Paul Tonko

Mr. TONKO

Mr. TONKO. Mr. Speaker, let me just address some of those that aren't as clearly connected. Mr. Garamendi talks about the need to address public health and to address that bending of the cost curve for healthcare. Well, wellness is an important part. If we can reduce the number of asthma cases, we are doing a big share of the activity that is required. Also, one would never expect, perhaps, that the Department of Defense would be out front on this issue. Why? Because they see a population boom around the world, and they see eroding land and crop failure because of drought. Well, they see that as civil unrest. They see it as a situation that can be damaging to the world community. That civil unrest is of great concern to the Department of Defense. So there are these dynamics that seem so disconnected from this overall topic of carbon pollution. And, yes, when people are faced with that direct question--Where are you on carbon pollution?--of course it is the logical thing: Reduce it. Reduce it. It doesn't take that much of an effort. It takes the will to go forward and relate to energy efficiency, relate to greening up our policy, relate to renewable energy, battery development as a linchpin that can provide more certainty and predictability. We have it within our capacity, and I am convinced we will move forward as a House come January addressing this issue that has languished for far too long. Mr. Speaker, I again thank the gentleman for leading us in this discussion this evening. It is critical; it is vitally important; it will save dollars; and it will grow jobs.

Mr. TONKO. Mr. Speaker, as Mr. Garamendi presented that panel with Make It In America, it reminds me that, as you solve this crisis, as you speak to carbon pollution, you are going across so many policy areas: economic development, transportation, health, job training, certainly science and technology, energy and commerce. All of these disciplines. It just travels across all of these areas of activity because the solution is multifaceted. We need to do that. I talk to folks who will say: Gee, my newborn, or the youngest of our family, is struggling with asthma. And they are saying: I hear that asthma is up. I say: Well, have you related it to carbon pollution? The public health cost, the public health impact here is tremendous. So, as we work on this, we are allowing for policy in so many different areas to take hold so that we can go forward with an inclusivity that allows for a lot of work to be done, which generates jobs, oftentimes with research. And research equals jobs--sound, paying jobs.

Mr. TONKO. Absolutely. Coast-to-coast this is an issue. We know that where there are innovative concepts, where there is an embracing of an aggressive agenda like in California, like in New York, there are ways to advance green energy, clean energy, innovation when it comes to efficiency, to make certain that those greenhouse gas emissions are addressed. It is within our control. So the human activity here, the human element, yes, is driving some of this. I know there are those who say I believe in climate change, but not human-inspired. Whether or not you believe that to be true, is it so bad to make cleaner the air we breathe, safer the water we drink, remediate the soils we require? These are important factors that can grow significant jobs in research, prototype development, and in product design. So let's move forward. The evidence is compelling. The temperatures have risen some 1.7 degrees Fahrenheit since 1901. That is major change. The warming, in large part, is due to human activity. The continuation of burning fossil fuels, adding to the greenhouse gas emissions out there, is unacceptable. Sixteen of the last 17 years are the warmest years on record. And there are those saying: Well, it's just a cycle. Well, that is a long stretch of time. There is no sign out there that it is going to stop. There is no pause there as a warning. Basically, the science that we have today, technology continues to advance in a way that enables us to have shelf-ready opportunity, the cleverness, the intellect that we harvest in this country, the intellect that allows us to design and understand concepts like capturing waste heat so that we can get more energy out of traditional designs, is a way to advance this cause. The green power that the gentleman just talked about with my fellow colleague from California, Representative McNerney, these are real. They are not pie in the sky. They are happening as we speak. We just have to show the will and break the pattern that has been just too comfortable for us to go forward and say: Oh, well, it is greenhouse gas emissions. And, yes, there is a lot of damage out there, but that should be telling us we are already paying for greenhouse gas emissions, we are already paying for climate change, and we need to change that saga.

