Frank Pallone

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today to speak on H.R. 5800, the Medicaid Institutions of Mental Disease ADDITIONAL INFO Act. This bill would require the Medicaid and CHIP Payment and Access Commission to conduct a comparative study to assess IMD quality in States and issue a report on requirements applicable to and practices of institutions for mental disease under the Medicaid program. We know that nearly half of all States already have or have applied for 1,115 waivers that allow for IMD services to be provided to patients with substance use disorder. Additional States provide IMD services already to patients in Medicaid through their managed care programs. It is important to understand the overall quality of institutions of mental disease that exists throughout the country. This cannot be accomplished without data on our current IMDs. The study will include information on how many institutions for mental disease are within States coverage limitations, services they provide, whether States have a waiver to provide such coverage through Medicaid, and funding involved with such institutions. Additionally, this study will seek recommendations on how State Medicaid programs can provide the standards of care provided by IMDs. Additional data is obviously a good goal, particularly on IMD coverage, given the controversy surrounding this issue, and so I support this legislation. Mr. Speaker, I reserve the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers. I would urge support for this legislation, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield such time as she may consume to the gentlewoman from Michigan (Mrs. Dingell).

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 5002, the Advancing Cutting Edge, or ACE, Research Act. This bill would grant NIH other transactions authority that allows NIH flexibility in entering into agreements for cutting-edge research that can lead to increased understanding of prevention, diagnosis, or treatment of diseases or disorders, including substance use disorder, as well as research that is urgently needed to respond to a public health threat, such as the opioid crisis. I urge my colleagues to support this legislation. Mr. Speaker, I commend Representative Dingell for her leadership on this bill, and I reserve the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers. Mr. Speaker, I urge my colleagues to support this bill, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield such time as she may consume to the gentlewoman from California (Ms. Judy Chu), the sponsor of the legislation.

