the U.S. and abroad, priorities and objective detail in the President's strategy to combat transnational organized crime. In a climate in Congress when we are working on a bipartisan basis to make our criminal justice system more just and effective and to reduce mandatory minimums, the best course is for us to limit the scope of this bill to high-level drug traffickers--a simple fix. While we do not have the opportunity to amend this bill today, I ask that my colleagues vote against it so that we may continue to work to address this concern, which would not undermine the goals of the bill. S. 32 also corrects an error in section 2320 of title 18, the statute that governs trafficking in counterfeit goods and services. In order to prove the offense of trafficking in drugs with counterfeit marks, there must be proof that the accused knowingly used a counterfeit mark on or in connection with a trafficked drug. I support those changes. The underlying change and spirit of the bill is a positive one. We are working here together. This scourge is something we must attack. May I simply say, Mr. Speaker, I commend the sponsors of this bill for their desire to improve our ability to pursue, convict, and ultimately imprison top-level drug traffickers who have plagued our Nation for decades and beyond. Although I believe this bill still requires a simple change to address the unintended issue impacting mandatory minimum sentencing, I look forward to us working in the manner in which we can work, and I look forward to this concluding in a positive way. Mr. Speaker. Although I support the goals of the Transnational Drug Trafficking Act, I must note a concern that I do not believe the sponsors intended but which I believe must be addressed. This bill is intended to help us do more to combat the importation of illegal drugs into our country. But, it could also subject more people to mandatory minimum sentencing--an unfortunate feature of our criminal justice system that we must address. The United States has been suffering from the damaging effects of illicit drug trafficking for decades. The majority of the drugs wreaking havoc in the U.S. originate in foreign countries, moving from one country to the next, under the direction of powerful and wealthy drug kingpins--many of whom never see or touch the drugs or enter the boundaries of this country themselves. Foreign drug kingpins in Columbia, Ecuador, and Peru are the leading producers of cocaine imported into the U.S. These kingpins lead operations which sell to traffickers in Mexico, who receive the drugs in Central America, South America, or Mexico and, then, smuggle the drugs into the U.S. In 2011 the Obama Administration reported instances of Afghan drug trafficking operations working with West African drug trafficking organizations to smuggle heroin into the U.S. I support enhanced efforts to combat international drug trafficking. S. 32 is intended to help federal prosecutors successfully prosecute foreign drug traffickers whose criminal activity outside of the U.S. threatens the health, safety, and security of Americans at home. At present, Section 959 of Title 21 targets criminal conduct committed outside of the United States. Section 959 makes it a crime to manufacture or distribute controlled substances or certain chemicals used to make controlled substances, intending or knowing that the substance or chemical will ultimately be brought illegally into the U.S. or within 12 miles of the coast of the U.S. In recent years, federal prosecutors have reported difficulties enforcing this statute in some circumstances. Since drug traffickers are aware of the methods used to charge and, then, extradite foreign criminals into the U.S. for prosecution, drug traffickers simply avoid any discussion of the destination of their drug shipments. This tactic leaves prosecutors with no direct evidence that the traffickers know the ultimate destination of their drugs or the drugs produced using their chemicals. S. 32 would amend Section 959, making it easier for prosecutors to obtain a conviction against drug traffickers who operate in other countries. Prosecutors would no longer be required to prove the accused intended or actually knew the drugs or chemicals would be brought illegally into the U.S. S. 32 would reduce the level of intent necessary to prove the accused's guilt, requiring prosecutors to only prove that there was reasonable cause for the accused to believe the drugs or chemicals used to make the drugs would be brought illegally into the U.S. I am troubled, however, that lowering the intent requirement in the statute, without limiting its use to leaders and organizers would expose even low-level offenders to mandatory minimum sentences, depending on the quantity of drugs involved. Historically, mandatory minimums created in the late 80's to target kingpins have been largely applied to low-level, non-violent offenders. Mandatory minimums have led to unwarranted and unfair sentences and over-incarceration. As the Ranking Member of the Subcommittee on Crime, I am engaged with colleagues on both sides of the aisle to address the problem of mandatory minimum sentencing. I am concerned that S. 32 may make matters worse. In the Judiciary Committee markup, Ranking Member Conyers proposed an amendment to H.R. 3380, the House companion to this bill, to specify that the reduced intent standard would only apply to leaders and organizers of foreign drug trafficking organizations. The amendment would have made certain that the substantial resources, time, and money necessary to extradite foreign criminals would be expended only on those individuals whose prosecution would disrupt or dismantle drug trafficking networks. If this bill was amended as recommended, it would be a useful tool to help target leaders of transnational organized crime networks in the U.S. and abroad--priorities and objectives detailed in the President's Strategy to Combat Transnational Organized Crime. In a climate in Congress when we are working on a bipartisan basis to make our criminal justice system more just and effective and to reduce mandatory minimums, the best course is for us to limit the scope of this bill to high-level drug traffickers. While we do not have the opportunity to amend this bill today, I ask that my colleagues vote against it so that we may continue to work to address this concern, which would not undermine the goals of the bill. S. 32 also corrects an error in Section 2320 of Title 18, the statute that governs trafficking in counterfeit goods and services. In order to prove the offense of trafficking in drugs with counterfeit marks, there must be proof that the accused knowingly used a counterfeit mark on or in connection with a trafficked drug, and I support this change. In conclusion, Mr. Speaker, I commend the sponsors of this bill for their desire to improve our ability to pursue, convict, and, ultimately, imprison top-level drug traffickers, although I believe the bill still requires a change to address the unintended issue impacting mandatory minimum sentencing.