Raul Ruiz

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to recognize Supervisor Marion Ashley on his retirement after more than 35 years of public service. Supervisor Ashley has served the people in Riverside County since 2002 with leadership, integrity, respect, and enthusiasm. He grew up in Riverside County, California, and like me, has had the privilege of returning home to serve. To see his positive impact on the cities of Banning, Beaumont, Calimesa, and others, you only need to look around. You will see medical centers, public parks, wildlife conservation areas, and fire stations that exist thanks to his advocacy. In retirement, I hope Supervisor Ashley will enjoy spending more time with Mary, his wife of more than 60 years, and their 6 children, 19 grandchildren, and 9 great-grandchildren. On behalf of communities across Riverside County, it is my honor to congratulate Supervisor Ashley on a well-earned retirement.

Mr. RUIZ

Mr. RUIZ. Madam Speaker, I rise today to recognize the Martin Luther King Commemorative Committee of the Coachella Valley for their dedication to celebrating the life and legacy of Dr. King. Since 1986, the MLK Commemorative Committee has kept Dr. King's commitment to civil rights, nonviolence, and grassroots activism alive. Every year, they have demonstrated to our Desert community that the values Dr. King preached--justice, love, respect--are as important today as they were during his lifetime. This committee was born from the vision and service of Mr. Joseph Beaver, a lifetime civil rights advocate and community leader. Answering the call to service during World War II, Mr. Beaver was one of the first African Americans to join the Marine Corps. We are blessed by Mr. Beaver's advocacy for social justice, which has inspired and enriched our valley. To this day, he remains on the frontlines fighting for civil rights here in our community. In 2014, it was my honor to present Mr. Beaver with the Congressional Gold Medal for his accomplishments as a service member and civil rights leader. While the manifestations of racism and prejudice may have changed, the injustice Dr. King battled endures today. Racism endures. Inequality endures. Dr. King prophesized that the arc of history bends toward justice, but the road there has never been smooth. As we remember Dr. King, we cannot relegate him to the history books. To keep his legacy alive, we must stand up to hatred, white supremacy, and the systematic racism that continues to plague our nation. In doing so, we embrace the values Dr. King lived: justice, equality, and the courage to do what is right. That is the mission of the Commemorative Committee: not to simply remember Dr. King once a year, but to inspire us to carry on his spirit in our hearts and enact his vision of love and equality. It's a message of freedom that, through their efforts, rings across the Coachella Valley and every valley, hill, and stream across our nation. On behalf of the residents of California's thirty-sixth congressional district, I congratulate the Martin Luther King Commemorative Committee of the Coachella Valley for their commitment to celebrating the life of Dr. Martin Luther King. I thank them for their service to our community.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise to celebrate a very special and personally meaningful victory for residents in the Coachella Valley in my district. I rise to celebrate the passage of Measure BB and the expansion of the Desert Healthcare District. You see, when I was a young boy growing up in a farm-worker trailer park in Coachella, I saw the dignity of good, humble people who loved God, worked hard, and struggled to make a better life for themselves and their children. I also saw their needless pain and suffering due to their poverty and lack of healthcare resources. I vowed at the age of four to become a doctor and serve them. As a freshman pre-med student at UCLA, I stayed awake at night on the top bunk bed of my tiny dorm room thinking about the difference I would one day make. After graduating from Harvard's medical, government, and public health schools, I returned home as an emergency medicine physician as promised. I rolled up my sleeves, organized, and went to trailer parks, rural community parks, and the poorest communities to help. I saw familiar faces with familiar stories of suffering still living in poverty and resource-poor communities. That is why I founded the Coachella Valley Healthcare Initiative in 2010, along with my wife, Monica, and our good friend Chauncey Veatch, to address our local healthcare access crisis. We produced a report and a strategic improvement plan. Our most important solution was the expansion of a healthcare district. Today, I am very happy to celebrate the passage of Measure BB and the expansion of the Desert Healthcare District to cover all medically underserved communities in the valley. It is significant, because the district has an annual multimillion dollar budget that funds healthcare and public health programs that improve the public's health. That means more providers caring for more patients and providing much-needed services like pediatric specialty care, mental health, veterans' health, senior services, and provider pipeline programs. It is proof that good things happen when good people come together to do good work. I would like to thank California Assemblyman Eduardo Garcia for answering the call and stepping up to be a champion for the expansion of the district. He got the bill to put expansion on the ballot passed into law, and together, we helped build local support by putting out fires and persuading others of the big idea. I also want to thank Riverside County Supervisor Manuel Perez. When the expansion of the healthcare district was under threat, Supervisor Perez and I worked closely to convince other county supervisors how much our communities would gain in both improved health outcomes and increased economic activity. The Riverside County Board of Supervisors voted unanimously in favor of the expansion. There were many other champions who pulled their weight and got the job done. Thank you to the leadership of the Desert Healthcare District itself, including the President of the Board of Directors, Dr. Les Zendle, previous CEOs Kathy Greco and Herb Schultz, and Interim CEO Chris Christensen. Thank you to board members Dr. Jennifer Wortham, Kay Hazen, and Carole Rogers, who voted in favor of expansion, and the many, many other staff members who have helped ensure this advocacy ran smoothly. Several key healthcare organizations were instrumental in this success. As the largest provider for the east valley, Tenet Healthcare has been enormously supportive by prioritizing the health of their patients above all else. Thank you to Borrego Community Health Foundation for your generosity and leadership to help create this victory. Thank you to Planned Parenthood for your tireless work, and thank you to Building Healthy Communities, Clinicas de Salud Del Pueblo, and Eisenhower Medical Center. Thank you to James Williamson, who led the campaign. Thank you to Barbara Fields, Juan Armenta, Mary English, Walter Clark, Oscar Armijo, Richard Meyer, and Jack Marco, whose generosity never wavered throughout this journey. Thank you to the voters who approved the expansion measure by an incredibly large margin. Thank you for helping to make the dream I had as a boy from a farm- worker trailer park a reality. Together, we are improving lives and making a difference.