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 4684, the Ensuring Access to Quality Sober Living Act of 2018, introduced by Representative Chu. This bill would require the Department of Health and Human Services to work with stakeholders, including individuals with substance use disorders and recovery housing groups, to develop best practices for operating recovery housing. The Energy and Commerce Committee's bipartisan investigation into disreputable sober homes and associated patient brokers and treatment facilities has made clear that we must do more to ensure that individuals with an opioid use disorder are not being taken advantage of by entities seeking to treat such individuals as commodities rather than people in need of treatment. In fact, in far too many instances, these homes and providers offered no treatment at all. In other instances, where treatment is offered, it is only provided to increase the provider's profits. In the worst instances, these rogue providers go so far as to help individuals stop their illicit use of opioids for the duration of their insurance limit for a given treatment service, only to supply opioids to these same individuals after they are released so they can relapse and their insurance once again can be milked for the duration of the benefit limit. Such providers are not only harmful to patients trying to stop their illicit use of opioids and enter recovery, this substandard treatment also costs many individuals their lives. Mr. Speaker, our investigation also has revealed that individuals with opioid use disorder and their families are particularly susceptible to such schemes, because there is not adequate information available to help them determine whether a facility is a quality provider of recovery housing or to detect the fraudulent intent of such actors. Many rely on bad information obtained through internet searches or questionable referrals from individuals who are actually patient brokers and paid to deliver patients to the highest bidding sober home or treatment provider. The bill before us, the Ensuring Access to Quality Sober Living Act, aims to prevent the often tragic consequences of the patient brokering schemes that send individuals to low-quality sober homes and treatment providers. I want to thank Ms. Chu for all she has done to move this bill. This legislation requires Health and Human Services, in coordination with the Department of Housing and Urban Development, and with stakeholders, to establish best practices that will aid States in establishing standards for the recovery houses, help recovery housing providers in establishing and maintaining housing that meets the highest quality of service delivery, and help individuals and their families identify what to look for in a quality provider of recovery housing. Mr. Speaker, I urge my colleagues to support this bill, and I reserve the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume; and I rise in support of H.R. 5812, the CONNECTIONS Act. I was pleased to work with Representative Griffith on this bipartisan legislation. This bill authorizes funding to enhance and improve State prescription drug monitoring programs, among other prevention efforts. This legislation codifies CDC's Prevention for States program, which includes funding to improve State prescription drug monitoring programs, or PDMPs. As part of that program, the CDC will implement the activities described in the National All Schedules Prescription Electronic Reporting, or NASPER Act, which I was pleased to see receive funding this year. As the original Democratic sponsor of NASPER, I have been a longtime champion of PDMPs as public health tools that can prevent and respond to opioid abuse. The role of PDMPs in the current opioid epidemic has proven why our longtime interests and push for investments in this space is so critical. As the technology has matured, we have moved from working toward the goal of ensuring the interstate sharing of PDMP data, to now aiming to make PDMPs more interconnected real-time, and usable for public health surveillance and clinical decisionmaking. Continuing to strengthen PDMPs will improve our ability to prevent addiction from occurring in the first place and help identify individuals who could benefit from treatment for opioid use disorder. I wanted to urge my colleagues, obviously, to support this legislation. Mr. Speaker, I know we have been here, I guess, for about 4 hours now, and we are done with these suspension bills that are part of this opioid package, and I don't mean to negate in any way this package, I do think it is important. But I still want to say, as we conclude today, I want to express my concern that collectively these bills that we are considering do not go far enough in providing the resources necessary for an epidemic of this magnitude. There are 115 Americans dying every day, and we have to ensure that people have access to treatment. The bills the House is debating and will pass this afternoon and over the next 2 weeks do not do enough to expand treatment for millions suffering from this crisis. I would also be remiss, again, if I did not also mention the Republicans' ongoing efforts to repeal the Affordable Care Act and gut Medicaid and take away critical protections for people with preexisting conditions. The Justice Department just announced, under President Trump and Attorney General Sessions, that they are not going to defend a lawsuit that is being brought by Republican attorneys general in many States that would basically say that the Affordable Care Act does not have to protect people anymore from preexisting conditions. When discussing the opioid crisis on the floor this week and next, I urge my colleagues to remember that protecting and expanding access to care is the most critical piece of the puzzle, and any efforts to roll back the Affordable Care Act, such as another Republican-led attempt to repeal the ACA or gut Medicaid, will hurt those people who need it most. I am pleased to support this bill in this package and the other bills that we considered on suspension today, and I yield back the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 5483, legislation that will direct the Drug Enforcement Agency to take action to allow registered healthcare practitioners to practice telemedicine. I want to thank our Democratic sponsor, Mrs. Bustos from Illinois. If we are to end the cycle of opioid abuse and addiction, more must be done to help provide those suffering with access to treatment. However, I am optimistic that the legislation before us now authored by Representatives Bustos and Carter will offer one way forward to providing more individuals suffering from addiction with access to treatment by enabling the use of telemedicine. Telemedicine offers one opportunity to potentially reach more patients who could not otherwise access treatment, whether due to geographic reasons, provider access issues, financial concerns about in-person treatment, or the stigma of seeking treatment. While DEA has the authority to establish a special registration pathway for purposes of treating a patient via telemedicine, DEA has not acted to do so to date. The Special Registration for Telemedicine Clarification Act of 2018 would direct the Attorney General to issue regulations establishing a special registration process for engaging in the practice of telemedicine within a year of enactment. This approach will enable telemedicine to finally be deployed in treating patients with addiction, while still allowing DEA to ensure that there are appropriate safeguards in place to mitigate against the use of telemedicine in any manner that could further exacerbate the opioid crisis. This is practical legislation that I believe will help open access to treatment, and I urge my colleagues to vote in support of the bill. Mr. Speaker, I yield such time as she may consume to the gentlewoman from Illinois (Mrs. Bustos), the sponsor of the bill.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 5353, Eliminating Opioid Related Infectious Diseases Act. As the opioid epidemic has grown, so have infectious diseases related to intravenous opioid drug abuse. These infectious diseases include serious blood-borne illnesses such as HIV, hepatitis B, and hepatitis C, which have devastating health consequences and require long-term treatment. In 2015, a community in Indiana experienced an outbreak of HIV in over 200 individuals related to intravenous use of oxymorphone. These infections also include infections from skin flora such as MRSA. Last week, CDC released a report finding that people who inject drugs are more than 16 times more likely to develop invasive MRSA infections. In the midst of an opioid epidemic, it is more important than ever to bolster national surveillance and education efforts on the infectious diseases related to use of IV drugs. The Eliminating Opioid Related Infectious Diseases Act of 2018, the bill before us, authorizes the CDC to improve surveillance of infections associated with intravenous drug use, such as HIV, infective endocarditis, and MRSA. The CDC can help reduce the rate of infectious diseases from intravenous drug use through the development and distribution of public educational materials on risks associated with intravenous drug use. This legislation, Mr. Speaker, would also help by improving the education and training of healthcare professionals on how to detect and treat intravenous drug use-associated infections, leading to better management, fewer complications, and overall improved quality of care for those suffering from IV-related infectious diseases. Mr. Speaker, I urge my colleagues to support this legislation. I have no further speakers, and I yield back the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers. I urge my colleagues to support the bill, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 5329, the Poison Center Network Enhancement Act. I want to thank Mr. Engel, the Democratic sponsor, for his leadership. Mr. Speaker, I rise in support of H.R. 5329, the Poison Center Network Enhancement Act. This legislation reauthorizes the Health Resources and Services Administration's (HRSA) Poison Control Center program. Poison control centers provide essential support to the public and healthcare providers nationwide. They assist with guiding the public to appropriate medical care and advise physicians and other healthcare providers on the appropriate medical management whenever an exposure to a poison has occurred. There are over 70 Poison control centers in the U.S and U.S. Territories and they serve a vital role in our emergency infrastructure, operating 24 hours a day, 365 days a year. The centers handle calls concerning over 430,000 different substances, but in recent years have seen a huge increase in calls related to opioid exposure. Receive nearly 200 consults per day on opioid related exposures alone. There is no doubt that Poison control centers play a role in fighting the national opioid epidemic. I support this legislation and continuation of the great work our nation's Poison Control centers do. I urge my colleagues to support this bill. Mr. Speaker, I yield such time as he may consume to the gentleman from New York (Mr. Engel).