Mr. TONKO. Mr. Speaker, I thank Representative Garamendi for leading us in this Special Order that speaks to an urgency. More and more, people are beginning to recognize that it is within our responsibility to provide for the stewardship of our Earth, of the environment, and to pass it on to generations coming. As you just acknowledged the birth of a grandson, congratulations to Mr. Garamendi and his wife, Patti. It is important, it is incumbent upon us to do that. When we see the denial and the disregard--the denial for science, for climate change as a concept; the disregard for the Earth, the environment, and for public health--it is troublesome. Here we have in recent weeks heard about and presented the U.N. report through the IPCC, the international committee that looks at climate change, and they are indicating that there is precious little time, if any, by which to act--a timeframe that is becoming more and more urgent. It is so important for us to address the science of this issue, to look at the stats, to look at the data that is compelling, that speaks to everything from public health to job creation to a greening up of our thinking so that our policy and our resource advocacy will go toward what is a crisis situation. Just very, very recent, we have witnessed a report on the climate that is under the auspices of the Trump administration where they have responded to the United States Global Change Research Program, a Presidential initiative started by President Ronald Reagan that incorporates, I believe, some 13 agencies and their thinking about climate change. Members of his own cabinet are recommending and advising and he is rejecting. I simply don't understand how we can ask people to utilize their expertise, invest their time and energy into forecasting where we are going to be and where we are, acknowledging where we are, and the work that is needed, and then to walk away from that presentation based on facts and science and data. You have witnessed at your end of the country what has happened with wildfires. I have seen 500-year storms three or four times over in a decade. So the nomenclature is even off target. We are witnessing tremendous damage, loss of lives, property damage, and farming impacts with very rich soil being washed away, erosion of our coastal zones. What more do we need to have as evidence? The Department of Defense; the farming community; the business community; States like California, the gentleman's home state; and New York, my home State, get it. We pull out of a Paris accord because we are not going to be part of an international community--the only industrial nation to pull out of that accord? It is revolting that we will not respond to this issue. As you indicated, we have been talking about this, we have been pushing this leadership since 2010 with the takeover of the House. We began our efforts in 2008 and 2009. We needed to continue to move forward. The efforts to go forward have been thwarted by a resistance to addressing this issue. I find it unacceptable. As we look upon the next few weeks before we take over with the majority in the House, we need to set a very ambitious tone that will move us forward with a number of issues being addressed under the umbrella of climate change. We have witnessed what has happened out there with the economy. We have calculated the hundreds of billions of dollars that are impacted because of public health costs, the damage to property, and the like. We need to move forward. We need to do this based on science and factual evidence that is available, that is at our fingertips. The time for denial is over. The time for disregard is over. The time for action is now. And we need to move forward, even asking as ranker on the Environment Subcommittee of the Energy and Commerce Committee for hearings in this regard, just hearings so that we can take testimony and advance the cause of the action that is required. Those requests have been falling on deaf ears. So we need to do better. We need to move forward with a sound plan and to understand that across the country more and more people are expressing their concern about climate change. They are witnessing it in the news every night. These wildfires have been greater in number, in severity. I believe this is probably the worst in history. So we need to do a lot more.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I thank the gentleman for yielding. Mr. Speaker, all across my district, I have encountered stories of individuals and families whose lives have been irrevocably changed by the scourge of the opioid epidemic: a father who lost his daughter too young and is pouring his grief into advocacy, a former neighbor and a dad who left behind two young children, a young man who is walking the hard path of recovery and showing others how to do the same. These are the stories I hear day in and day out. They fill my heart; they fill my voice. And it is because of them that I am so very proud to cast a vote in favor of H.R. 6 today. It is my hope that this legislation will be another small step for our Nation on its road of recovery from this epidemic. I am particularly proud that this bill incorporates legislation that I have introduced, along with my good friend Representative Ben Ray Lujan of New Mexico, which will provide a meaningful expansion to high- quality addiction treatment by allowing additional healthcare providers, such as nurse midwives, to prescribe buprenorphine, a medication-assisted treatment for opioid use disorder. In addition, this provision will make permanent buprenorphine- prescribing authority for nurse practitioners and physician assistants and allow certain providers to treat more patients in the first year of their license. These changes will make a big difference for individuals struggling from addiction across our country, especially in rural areas, and for vulnerable populations like pregnant and postpartum women and the 13,000 babies born each year with neonatal abstinence syndrome. I also want to highlight the inclusion of my Medicaid Reentry Act into this bill, which aims to improve care for individuals who are leaving jail or prison and reentering a community setting.