Mr. RUIZ

Mr. RUIZ. Madam Speaker, I rise today to recognize Supervisor Marion Ashley on his retirement after more than twenty-five years of serving in elected office. Since 2002, Supervisor Ashley has been a tireless advocate for Riverside County's Fifth District, bringing his energy, leadership, and enthusiasm to the cause of serving his constituents. As we have worked together over the years, I've known Supervisor Ashley to be a man of integrity and compassion, always ready to put the interests of others before his own. Supervisor Ashley grew up in Riverside County, and like me, has had the privilege of returning home to serve the community that helped raise him. To see his positive impact on towns like Banning, Beaumont, and Calimesa, you only need to look around. You'll see medical centers, public parks, wildlife conservation areas, and fire stations that exist thanks to his advocacy. During his decades of public service, Supervisor Ashley has demonstrated his strong commitment to positioning Riverside County as a leader in environmental conservation and renewable energy. He has helped Riverside County protect our Desert habitats and wildlife and become a national leader in wind and solar energy. He has personally donated hundreds of acres of land in pursuit of those goals. Throughout his tenure, Supervisor Ashley has shown a willingness to work on a bipartisan basis. He has welcomed innovative ideas and treated opponents and allies with respect. In retirement, I hope Supervisor Ashley will enjoy spending more time with Mary, his wife of more than sixty years, and their six children, 19 grandchildren, and 9 great-grandchildren. On behalf of communities across Riverside County, it is my honor to congratulate Supervisor Ashley on a well-earned retirement.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to recognize the thirtieth anniversary of Lideres Campesinas and to congratulate the incredible women of the Coachella Valley who founded it. For three decades, Lideres Campesinas has empowered farm working women across California to advocate for themselves, their families, and their communities in a struggle for equality. I was 16 when Lideres Campesinas was founded by friends and neighbors I've known my whole life. These were women who looked out for me and fed me tamales. One of the members even gave me the affectionate nickname, ``mi chaparrito,'' Mexican slang for short guy. Actually, she still calls me chaparrito. These women have deep connections to our community, but as farmworkers, they endure many hardships. Farmworkers don't share the same protections under our labor laws, and they often face difficult working conditions and wage discrimination. On top of that, women farmworkers face higher rates of domestic violence and sexual assault, and a severe lack of legal resources and women's health services. The founders of Lideres Campesinas experienced those hardships firsthand, so to fight for themselves and their community, they decided to organize. Maria Aguirre Rosales De Banuelos was one of those founders. Maria migrated to the U.S. in 1977, and she held a demanding agricultural job for twenty years. After being trapped in an abusive marriage for most of her life, Maria met with some of her farmworking neighbors in the Coachella Valley. In that room, she realized she was not alone: many of the women she spoke to had also experienced domestic abuse, and like her, finally felt the freedom to share their experiences with others. That realization gave Maria the strength to free herself from an abusive relationship, and to help create an organization that would connect and empower women in the Coachella Valley. That's how Lideres Campesinas was born. Out of community. Out of compassion. And those are the values to which it has stayed true. Lideres Campesinas has since grown to include chapters across California. By providing women with health education services, they are helping women live healthy and productive lives. By educating their communities about workplace harassment and labor exploitation, they have helped women stand up for their rights. And by connecting women with legal and social services, they have helped women remedy the discrimination they face. Maria Aguirre passed away earlier this year, but she will forever be remembered as an empathetic, kind-hearted leader of our community. To the women of Lideres Campesinas, thank you for your service to our community. A todas las mujeres de Lideres Campesina, gracias por su servicio a nuestras communidades.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to recognize the communities affected by the Cranston fire, one of the largest wildfires my congressional district and eastern Riverside County has ever seen. While the Cranston fire was contained in August, many of my constituents are continuing to piece their lives back together, and anytime severe rain is forecasted, they once again go into high alert for mudslides from the burn scar. The Cranston fire started on July 25, 2018, and within a matter of a few hours residents of Idyllwild and the mountain communities were immediately forced to evacuate from their homes. Without hesitation, first responders from the Idyllwild Fire Department, the Idyllwild Volunteer Fire Company, CAL FIRE, the California Highway Patrol, the U.S. Forest Service, and countless others from all over the Nation sprang into action. Thanks to their efforts, no lives were lost and the fire was fully contained by August 10, having burned more than 13,000 acres. Months later, I am left with the image of police officers walking through smoldering neighborhoods with megaphones, making sure no one was left behind. Today, Idyllwild continues to embody that spirit of community and togetherness. They are rebuilding homes, clearing debris, and preparing for the next wildfire that threatens our communities. Friends and neighbors continue to support one another, and I continue to be inspired by their compassion and determination. Throughout this rebuilding, our communities have expressed something profound: gratitude. Rarely have I seen such an outpouring of support for our first responders. I have seen fences papered with handwritten signs thanking the firefighters and countless tributes to their courage and sacrifice at local festivals and benefits. The affected communities could not have made it this far without the support of religious groups, nonprofits, local businesses, and generous neighbors. During the fire, volunteers with the American Red Cross and the FIND Food Bank delivered food to evacuation centers. So did