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers. I urge my colleagues to support the bill, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield such time as he may consume to the gentleman from New Mexico (Mr. Ben Ray Lujan), who is one of the Democratic sponsors.

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 5327, the Comprehensive Opioid Recovery Centers Act. Mr. Speaker, I rise in support of H.R. 5327, the Comprehensive Opioid Recovery Centers Act. More than 21 million individuals in this country need substance abuse treatment, but we know there are numerous barriers to accessing help for substance abuse disorder. One of the many barriers that exists is the gap in healthcare providers available to treat opioid use disorder. Worsening the situation, our current healthcare system and the methods of treating substance abuse disorders is often fragmented, leading to incomplete patient care. Without a standardized way of approaching screening or treatment for opioid use disorder, treatment centers use a range of methods to manage opioid use disorder, some are more successful than others. H.R. 5327, bipartisan legislation which would require SAMHSA to provide grants to develop comprehensive opioid recovery centers will begin to address some of the deficits in opioid use disorder care. These centers will provide outreach to help educate the communities about opioid and other substance use disorders, assist with coordination of treatment, and offer recovery activities. The comprehensive opioid recovery centers will use best practices, to deliver integrated opioid use disorder care, giving other treatment centers a model to look towards, improving the quality of OUD treatment. Improving access to evidence-based substance use disorder treatments is critical for ensuring patients get the care that they need. I urge my colleagues to support this bill. Mr. Speaker, I yield such time as he may consume to the gentleman from Texas (Mr. Gene Green), who is the ranking member of our Health Subcommittee.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers. I would ask support for the bill, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of this bill, H.R. 5272, and I want to thank Mr. Engel, the Democratic sponsor. The purpose of this legislation is to promote the increased uptake of evidence-based treatment by individuals with mental health and substance use disorders. We know that increasing the utilization of evidence-based treatment for behavioral health disorders results in improved outcomes. This is particularly important for individuals with opioid use disorder, as we know that MAT is the gold standard for treatment and is associated with improved retention in treatment, decreased relapse rates, and decreased fatal and nonfatal overdoses. Expanding access to and uptake of MAT as well as other evidence-based behavioral health treatments, as promoted by this bill, is a critical piece to combating the tragic opioid epidemic, so I encourage my colleagues to support this legislation. Mr. Speaker, I yield such time as he may consume to the gentleman from New York (Mr. Engel).