Mr. TONKO. These individuals are highly vulnerable to opioid overdose due to lack of effective addiction treatment while incarcerated. By passing this legislation, we will allow States to engage in demonstration projects to improve medical care and transition-related services to Medicaid-eligible incarcerated individuals in the 30 days prior to their release, reducing the risk of overdose as individuals are coming back into the community for a second chance. I truly believe that this provision will transform lives. I thank Ranking Member Pallone, Chairman Walden, and their staffs for their continued efforts in this process. Without their dedicated, bipartisan work, we would not be making this progress today. Mr. Speaker, I urge my colleagues to support H.R. 6.

Mr. TONKO

Mr. TONKO. Mr. Speaker, during this 115th session of Congress, the House lost one of its most passionate souls, the late Representative Louise McIntosh Slaughter. She worked day in and day out with great passion and with great integrity. She understood that it was about trust that was placed into a Member of Congress by the people who have chosen you to be their voice here in Congress. To Louise Slaughter it was important to make certain that government was transparent and accountable, so she drove the Stop Trading On Congressional Knowledge Act, which was dubbed the STOCK Act. I am so proud to have sponsored legislation today that has renamed, in her honor, the STOCK Act. Louise Slaughter worked for transparency in this House. She knew that it was about making lives of the constituents that we represent all the stronger and all the fuller and not enriching our own lives by the trust placed in us. It is an honor to rename the STOCK Act because of her hard work and because of her integrity.

Mr. TONKO

Mr. TONKO. Madam Speaker, I rise today to urge my colleagues to support much needed investments in our Nation's water systems. Earlier this year, EPA estimated some $472 billion is needed to maintain the Nation's drinking water infrastructure over the next 20 years. We have woefully underinvested in drinking water for far too long, and now crumbling pipes and failing systems pose a serious threat to public health and public safety. Later today, the House is expected to vote on S. 3021, America's Water Infrastructure Act, the latest iteration of WRDA. It is a good bill, the result of bipartisan and bicameral negotiations. I am incredibly proud of the work done by both majority and minority members of the Energy and Commerce Committee on H.R. 3387, the Drinking Water System Improvement Act, which was reported out of committee unanimously in July of 2017. Nearly all of that bill has been incorporated into S. 3021. I would like to highlight a number of the provisions that I am pleased were included in the final package. Since 2014, I have introduced legislation to reauthorize the Drinking Water State Revolving Fund, the primary source of Federal funding for our water systems. Since its creation, the program has never been reauthorized, and funding has been flat, despite the growing needs in our communities. S. 3021 would increase the authorization from $1 billion annually until it reaches a $1.95 billion level in fiscal year 2021. In addition to providing significantly increased funding through the SRF, I want to mention a number of other provisions. First, WRDA makes numerous important changes to the SRF program, including extending the length of loans from 20 to 30 years, and up to 40 years for disadvantaged communities, while increasing the set-aside for these communities by raising the maximum and, importantly, instituting a minimum amount of assistance. It provides $125 million annually to support State water offices through the Public Water Systems Supervision grant program. It seeks to improve the availability of compliance data submitted by water systems and States. It promotes better asset management practices, improves consumer confidence reports, and reauthorizes the Source Water Petition Program. It includes funding for EPA to review methods and technologies to prevent and detect leakage, contamination, and other problems. It requires Buy America standards for SRF projects through fiscal year 2023 and prevailing wage standards to ensure that American workers are benefiting from these investments. It provides funding for systems to conduct risk assessments of their resilience to extreme weather. It establishes a grant program to help schools and daycare centers replace water fountains containing lead components. Also related to lead, it requires future EPA needs assessments to include the cost of replacing lead service lines. I know a number of communities are dealing with emerging contaminants, such as PFOA and PFOS. Currently, only systems serving more than 10,000 people are required to test for unregulated contaminants. This bill requires water systems serving over 3,300 people to monitor for these contaminants, empowering local residents to take action to mitigate serious health threats that they may not have known existed otherwise. This would mean that thousands of communities, communities like Hoosick Falls, New York, and similarly sized systems would no longer have emerging contaminants go undetected, potentially threatening their residents for years. Finally, while not included in the committee-passed bill, WRDA authorizes $100 million for areas hit by natural disasters to repair their water systems, enabling post-Maria Puerto Rico to access funds without the financial burden of State matching requirements. This is not an exhaustive list of provisions in this title, but it gives a sense of the breadth of policies that were included to improve the Safe Drinking Water Act. This bill is not a clean water silver bullet, but it will put us on the path to end the decades of neglect of our water infrastructure and make the investments needed to maintain and upgrade our systems in order to protect public health. I want to thank my colleagues, Representative Harper, Chair Shimkus, Chair Walden, and their staffs for working with our side of the aisle on this legislation. I want to acknowledge the contributions of our ranking member Representative Frank Pallone, Jackie Cohen, Jean Fruci, and Rick Kessler, and other members of the Energy and Commerce minority staff for their hard work. I always say that every life and every job in this country depends on access to safe drinking water. The needs are great and the cost of inaction is high. Today, Congress has the opportunity to act. I urge my colleagues to support America's Water Infrastructure Act and for the Senate to take it up immediately