local restaurants, including Idyllwild Bake Shop & Brew, Cafe Aroma, Coyote Red's, the Mile High Cafe, and many others. The Ace Hotel, V Palm Springs Hotel, and Grand Idyllwild Lodge were just a few of the businesses that generously opened their doors to displaced residents. That generosity extended to our four-legged friends, too. I visited the San Jacinto Valley Animal Campus, where staff provided shelter for more than 160 local pets. Their legacy of compassion lives on through community organizations like Young Idyllwild, who hosted a music festival and benefit to raise money for neighbors still struggling to piece their lives together. I was particularly moved by the generosity of local musician Ernesto Ale and his family, who lost their home in the fire. In the midst of this hardship, Ernesto found the strength to perform, bringing music to his community and raising money for neighbors who, like him, lost so much in the fire. Ernesto is proof of the kindness and strength exhibited by every neighbor, firefighter, police officer, and business owner who pitched in after the Cranston fire. Government should follow the example of communities it serves, pulling together in times of crisis and lending a hand to those in need.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, it is my privilege to acknowledge November as Eye Donation Month, dedicated to increasing awareness of the need to register as an eye, organ, and tissue donor. Since 1983, the Eye Bank Association of America, EBAA, and each of its 75-member eye banks across the U.S. have dedicated this month to honoring the Nation's eye donors and their families, and to celebrate the transformative impact of corneal transplants on the lives of their recipients. With a 97 percent success rate, corneal transplants are the Nation's most successful organ transplant procedures. Since the Association's founding in 1961, nearly 2 million corneal tissue recipients have regained their sight. In 2017, EBAA member eye banks recovered 135,203 corneas from 68,565 donors across the United States. This made it possible to provide the gift of sight to approximately 51,000 men, women, and children in the U.S., and over 26,000 recipients internationally. These eye banks also provided more than 24,000 corneas for research and educational purposes. My home State of California is served by eight eye banks that recovered nearly 8,000 corneas last year, making it the largest source of corneal tissue for transplant and research in the country. These donations allowed thousands of Californians to regain their vision and resume the lives they had planned on living before disease or injury deprived them of their sight. In addition to improving their recipients' quality of life and giving comfort to donor families, corneal transplants also have a considerable economic impact on America's healthcare system. A recent EBAA analysis found that the net lifetime economic benefits of cornea transplants performed in 2017 will exceed $6 billion, due to the elimination of medical expenses related to vision care and the increased productivity of both the cornea recipients and their caregivers. I thank the Eye Bank Association of America for its decades-long dedication to the restoration of sight. I thank all of those who list themselves as an organ donor on their driver's license. I thank all of those who are willing to give of themselves for others. I want to reassure and thank their loved ones, because those who have passed have done a great good for society, for people who have lost their sight, and for future generations who will one day benefit from the research they have contributed to by donating their corneas. I encourage my colleagues to join me in urging all Americans to give the selfless gift of vision and life by registering to become eye, organ, and tissue donors.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to recognize Idyllwild's ``Jazz in the Pines'' festival, a celebration of music, art, and community in my congressional district. Jazz in the Pines is one of my family's favorite traditions. It's a chance to marvel at the handiwork of local artists, catch up with friends, and listen to the sweet, sweet sounds of smooth jazz. Every year, we join our neighbors in the San Jacinto Mountains to celebrate the natural and cultural beauty that makes Idyllwild unlike any other place on earth. The proceeds of this yearly celebration benefit the Idyllwild Arts, a foundation that teaches adults and children of all ages to realize and develop their artistic talent. Through summer camps and college preparatory courses, Idyllwild Arts is enriching the lives of students from Idyllwild and across the country. This year's Jazz in the Pines is particularly special. Not only does it mark the festival's twenty-fifth year--it comes in the wake of and in spite of the largest wildfire to threaten the community of Idyllwild in nearly five years. The Cranston fire burned more than 13,000 acres, destroying buildings, closing major roads, and forcing thousands from their homes. But no matter how large the fire grew, our mountain community's passion for celebrating music and the arts burned brighter. We owe this year's festival to the incredible first responders who risked their lives to protect Idyllwild, Pine Cove, Mountain Center, Fern Valley, and many surrounding communities. I am also grateful to the hundreds of musicians, artists, and volunteers who made this year's event possible. Jazz in the Pines was born from conversations around a kitchen table. Today, it demonstrates what we can achieve when neighbors, local businesses, and non-profits work together. That community spirit helps us bounce back from every challenge. It's a lesson in resiliency that I am proud to share with my daughters.