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 5048, the ``Good Samaritan Assessment Act of 2016.'' Our nation currently faces epidemic levels of opioid drug users and addicts, with a corresponding increase in the number of opioid drug overdoses and deaths. According to the Centers for Disease Control, drug overdose death rates more than doubled between1999 and 2014. Each day, more than 100 Americans die as a result of an overdose, making drug overdoses the leading cause of death in the United States. Compounding this tragedy is the fact that many of these deaths could have been prevented if the victim had received emergency medical treatment. Opioid reversal drugs such as Naloxone have proven effective in reversing opioid drug overdoses and reviving victims. But a victim's chances of surviving an overdose can depend on how quickly medical assistance is received. Those closest to a victim--family, friends, or other drug users--are commonly the first to become aware that an individual is suffering an overdose and needs emergency medical assistance. Their prompt call to 911 can mean the difference between life and death. Similarly, first responders or other persons serving as caregivers to individuals with drug problems are often in the best position to promptly administer a reversal drug. However, such life-saving assistance may not be made available in time if a witness to an overdose delays or fails to call 911, or a caregiver or first responder does not promptly administer an overdose reversal drug or device, due to fear that they might be prosecuted or otherwise held responsible for their involvement, or held liable if something goes wrong. To encourage people to seek medical attention for someone suffering an overdose, and to have first responders trained, equipped, and able to administer opioid reversal drugs or devices, states and localities need to enact Good Samaritan laws that protect from criminal or civil liability individuals who seek or provide life-saving assistance in drug overdose situations. In 2013, only ten states and the District of Columbia had such drug overdose Good Samaritan laws. The Office of National Drug Control Policy (ONDCP) has been working with states and municipalities to enact Good Samaritan laws providing protections to individuals who call for emergency assistance and first responders, law enforcement personnel, and caregivers who administer opioid reversal drugs or devices. Thanks in part to ONDCP's efforts, 35 states and the District of Columbia now have some form of Good Samaritan or emergency drug treatment immunity law. Under this bill, the General Accounting Office would provide the appropriate House and Senate committees with a report on the results of ONDCP's work, as well as a compilation of the various Good Samaritan laws currently in effect. While the report will not take a position on any formulation of such laws, this information will be helpful to Congress and the states in cataloging and understanding the various approaches states are taking with respect to this issue. With more information, we can make better decisions and adopt the best approach. Therefore, I urge my colleagues to support H.R. 5048.

Ms. JACKSON LEE

Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 5052, the ``Opioid Program Evaluation Act of 2016,'' otherwise known as the ``OPEN'' Act. This is an important bill intended to provide a mechanism to evaluate the effectiveness of the grant programs being considered by Congress to address the serious and growing problem of opioid abuse. The current surge in the use of heroin and other opioid drugs such as hydrocodone and oxycodone requires a strong, national response. Opioid abuse leads to physical and functional changes to parts of the brain affecting, impulse, reward, and motivation. In recent years, it is estimated that the number of heroin users in the United States has grown to over 680,000 people. Similarly, the use of other opioids, such as hydrocodone and oxycodone has grown by 100 percent and 500 percent respectively. To fight this crisis involving illegal opioids and the abuse of prescription opioids, we must employ a multi-faceted approach that actually achieves results. This bill would evaluate the effectiveness of H.R. 5046, the ``Comprehensive Opioid Abuse Reduction Act,'' a bill reported by the Judiciary Committee. That bill was written with the goal of assisting States in the implementation of a variety of strategies, including: Providing treatment alternatives to incarceration; training criminal justice agency personnel on substance use and co-occurring mental illness; increasing collaboration between State criminal justice agencies and State substance abuse systems; purchasing opioid reversal drugs and devices for first responders and providing training to carry and administer opioid reversal drugs and devices; and implementing medication-assisted treatment programs used or operated by criminal justice agencies. As opioid abuse grant programs move forward, it is important we find a way to evaluate the success of these strategies and the effectiveness of the programs in implementing them. This is why I support the requirements of the OPEN Act. Specifically, the OPEN Act will: Instruct the Departments of Justice and Health and Human Services to identify outcomes to be achieved and develop metrics for evaluating success in achieving those outcomes; enlist the National Academy of Sciences to evaluate and report to Congress on the outcomes and metrics of the grant programs; require grantees to report annually on the progress made through the grants; and instruct the Departments of Justice and Health and Human Services to complete an evaluation of the effectiveness of their grant programs after five years. I am confident that the comprehensive approach we are taking to address opioid abuse will help address the Nation's growing epidemic. For these reasons, I support the OPEN Act and the goal of ensuring the best possible response to treat and prevent opioid abuse in America, and I urge my colleagues to join me in supporting this bill.