Mr. TONKO

Mr. TONKO. Mr. Speaker, I rise to give a voice to millions of Americans who are at risk of being overlooked in our Nation's response to the opioid epidemic, America's youth. Our Nation's opioid crisis knows no boundaries of geography or demographics, and age--age--is no exception. One of four individuals under the age of 20 has been prescribed opioids at some point in life, and 2.2 million young people between the ages of 20 and 24 abused opioids in the last year. Opioid abuse early in life often leads to poorer academic performance, more negative health outcomes, and higher rates of future drug use. In order to prevent the next generation of drug abuse, we have to ramp up our investment in critical programs like drug-free communities grants and substance abuse prevention and treatment block grants. We can also help young people build resilience by supporting our school-based health centers, where students are able to get healthcare in a convenient setting. When students are empowered to meet with healthcare providers, ask questions, and receive needed care, they can become powerful advocates in turning the tide of this epidemic around.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise to support H.R. 3994, the Advancing Critical Connectivity Expands Service, Small Business Resources, Opportunities, Access, and Data Based on Assessed Need and Demand Act, or in short, ACCESS BROADBAND Act. Mr. Speaker, I thank the chair and ranking member for moving this measure forward, and offer special thanks to my friend, Representative Lance, for partnering with me on this legislation. I also thank the bipartisan group of Members who have cosponsored this legislation, including 14 members of the Energy and Commerce Committee who have worked together and who agree that these are vital steps worth taking. This bill is about serving the people. My own constituents continue to reach out about their limitations of access to broadband internet throughout the capital region. Some of these areas are rural and many are underserved and unserved entirely. Other areas are underserved with a few houses having access, while many others are left with no affordable options in sight. Constituents ask: When will we get access? What about western Schenectady County? What about Amsterdam? What about Berne? What about Fort Johnson? What about western Saratoga County in the 20th Congressional District? I have heard from doctors who depend on broadband internet to read X- rays when they are on call. I hear from librarians who find students sitting in the library parking lot after hours so that they can access the internet and finish their homework assignments. I hear from workers who are forced to leave home to find high enough internet speed that they can upload or download large files. They all ask: When will we have access? As a Congress, we owe these folk an answer. A lack of access to broadband internet in the capital region is one of many reasons I pushed to join the Energy and Commerce Committee and why I have worked to advance this legislation. This bill is the first part of that answer. H.R. 3994, the Advancing Critical Connectivity Expands Service, Small Business Resources, Opportunities, Access, and Data Based on Assessed Need and Demand Act, the ACCESS BROADBAND Act, would establish a coordinating office for Federal broadband resources. It would use existing resources to streamline management of Federal broadband resources across multiple agencies and simplify the process for small businesses and local economic developers to access them. Currently, there is no comprehensive system that tracks where Federal dollars are going and how the funding is impacting communities. Investments are made with little accountability and oversight on behalf of the taxpayer. ACCESS BROADBAND, as an act, would begin to address the issues. This bill would track Federal broadband dollars and streamline management of Federal broadband resources across multiple agencies. Most notably, it would simplify the process for small businesses and local economic developers to access them. There is still much more work to be done on this issue. I do hope that this can serve as a starting place for us to open doors of opportunity and access for the millions of Americans who require the better and improved outcomes by investing in broadband expansion. I thank all of the members and staff working together on ACCESS BROADBAND, helping ensure that our communities can access the broadband resources they need to grow and to prosper. Mr. Speaker, I urge a ``yes'' vote on this bill, and I reserve the balance of my time.