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, the military burns their trash, including computers, plastic, and medical waste, in open-air burn pits, creating smoke with toxic chemicals like metals and carcinogens that pose serious health risks to our troops. Our servicemembers and veterans are developing severely debilitating pulmonary diseases, like pulmonary fibrosis and constrictive bronchiolitis, leaving them oxygen-dependent. And other young veterans are dying from rare cancers in the brain, pancreas, blood cells, and other locations. I am an emergency medicine physician and a public health expert. In public health and in medicine, it is practice that if there is a high enough suspicion of a harm that causes a severe enough illness, then we need to act on that suspicion, remove the harm, and treat the person. We can't wait 10 or 20 years for the perfect research study. We must act now. We must do that by simultaneously and immediately addressing these 4 points: First, stop our troops' exposure to dangerous burn pits out in the battlefield. Second, educate doctors, veterans, and servicemembers to help doctors understand the risks of being exposed to burn pits, and to help veterans and servicemembers understand the early signs of potential serious illness so they can get treatment early. Third, take care of burn pit exposed veterans and servicemembers at the VA and DOD, and ensure illnesses caused by burn pit exposure are recognized in their claims for disability benefits. Fourth, do more research that is needed to identify all the different health impacts exposure to burn pits can cause. The conference report for Fiscal Year 2019 National Defense Authorization Act includes two of my amendments that will help address the first 2 points: Stopping the use of burn pits. And educating veterans and their caregivers about the health risks that could be connected to exposure to burn pits. My first amendment directs the Department of Defense to conduct a feasibility study on ending the use of dangerous burn pits by using incinerators and other technology. My second amendment requires the Department of Defense to conduct an annual education and outreach campaign to veterans exposed to burn pits and who are qualified to enroll in the burn pit registry. The burn pit registry will improve our understanding of the different health effects of exposure to burn pits and help our ability to communicate with veterans and increase their awareness of subtle changes in their health so that they could understand the early signs of potential serious illness. The Government must acknowledge the dangers of burn pits and the suffering of burn pit exposed veterans with severe illnesses. The Government has a responsibility to immediately provide them with the care and benefits they have earned while defending our freedoms. I want to thank the conferees and the ranking member and chairman of the Armed Services Committee for their support of my amendment and for including these amendments in the final conference report. Congress must continue to work together to provide solutions for our veterans and servicemembers exposed to these dangerous chemicals, toxins, carcinogens, and the smoke of burn pits.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, premiums are skyrocketing across the country, caused by this administration's sabotage of the Affordable Care Act. Just listen to the insurance company CEOs who are directly stating that not funding cost-sharing reductions for point of care for patients who are struggling to pay their bills will increase premiums. And also, by not outreaching to more people and low-risk individuals to come into the insurance pool, they are also increasing the premiums for everybody else. But rather than making healthcare more affordable for all middle class families, this Congress is focusing on making healthcare more affordable for the wealthy few. Instead of protecting the 130 million Americans with preexisting conditions, this Congress is sitting idly by as this administration once again allows insurance companies to sell junk plans that don't even cover basic healthcare services. At a time when we should be stabilizing premiums by supporting risk- adjustment transfers and ACA enrollment outreach, the majority is refusing to act, simply ignoring the anticipated 18 percent increase in premiums for hardworking Americans throughout our country because, rather than help the American people, the majority would rather sabotage the Affordable Care Act for their own political gain. This is wrong. So I offer the majority and all the Members of the House this choice: Members can support the previous question, ignore the people who will be priced out of healthcare, and ignore all the politically motivated actions by this administration to undermine access to affordable healthcare in our Nation; or Members can defeat the previous question so that we can bring up my bill, H.R. 6479, the Stop Junk Health Plans Act, which will lower costs and will ensure that Americans continue to have access to high-quality, affordable health plans. It is that simple. You see, in general, there are three out-of-pocket or more than three out-of-pocket costs; in fact, one is the premiums, two is the deductibles, three is the co-pays, and four is the out-of-pocket costs Americans will have to pay if their health insurance doesn't cover those specific services. So only focusing on premiums is a message deception. You see, with junk plans, that will increase out-of-pocket costs for patients because these junk plans may offer Americans a less expensive premium; however, the deductibles will be too expensive. Also, if the majority goes after the essential health benefits and allows insurance companies not to cover things like emergency care, mental health, or prescription drugs, then they will be responsible for those out-of-pocket costs. Also, if the majority does not defend the protections of people with preexisting illness--and insurance companies are now able to discriminate against those with diabetes, heart conditions, asthma, et cetera--then those individuals will have to pay more overall out-of- pocket costs either because they were denied or because health insurance companies will be able to charge them an exorbitant amount of money. So this is why it is so important to keep patient out-of-pocket costs in perspective and not just focus on the political messaging tools of narrowly focusing on premiums, because someone can buy a low-cost premium health insurance, but, again, if it doesn't cover mental health, prescription drugs, emergency care, or other forms of guaranteed coverage under the Affordable Care Act, then they are going to have to pay that completely out of pocket. If the majority doesn't protect patients with preexisting illness, then that is 180 million people in this country who have preexisting illnesses who are going to have to pay more out of pocket. So, therefore, we must focus and stabilize the health insurance market; we must lower insurance costs by increasing enrollees into the insurance market by low-risk individuals; we must protect essential coverage and protect people with preexisting illness; and we must lower drug prices and the cost of overall care. I urge all my colleagues to make the right choice--the only choice-- that supports the American people, in this case, the out-of-pocket costs.