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers. I urge my colleagues to support the bill, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield such time as he may consume to the gentleman from New York (Mr. Tonko), our Democratic sponsor.

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 5261, the TEACH to Combat Addiction Act, and I want to thank Mr. Tonko, the Democratic sponsor of the bill. While the evidence is clear that medication-assisted treatment is the gold standard for treatment of opioid use disorder, many healthcare providers know little about this lifesaving treatment. Providers' limited knowledge of and training on substance use disorder treatment and recovery support services, such as MAT, harms efforts to respond to patients who suffer from such conditions. The TEACH to Combat Addiction Act will help improve providers' knowledge and training on such services by establishing centers of excellence and substance use disorder education. These centers will support the development, evaluation, and distribution of evidence-based curricula for health professional schools on substance use disorder prevention, treatment, and recovery. Such curricula can be used to help ensure that we get the right curriculum and training to all different kinds of healthcare providers. Mr. Speaker, I urge my colleagues to support this bill, and I reserve the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers. I urge my colleagues to support the bill, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise to voice my strong support for H.R. 5228, legislation that I authored that will strengthen FDA's ability to prevent illicit opioids from coming in through our international mail facilities by providing the agency with additional enforcement authority and financial resources. In April, Mr. Speaker, I had the opportunity to visit an international mail facility in my home State of New Jersey with the Food and Drug Administration, Customs and Border Patrol, and the U.S. Postal Service, and to see firsthand the problems that these agencies are facing when it comes to illegal, unapproved drugs entering our country through international mail facilities. FDA staff showed us boxes of pills that had limited labeling, labeling in foreign languages, or no labeling at all, and were sent from unknown and unregistered facilities. FDA staff explained that it takes the agency days to catalog these boxes, identify what products contained inside are legitimate, and identify what products, under current law, the agency can destroy. FDA then had no other option but to return that box to the sender. This leaves open the possibility that the sender will just drop the box of illegal pills back in the mail and try to enter the country again through another international mail facility. The agency also showed me a series of similarly wrapped and marked packages that contained little labeling and were misidentified as gifts. Upon inspection, these packages included bags of drugs, some labeled and some labeled in another language. Again, the agency faced the task of trying to identify if the product was a drug before it could take further action. Now, the SCREEN Act, the bill before us, which passed the Energy and Commerce Committee by a voice vote, would give FDA authority to act in these situations to stop illicit drugs from entering the marketplace and allow the agency to better target their resources. Specifically, the SCREEN Act would, first, expand FDA's authority to refuse or destroy illegal drugs; second, provide FDA with the ability to order manufacturers to cease distribution or to recall drugs that pose an imminent or substantial hazard to the public health. Third, it would allow FDA to refuse admission or to destroy bulk shipments of drugs from manufacturers, distributors, or importers, if they are found to be misbranded or adulterated. Then it would authorize new resources to help provide additional capacity at international mail facilities and to upgrade infrastructure, equipment, and other needed technology for screening purposes. Mr. Speaker, having worked closely with FDA on this legislation, I know that the authorities outlined in the SCREEN Act will go a long way toward empowering the agency to take on repeated illicit drug traffickers and ensure that dangerous, unapproved drugs are stopped at our ports and at our mail facilities. I urge my colleagues to vote in support of this bill, and I reserve the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. I rise in support of H.R. 5176, Preventing Overdoses While in Emergency Rooms Act. This legislation would provide grant funding for emergency departments to develop protocols for treating and discharging patients who have presented with an opioid overdose or are at increased risk for overdose. These protocols will help increase the uptake of evidence-based treatment services by promoting the initiation of medication-assisted treatment in emergency departments, as well as referral to community- based providers for treatment and recovery support services. This is particularly important since an individual's willingness to seek substance use disorder treatment often increases immediately following a nonfatal overdose. The protocols also will help reduce the risk of future fatal overdoses by such individuals by requiring the provision of naloxone at discharge. This helps ensure that these individuals at high risk of overdose have this lifesaving drug available if it is needed to reverse a potentially fatal overdose. So I urge my colleagues to support this legislation, and I yield back the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have no additional speakers, so I urge support for the bill, and I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield such time as he may consume to the gentleman from Maryland (Mr. Sarbanes).