Mr. TONKO. Mr. Speaker, I have no other speakers on my side. If the other side is ready to close, I yield back the balance of my time.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I ask unanimous consent to amend the rule to make in order the Quigley amendment to restore funds to prevent Russian interference in our elections.

Mr. TONKO. Mr. Speaker, I thank the gentleman for yielding. Americans across our country are very much suffering the negative effects of climate change. They expect Congress to respond with a plan. We may not agree on all the details, but our constituents deserve a serious debate. This resolution is not serious. It reflects an extreme rightwing climate inaction plan: embrace denial, sow disinformation, and cash checks from polluters. This resolution reveals the hypocrisy of the Republican energy strategy. They claim to care about innovation, but support budget cuts to critical research programs like ARPA-E and EERE. They claim to care about economic growth, but ignore the millions of jobs that have been created in the clean energy universe and fail to see the opportunities to add millions more. They claim to care about low-income Americans, but cheer the rollback of environmental standards that would protect them. They claim to support free markets, but fail to speak out when President Trump suggests unprecedented market interventions to bail out uncompetitive coal plants at great expense to Americans, especially manufacturers. Make no mistake: greenhouse gases are serious pollutants that will have long-term consequences. America needs a climate plan, not a love letter to polluters. Members that support this resolution are sending a clear message to the American people that they care more about polluters' interests than the people we are asked to serve. Mr. Speaker, I urge my colleagues to reject this misguided resolution.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I rise to congratulate an extraordinary constituent, Dr. Maria Delores Cimini, who was recently awarded the Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring by the National Science Foundation. As a leader and mentor, Dr. Cimini has helped countless individuals, especially women with disabilities, study science, technology, engineering, and mathematics. Drawing on her background as a psychologist and her own experience living with a visual disability, she has paved the way for many to follow their curiosity and realize their potential through STEM education. Dr. Cimini currently works as an Adjunct Clinical Professor in the School of Education at the University at Albany, a position she's held for more than 20 years. She has also served as Assistant Director for Prevention and Program Evaluation of the University's Counseling Center for more than 10 years. Our National Institutes of Health and the U.S. Department of Education have both recognized Dr. Cimini with numerous awards for her extraordinary work. In 2012, President Obama recognized her in a White House ceremony as a ``Champion of Change in STEM.'' Her repeated national recognition reflects her enduring work that has changed the lives of so many. I am honored to congratulate Dr. Cimini for earning her most recent impressive distinction, and thank her for her selfless commitment to serving and educating others. We can all learn from her example.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I rise to herald the achievements of a brilliant young constituent, Priyanka Kumar. As a volunteer at a medical research lab, Priyanka assisted in developing human skin grafts using 3D print technology that could be used to treat burn victims. Last week her exceptional spirit of volunteerism earned her a Congressional Award Gold Medal. A resident of Latham, NY, Priyanka has also worked closely with her STEM peers to create a mental health awareness initiative and has tutored local children in an array of subjects. She has said working with other women in STEM is especially gratifying, and she takes great pride in her commitment to breaking stereotypes in this male-dominated field. Priyanka also showed exceptional ingenuity in service of others by using computer programming tools to identify tweets from people requesting aid during natural disasters, to make hospitals safer by reminding doctors to use hand sanitizers, and to master machine- learning algorithms that detect cancer in the human genome. Priyanka described receiving the Congressional Award as an amazing experience that taught her the importance of giving back to a community. Well done, Priyanka. Her future is incredibly bright, and her friends, family and all of us in her community are very proud of all that she has accomplished

Mr. TONKO

Mr. TONKO. Mr. Speaker, I have a motion to recommit at the desk.

Mr. TONKO. I am opposed in its current form.