Mr. RUIZ. Mr. Speaker, I urge Members to defeat the previous question. I urge Members to do the right thing, to think strategically, and to think about the overall out-of-pocket costs.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, the United States Constitution defines Tribes in our Nation as sovereign governments with a unique relationship with the United States Federal Government. Many treaties and Supreme Court cases show legal precedent that they are sovereign nations, and the United States has a trust responsibility to ensure they have Social Services like healthcare in exchange for taking their land. The Trump administration is not recognizing the legal right Tribes have. They are solely considering Tribes as a racial group as their justification to impose Medicaid work requirements that we know will disproportionately result in less healthcare for Native Americans. This is wrong, illegal, and a dangerous precedent. What happened to the treaties our government signed? What happened to the Federal trust responsibility? And what other social and legal responsibility will they negate next? I will not stand by and watch the sovereignty of our Nation's first people attacked, and neither should you, Mr. Speaker.

Mr. RUIZ

Mr. RUIZ. Madam Chair, I want to thank Chairman Calvert along with our friend and neighbor, Congressman Cook, on this issue which is, quite frankly, a matter of survival for two communities in my district. I submitted an amendment to this Appropriations bill to ensure the city of Banning and the community of Banning Heights can continue to receive water from a conveyance flume that they have relied on for over 100 years. The water from the flume provides 100 percent of the water for the community of Banning Heights and approximately 30 percent of the water for the city of Banning. This isn't a small matter for these communities. In fact, I understand that during times when Banning Heights hadn't received water from the flume, the city of Banning has had to use temporary means to deliver an emergency supply of water to them. This shouldn't even be an issue. The two communities have an undisputed water right and a historic right-of-way to maintain the flume that brings the water to the community. The flume was previously used by Southern California Edison under a hydroelectric permit with the Federal Energy Regulatory Commission. For more than a decade, Edison has been in the process of decommissioning this permit, and the city of Banning and Banning Heights are simply seeking to ensure that the flume can be repaired and maintained and continues to deliver water. Earlier this month, the Forest Service issued a letter stating that they would require the inclusion of new instream flows as a contingency of the issuance of a special use permit just to allow the city to make repairs to the flume. This requirement would mean that in an average year, the two communities would receive no water from the flume on more than 100 days, I repeat, no water for nearly one-third of the year. Additionally, during periods of drought, the Forest Service estimates that the communities could go more than 50 consecutive days during the summer months without water. This is simply unacceptable. While my amendment will not be debated on the floor today, I will continue to work with the Forest Service to resolve this situation in a way that protects the water rights of Banning and Banning Heights and makes sure that any new instream flows do not take away water from communities that need it. Madam Chair, I thank Chairman Calvert again for his attention to this. I ask the gentleman for his commitment to work with me to resolve this critical issue for my constituents.

Mr. RUIZ. Mr. Chairman, I rise as the designee of Congressman Polis, and I have an amendment at the desk.

Mr. RUIZ. Mr. Chairman, I rise today in support of this bipartisan amendment with my colleagues Representatives Polis, King, and Renacci to support the brave men and women who serve as volunteer firefighters. This commonsense amendment would add an additional $2 million for volunteer fire assistance grants. These grants provide matching funds to local and rural volunteer fire departments to assist with training and the purchase of communications and safety equipment. California experienced one of the worst wildfire seasons in history last year, and this year is shaping up to be no different. Volunteer firefighters will provide nearly 80 percent of the initial defense of homes, businesses, and communities in the face of these fires before reinforcement arrives. In my district, where we are under the constant threat of wildfire, departments such as Idyllwild Fire Protection District and the Riverside County Fire Department have benefited from the VFA grant program. These departments provide fire protection services to dozens of rural communities in my district that are at a heightened risk of wildfire due to the sustained drought and heat California is experiencing. The volunteer firefighters who serve Idyllwild routinely overcome significant communications and topographical challenges. Grant programs, like volunteer fire assistance grants, help them respond quickly and effectively to fire emergencies. Throughout the rest of my district, interim Riverside Fire Chief Daniel Talbot has done an excellent job leading the department and preparing for what is already an intense fire season. This week alone, several new fires have sprung up as triple-digit temperatures continue to create a tinderbox across the Western United States. Images of blackened cars and houses reduced to their foundations are already far too common, images we will, unfortunately, only continue to see more of. Despite this constant and recurrent threat, we still fail to treat fires like the devastating natural disasters that they are. The damage caused by wildfires in California, Colorado, and other States has been heartbreaking, and yet we still continue to underfund mitigation, suppression, and prevention efforts for these disasters. Any additional assistance we can provide to those on the front lines to keep our communities safe is our social responsibility to protect the common good, especially when volunteers risk their lives to save our lives without pay. Many of these departments who benefit from the VFA program operate in rural towns on shoestring budgets, so an additional $2 million will go a long way to helping them purchase critical extra equipment. Mr. Chairman, I urge my colleagues to support this bipartisan amendment to give our firefighters the equipment and training they need to keep the public safe. Mr. Chairman, I reserve the balance of my time.