Ms. JACKSON LEE

Ms. JACKSON LEE. I thank the authors of this legislation, as well as the previous speaker, my friend, for his articulation of this bill, and I thank all of the Members who are on the floor joining in support of H.R. 2137, the Federal Law Enforcement Self-Defense and Protection Act of 2015. I thank Mr. Conyers, the ranking member, for yielding to me. Mr. Speaker, let me express my recognition and appreciation of the thousands of families who will come to honor those police officers who have fallen in duty--many of them, their loved ones. We honor law enforcement officers who gave their lives in the line of duty. The loss of one officer's life is one too many. In considering the myriad of dangers our officers face, we must ensure they have the appropriate authority to protect our communities and themselves. I support this legislation because it will make it clear that the brave Federal law enforcement officers who protect us will not be forced to lock away their government-issued firearms in the event of official furloughs, such as those occasioned by government shutdowns. Our Federal law enforcement officers must be prepared to respond to numerous threats faced each day by our country, and this bill will help them do so without expanding any existing authority or creating new ones. This bill ensures our Federal law enforcement agencies uniformly provide our special agents and other law enforcement officers with the necessary support to respond to critical incidents. Our officers are highly trained and understand the importance associated with possessing government-issued weapons. Let me conclude my remarks by again expressing my appreciation to the authors and the chairman and the ranking member of the full committee. I look forward as we move forward on legislation such as the Law Enforcement Integrity Act. We want to continue to give our police officers the skills and tools to be able to do the work that they love, and that is protecting the men and women of this Nation. Again, I offer my appreciation, respect, and sympathy as we honor those who have fallen in duty to all of their families. I ask support for H.R. 2137. I wish to express my full support for the Bulletproof Vest Partnership Grant Program Reauthorization Act of 2015. I am a cosponsor of the House version of this bill, and I support adoption of this Senate-passed bill so that we can send it to the President for signature. In an effort to keep our citizens safe, law enforcement and correctional officers put their lives on the line each day, in every state and territory of the United States. Gun violence poses a lethal threat to all of us, and our law enforcement officers are often particularly at risk while protecting us. Reauthorization of the Bulletproof Vest Partnership Grant Program will provide our officers with needed protection when they come face- to-face with individuals who seek to do harm to the officers and others. Last year, 42 law enforcement officers were killed by gunfire. Seventeen law enforcement officers have already been killed by gunfire this year. In some instances, greater availability of protective vests may have saved the lives of these officers. This program not only promotes the purchase of protective vests and body armor, but it also encourages officers to protect themselves by wearing the equipment. In order to receive funds, grantee jurisdictions must certify during the application process that they have a mandatory wear policy. This requirement ensures that all uniformed patrol officers in a grantee jurisdiction will wear protective vests or body armor while on duty. Each vest purchased through the program must pass strict performance standards set by the National Institute of Justice. The program also gives special consideration to jurisdictions with fewer than 100,000 residents. Without these grants, small jurisdictions might f not be able to include this life-saving equipment in their budgets--leaving officers vulnerable to the daily dangers of policing. Last year, in my district, the Houston Community College Police Department received $8,260.45 from the BVP program, enabling the purchase of 24 protective vests. And the Jacinto City Police Department was able to purchase 7 armor vests with $2,135.90 received through the BVP program. The state of Texas received a total of $1,090,175.60 in matching funds from this program in 2015, which made the purchase of 2,834 new protective vests possible. Since its inception in 1999, the Bulletproof Vest Partnership Grant Program has helped provide more than 1 million vests as of December 2014, to law enforcement officers in more than 13,000 jurisdictions. The number of women in law enforcement continues to grow. Yet much of the protective armor currently offered is primarily designed for male officers. To be certain female officers receive the same level of protection as their male counterparts, the BVP program gives priority to jurisdictions that provide uniquely-fitted vests, including protective vests that conform anatomically to females. From conducting traffic stops to responding to domestic violence calls, our law enforcement officers often face extreme danger. Those dangers are evidenced this week--National Police Week--as we honor the brave men and women who gave their lives to protect us and our communities. As we honor our law enforcement officers during National Police Week, with particular recognition for the sacrifice of fallen officers and their families, it is fitting that we complete work on this legislation today so that it may become law. Therefore, I urge my colleagues to support S. 125.