Mr. TONKO. Mr. Speaker, this is the final amendment to the bill, which will not kill the bill or send it back to committee. If adopted, the bill will immediately proceed to final passage, as amended. For more than a year and a half, Republicans in the House have been engaged in an all-out ideological assault to weaken healthcare for Americans by working to repeal the Affordable Care Act and gutting protections for preexisting conditions. Republicans have repeatedly voted to strip Medicaid coverage for millions struggling with addiction. Thanks to Republican policies, we are seeing this uninsured rate rise sharply for the first time in years. This attack on our healthcare has had serious consequences for our ability to adequately address the needs of those struggling with the opioid epidemic. I remind my friends that we can't have it both ways: We either are for fighting this epidemic every way we can, or we are not. I have seen the carnage this epidemic can produce in my own backyard, where my hometown of Amsterdam, New York, with a population of a little over 18,000 people, saw four overdose deaths and a dozen close calls within a single month. We know that, as of today, less than 20 percent of Americans who need substance abuse treatment are able to receive it. We need to move toward a system of treatment on demand so that, when an individual has that moment of clarity, we are ready with a helping hand to pull them away from the deadly grip of addiction. While I am pleased that the bill before us will make some incremental progress in our fight against the opioid epidemic and is the product of a significant amount of bipartisan work, every single Member of this Chamber knows that we can and we should be doing more. This motion to recommit is our chance to do just that and to make additional progress in this fight. First, the motion would invest in our addiction workforce by incorporating a proposal advanced by Representatives Crowley and Costello to add 500 new resident physician slots to hospitals that have developed or are developing training programs in addiction medicine, addiction psychiatry, or pain medicine. We all have seen firsthand the need for more addiction specialists out there, and we have a chance to take action on that right now. Secondly, this motion would allot an additional $1 billion annually to States through 2021 so that we can continue to invest in locally designed prevention, treatment, and recovery solutions. It is clearly going to take more than 2 years to battle the epidemic, and we need to let providers in States know that we are making sustained, meaningful investments in this area. Finally, our motion to recommit includes a commonsense prescription drug policy which will reduce prescription drug prices for all Americans by reducing gaming by drug manufacturers to prevent generics from coming to market. The CREATES Act, introduced by Representatives Marino and Cicilline, is estimated to save the Federal Government some $3.8 billion and patients far more. This legislation has been passed by the Senate Judiciary Committee on a bipartisan basis, but we have been denied a vote on the House floor to consider this practical, positive policy to halt pharma gaming and mischief. Each of the policies contained in this package is bipartisan, fully paid for, and would bolster our ability to respond to the crisis. We have the opportunity to provide a more robust response for the American people and to save the lives of countless of our friends and neighbors all across this country who could be the next to fall victim to this deadly disease of addiction. Every day, every week, every month, every year that passes, the challenge rests in our collective laps: Will we do more? We need to do more. Let's do it for those families living with the pain and loss. Let's do it for those individuals who struggle with the illness of addiction. Let's be the light, the candle that brightens their darkness. Let's go forward with the recovery that is inspired by this legislation. Mr. Speaker, I urge all of my colleagues on both sides of the aisle to support this motion to recommit, and I yield back the balance of my time.

Mr. TONKO. Mr. Speaker, on that, I demand the yeas and nays.

Mr. TONKO. Mr. Chair, I thank Chairman Walden for yielding. Although I know my colleague plans to withdraw, I rise in opposition to this amendment, and I just want to articulate a bit of my reasoning. I think my colleagues and I both share the same goal of safely expanding access to addiction treatment. Where we differ is that I believe that the provisions in H.R. 6 expanding buprenorphine prescribing privileges to advanced practice nurses meet that test. We all know that there is a dire need for expanded treatment capacity to meet the demands of this current epidemic. As many as 40 percent of counties across the country lack even a single provider that is able to offer buprenorphine. Advanced practice nurses play an outsized role in providing care in rural America, and H.R. 6 will help expand addiction treatment capacity into these communities where it is most needed. Expanding buprenorphine prescribing privileges to APRNs is supported by medical groups that serve on the front lines of this epidemic, such as the American Society for Addiction Medicine and the American Congress of Obstetricians and Gynecologists. All advanced practice nurses who wish to prescribe medication- assisted treatment would have to receive a special waiver from the DEA and would have to undergo three times as much specialized addiction training as their physician colleagues. In addition, in order to receive a waiver, practitioners are required to be able to provide appropriate counseling and ancillary services that are the hallmark of high-quality addiction treatment. All APRNs wishing to prescribe buprenorphine would still be subject to State laws regarding prescription authority, scope of practice, and collaboration or supervision requirements with a physician. While I understand that providing addiction treatment is a complex and nuanced area of medicine with potential complications if done poorly, I would point out that we don't restrict advanced practice registered nurses in Federal law from providing such high-risk services as delivering babies, administering anesthesia, or prescribing as many opioids as they wish. Why would we want to maintain an outdated barrier in Federal law that prevents these practitioners from being part of the solution to the opioid epidemic? So in closing, I appreciate that my colleagues are withdrawing this amendment today, and I would urge that, as we move forward toward a potential conference committee, we continue to recognize the role that advanced practice nurses can play in addressing this epidemic.