Mr. RUIZ. Mr. Chairman, I certainly appreciate and thank my colleague, who has given his time in fighting fires in his capacity. I thank my colleagues, as well as the chairman and the ranking members for their work on this bipartisan bill. Mr. Chairman, once again, I urge my colleagues to support this bipartisan and commonsense amendment to support the volunteer firefighters who protect our communities, and I yield back the balance of my time.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, this week marks the 49th anniversary of the Stonewall riots in New York City, where, on June 28, 1969, a group of bar patrons led by transgender women of color began to fight for LGBTQ equality. Over nearly 50 years, the LGBTQ community has celebrated many historic victories. In fact, just yesterday, we celebrated the third anniversary of marriage equality becoming the law of the land nationwide. However, while we celebrate LGBTQ Pride Month, it is important to remember we still have a long way to go. In most States, LGBTQ individuals can still get kicked out of their housing, be refused service from restaurants and other businesses, or lose their jobs simply for being who they are. The Equality Act would end this injustice by extending civil rights protections to LGBTQ individuals nationwide. I am a proud sponsor of the Equality Act and urge Speaker Ryan to bring this commonsense bill to the House floor for a vote

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to congratulate Mr. Mike Stutz on his retirement as General Manager of KESQ, CBS Local 2, and KUNA Noticias at Gulf California Broadcast Company in Thousand Palms, California. During his esteemed career, Mr. Stutz always sought the truth throughout his accomplished career in journalism. He has overseen newsrooms in cities across the country--in St. Louis, Missouri; Jacksonville, Florida; Denver, Colorado; and San Diego, California. In his most recent position, he oversaw television and radio news stations across the Coachella Valley, directing the operations of diverse and bilingual news departments that inform my constituents and connect them with their communities. Along the way, Mr. Stutz has won many national awards for excellence in journalism, including two Edward R. Murrow Awards for Overall Excellence and a National Headline Award. His success is a testament to his trust in his reporters, commitment to holding power accountable, and above all, his dedication to the thousands of viewers who have looked to his newsrooms to stay informed about the issues and events that matter most. Mr. Stutz is also a cancer survivor, and since winning his battle against the disease, he has served on the Board of the Leadership, Council of the American Cancer Society in Palm Springs. He has dedicated himself to his community in service to this and other organizations, serving on the Boards of the Boys and Girls Clubs of Coachella Valley, the FIND Food Bank, and the N H & Frances C. Berger Foundation. Mr. Stutz's generosity to his community and tenacity as a reporter have brought light to the lives of so many in our community. In retirement, I am confident he will continue to share his wisdom--as well as spend some well-deserved time with his wife Ellen, three sons Tim, Teddy, and Andy, and five grandchildren. On behalf of the thousands of Coachella Valley residents who have come to rely on the products of his journalistic leadership, I congratulate Mr. Mike Stutz on reaching this milestone, and I wish him a long and happy retirement.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, as an emergency medicine physician, I know firsthand what this devastating opioid crisis does to families, to individuals, to children, to parents. I have taken care of many who have come in overdosed, blue in the face, not breathing, many of which I have been resuscitated successfully and a few tragic losses along the way. I know that many of them rely on being able to get the treatment whenever we are able to convince them to get treatment, but one of the biggest concerns that they have is: How much is this going to cost? Many of them rely on Medicaid to be able to take advantage of some of the rehabilitation and the medication-assisted treatments that are offered to them. But, unfortunately, many of them, being uninsured, are unable to do so, and so then they repeat the cycle of abuse and misuse, and unfortunately, again, they present themselves overdosed in the emergency department. I have an article here that sheds light on the importance of Medicaid. I bring Medicaid up because I feel like we are taking a few good steps forward in this opioid crisis, but we are missing the big picture when we have to defend Medicaid over and over again. Up to 45 percent of opioid-addicted patients rely on Medicaid to get their opioid rehab or misuse treatments to get back on steady footing. There is an article here that I brought by Alana Sharp, et al., that was published in the May 2018 American Journal of Public Health, entitled: ``Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication-Assisted Treatment.'' Basically, by using Medicaid enrollment and reimbursement data from 2011 to 2016 in all States, they evaluated prescribing patterns of opioids and the three FDA-approved medications used in treating opioid use disorders by using two statistical models--I won't bore you with which ones they used--and they found that although opioid prescribing for Medicaid enrollees increased overall, they observed no difference between expansion and nonexpansion. These are States that expanded Medicaid. By contrast, per enrollee rates of buprenorphine and naltrexone prescribed increased more than 200 percent after States expanded eligibility, meaning that States that expanded Medicaid increased medication-assisted treatments for opioid misuse disorders by 200 percent. That means it works. That means when people get Medicaid, they use their Medicaid insurance to help get off of their dependency on opioids. In the States that did not expand Medicaid, only less than 50 percent expansion of use.

Mr. RUIZ. Mr. Speaker, the States that didn't expand their Medicaid enrollment, you saw that there continued to be a disparity of patients between those States and States that expanded their Medicaid in their ability to seek treatment. So when we attempt to cut Medicaid in order to pay for the tax breaks we gave millionaires and billionaires, when we continue down that terrible path--or, I should say, government continues down that terrible path--to repeal the Medicaid expansion, which we must protect, then we are hurting patients. We are not providing them with tools that they need to get access to treatment. The other big picture here is that mental health and emergency care payments are part of the essential health benefits. We have just passed experiences where we had to defend keeping these essential health benefits within the Affordable Care Act from being repealed. We know that those patients who go to the emergency department at their last wits' end or that are suffering from overdose or severe side effects from misuse of the opioid medication, then they won't be covered if we repeal those essential health benefits. And then, finally, having an addiction is a chronic condition. It is a mental health disorder with addiction characteristics, and this can be considered a preexisting illness. We have States that are trying to repeal this through litigation. And when the government decides not to defend those protections for people with preexisting illnesses, they basically agree with those that want to repeal it and allow and facilitate the case to repeal those protections for preexisting illnesses. If that happens and if they are successful in doing so, that means that insurance companies can deny those who are addicted to opioids the insurance. So I just want to keep the big picture in mind as we go forward that taking 2 steps forward doesn't justify taking 10 steps backwards.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise to support H.R. 5605, the Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act. I introduced the bill to give older Americans across our Nation more access to comprehensive addiction treatment services through Medicare. Seniors are frequently prescribed opioids to treat chronic illnesses with constant, lasting pain issues, such as arthritis and other issues related to their musculoskeletal system. The frequency and chronicity of this prescribing puts them at risk of developing a dependency, as seniors are more physiologically vulnerable to experiencing dependency and overdose effects. That is because as you get older your physiology changes, which makes seniors less able to deal with the side effects of opioids and more prone to respiratory depression, the leading cause of opioid-related death. When you consider that roughly one-third of Medicare beneficiaries received an opioid prescription in 2016, with over half a million receiving a high dose, it makes sense that the hospitalization rate related to opioid misuse in patients over 65 has increased by 500 percent in the past two decades. Despite these heightened risk factors, many seniors still do not have access to comprehensive, evidence-based treatment under traditional Medicare, and we cannot leave our seniors behind as we work to address this national crisis. Our seniors deserve access to the gold standard of care for treating opioid addiction. It is that simple. My bill, H.R. 5605, the Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act, will open doors for older Americans to get that gold standard of care by strengthening Medicare for our seniors. My bill does this by creating an alternative payment model demonstration program through Medicare for comprehensive treatment and care programs for opioid misuse disorder and will establish quality measures that reward comprehensive treatment programs that actually produce the best patient outcomes. It works by giving providers and institutions that choose to participate a case management payment, which they would use to provide wraparound services for Medicare beneficiaries. Teams with an addiction specialist would also receive a higher incentive. Seniors participating in this program will receive medication-assisted treatment alongside psychosocial support, such as psychotherapy, treatment planning, and appropriate social services. This coordinated care approach is considered the gold standard of care, and if we want to successfully address this crisis, we need to ensure that individuals have access to treatments that will result in successful outcomes. I have seen firsthand the importance of this with my own patients in the emergency department. Getting medication- assisted treatment is important, and the success of that treatment is enhanced if that patient is also participating in psychotherapy and receiving the appropriate social services. That is why this demo is supported by the American Society of Addiction Medicine and the California Medical Association, among others. It is critical that all Americans, regardless of their age or how much money they make, have access to high quality, comprehensive treatment. My bill will strengthen Medicare so we can help seniors address opioid dependence by ensuring they get the care they need. I also want to thank Ranking Member Pallone and Chairman Walden for their support of this legislation and of our seniors. Also included in my bill is H.R. 3528, the Every Prescription Conveyed Securely Act, introduced by Representative Katherine Clark from Massachusetts, with the assistance of Representative Mullin. I want to thank Representative Clark for her hard work to address this crisis by expanding the use of technology to reduce fraudulent prescribing. Her legislation will direct providers to use electronic prescribing for controlled substances technology for Medicare part D by 2021 to cut down on fraud and overprescribing. Already, seven States have implemented this system in an effort to combat this crisis and keep illicit opioids off the streets. According to the Department of Justice, most fraudulent opioid prescriptions are obtained either through doctor shopping, forged prescriptions, or theft, all of which can be addressed by an effective electronic prescribing for controlled substances system. As amended, my bill, H.R. 5605, will improve care for our seniors and help get illegally obtained opioids off the streets.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to raise awareness about a silent killer that has quickly grown into a public health crisis endangering the lives of millions of Americans. Nonalcoholic steatohepatitis, known as NASH, is a metabolic disease that, if left untreated, can lead to non-alcoholic cirrhosis, liver failure, liver cancer, and even death. The disease is estimated to affect between 3 and 12 percent of all American adults--including as many as 70,000 of my constituents. There are only a few physicians in Congress, and although our constituencies differ, we share a profound and personal connection to the individuals we serve. We also share an understanding that when a threat of this magnitude arises, we must take proactive steps to effectively diagnose and treat the disease. The most difficult part is that NASH is ``silent''; it does not present symptoms until late in the disease's progression. Most Americans with NASH in my district and across the country don't even know they have it. There is no approved cure for NASH and no alternative to an invasive and painful liver biopsy to diagnose the disease, and researchers have yet to get a full understanding of what causes it. With more research and professional awareness, we can start to improve early detection and halt disease progression while waiting for approved effective treatments. This past Tuesday, June 12, marked the first-ever International NASH Day. Medical experts in seven cities across the U.S. joined over 20 international experts in the field of NASH to educate potential patients and other interested stakeholders to increase awareness and improve health outcomes. I ask my colleagues--physician or not--to remain vigilant and work to improve access to information about this disease, ensure access to healthcare, and provide adequate funding levels for research and care. It is the right prescription for a better, stronger, and healthier America.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to congratulate Mr. Kent Braithwaite on his retirement after 39 years of service as a teacher, counselor, and role model for the students of Coachella Valley High School. During his tenure, Mr. Braithwaite has left an indelible impression on countless students. As a social studies and English teacher, an adviser, and a mentor, he has helped countless students prepare for and pursue a college education. More importantly, he instilled in his students a lifelong love of learning. Many years ago, I was one of those students in Mr. Braithwaite's English class. I like to think I tried my best in every class, but Mr. Braithwaite was the kind of teacher who not only taught, but inspired his students to work even harder. He challenged my classmates and me every day, pushing us to write clearly, read carefully, and question the beliefs and assumptions we brought to his classroom. In the Coachella Valley, the region I grew up in and have the privilege to represent, there are still far too many young people who drop out of high school before they can graduate or pursue a higher education. Teachers like Mr. Braithwaite are helping to show these students that they can achieve their dreams by pursuing their education. During his nearly four decades of teaching, Mr. Braithwaite has served his fellow teachers and the Coachella Valley Unified School District in various leadership positions and received prestigious recognitions from the California State Assembly, the House of Representatives, and many local advocacy organizations for his excellence in teaching. Most importantly, he has the gratitude of thousands of Coachella Valley High School alumni. Mr. Braithwaite is joining his wife and fellow teacher, Jennifer Braithwaite, for a well-earned retirement. Over her 38-year career, Mrs. Braithwaite invited Holocaust survivors and Vietnam veterans to speak to her classes, gave out scholarships to her students, and helped bring the Advanced Placement program to Coachella Valley High School. Like her husband, Mrs. Braithwaite has always gone above and beyond to serve her students. On behalf of all the students whose lives Mr. and Mrs. Braithwaite have touched, I would like to offer my sincerest thanks and congratulate them both on their inspiring and meaningful careers. Congratulating Rafael Barboza on His Retirement

Mr. RUIZ. Mr. Speaker, I rise today to congratulate Mr. Rafael Barboza on his retirement after more than 30 years of service as a guidance counselor for the students of Coachella Valley High School. For more than 30 years, Mr. Barboza has spearheaded Coachella Valley High School's efforts to make attending college a reality, leading college application workshops and connecting students with financial aid and scholarship opportunities. He has influenced countless students' lives, and our entire community is grateful for his dedication and commitment to the next generation of leaders. When I was a student at Coachella Valley High School, my goal was to one day attend medical school and become a doctor. That dream often felt very far away, and at times I wondered whether it might come true. If it wasn't for the support and encouragement of my teachers and counselors, especially Mr. Barboza, I do not know whether I would have achieved my lifelong dream of becoming a physician. Mr. Barboza was my guidance counselor and mentor, as he has been for thousands of students over the years. Few people have had such a positive impact on my life. Mr. Barboza drove me to become a better student and a better person. He taught me the value of hard work, integrity, and perseverance. Like me, many students in my congressional district aspire to pursue a higher education but often struggle to afford the application fees, tuition, textbooks, and many other expenses. When the time came for me to apply for college and money was tight at home, Mr. Barboza paid for my application, as I am sure he has done for others. Without his generosity, the first step in my journey towards becoming a doctor would never have been possible. Mr. Barboza has also lent his voice to local and national conversations about the rising cost of higher education. As someone on the front lines of our public school system, I hope he will continue to enrich this discussion with his insights. In recognition of the positive impact he has had on my life and the lives of countless students and alumni of Coachella Valley High School, it was my privilege to host Mr. Barboza as my guest for President Barack Obama's 2015 State of the Union Address. Now, on the eve of his retirement, I am honored to congratulate my counselor and mentor, Mr. Rafael Barboza, on his well-earned retirement and wish him health and happiness in this new chapter of life.

Mr. RUIZ

Mr. RUIZ. Mr. Speaker, I rise today to congratulate Mr. Rafael Barboza on his retirement after more than 30 years of service as a guidance counselor for the students of Coachella Valley High School. For more than 30 years, Mr. Barboza has spearheaded Coachella Valley High School's efforts to make attending college a reality, leading college application workshops and connecting students with financial aid and scholarship opportunities. He has influenced countless students' lives, and our entire community is grateful for his dedication and commitment to the next generation of leaders. When I was a student at Coachella Valley High, my goal was to one day attend medical school and become a doctor. That dream often felt very far away, and at times, I wondered whether it might just be a fantasy. If it wasn't for the support and encouragement of my teachers and counselors, especially Mr. Barboza, I do not know whether I would have achieved my lifelong dream of becoming a physician. Mr. Barboza was my guidance counselor and mentor, as he has been for thousands of Coachella students over the years. Few people have had such a positive impact on my life. Mr. Barboza drove me to become a better student and a better person. He taught me the value of hard work, integrity, and perseverance. Like myself, many students in my congressional district aspire to pursue a higher education, but often struggle to afford the application fees, tuition, textbooks, and many other expenses. When the time came for me to apply for college, and money was tight at home, Mr. Barboza paid for my application, as I'm sure he has done for others. Without his generosity, the first step in my journey towards becoming a doctor would never have been possible. Mr. Barboza has also lent his voice to local and national conversations about the rising cost of higher education. As someone on the front lines of our public school system, I hope he will continue to enrich this discussion with his insights. In recognition of the positive impact he has had on my life, and the lives of countless students and alumni of Coachella Valley High School, it was my privilege to host Mr. Barboza as my guest for President Barack Obama's 2015 State of the Union Address. Now, on the eve of his retirement, I am honored to congratulate my counselor and mentor, Mr. Rafael Barboza, on his well-earned retirement and wish him health and happiness in this new chapter of life.