Mr. TONKO

Mr. TONKO. Mr. Chairman, I thank the gentleman from New Jersey for yielding. Mr. Chairman, I rise in support of H.R. 6, the SUPPORT for Patients and Communities Act. The SUPPORT for Patients and Communities Act incorporates legislation that I introduced along with my good friend and colleague, Representative Ben Ray Lujan of New Mexico, which will provide a meaningful expansion to addiction treatment across our country, especially in rural areas, and for vulnerable populations like pregnant and postpartum women and the 13,000 babies born on average each year with neonatal abstinence syndrome. Our legislation includes three main policy changes to expand access to treatment. First, it eliminates the current sunset provision that would prohibit nurse practitioners and physician assistants from treating patients with addiction medicine after 2021. By ending this sunset, we can provide certainty to our healthcare community and encourage more NPs and PAs to become part of the addiction treatment workforce. Second, this legislation would expand the classes of practitioners eligible to prescribe buprenorphine to other advanced practice nursing professionals to include nurse midwives, clinical nurse specialists, and certified nurse anesthetists. This provision was included based on feedback that my office has received from medical groups such as the American Society of Addiction Medicine and the American College of Obstetricians and Gynecologists who are on the front lines of this crisis who have made the case that adding additional classes of highly skilled nurses can help more people access treatment and find that important road to recovery. In many rural areas, advanced practice nurses play an outsized role in providing care, and this legislation will help expand addiction treatment capacity in these rural areas where it is most needed. In addition, these advanced practice nursing professionals are already providing primary care for some of our most vulnerable populations: pregnant and postpartum women. By allowing these skilled providers to provide addiction treatment as well, we can bolster continuity of care for our moms and for our babies. Finally, our legislation would make a technical change that would allow DATA 2000 waivered providers to treat up to 100 patients in their first year if they possess additional credentialing or are practicing in a qualified practice setting. Taken together, these three changes will make a meaningful difference in moving toward a system of treatment on demand for individuals struggling with the disease of addiction. To those who would say we need more data or we need to be cautious about expanding access to treatment, I would respond that more and more people are dying in our streets every day. We don't have time to drag our feet any longer. Finally, I want to thank Ranking Member Pallone, Chairman Walden, and their staffs for the continued efforts on these provisions through many months of back and forth. In a personal way and a very upfront way, let me thank Representative Pallone, our ranking member, and his outstanding staff for the intellect and the energy they poured into this because it truly made this a better bill, and it is going to save lives. Mr. Chairman, I urge my colleagues to support H.R. 6.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I thank the gentleman for yielding. This week marks 100 days until the expiration of the Land and Water Conservation Fund authorization. The LWCF has assisted New York State in many, many ways over its 50 years to protect some of New York's most special places and ensure recreational access for hunting, fishing, and other outdoor activities. Both the House and Senate have currently introduced bipartisan bills to permanently reauthorize the LWCF. I am a proud cosponsor of the House bill, H.R. 502, and I urge the House leadership to bring it up for a vote. Some examples of special places in New York's 20th Congressional District include Thatcher Park in Albany, Frear Park development in Troy, the bike-hike trail in Glenville, Schenectady, Niskayuna, Peebles Island, Congress Park in Saratoga, and Mohawk Mills Park in Amsterdam.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I thank the gentleman from Massachusetts for yielding. Mr. Speaker, I rise in strong support of the Medicaid Reentry Act, and I urge all Members to support its swift passage in the House. This bill is about saving lives, pure and simple. 64,000 Americans died of a drug overdose in 2016, more than were lost at the peak of the HIV/AIDS crisis. Based on data from the States, we can estimate that as many as 10,000 of those deaths annually are individuals who have had some interaction with the criminal justice system in the previous year. This is a national emergency that demands immediate action. Individuals who are returning to society after a stay in a corrections facility are particularly vulnerable to overdose deaths. Research has found that formerly incarcerated individuals reentering society are 129 times more likely to die of an overdose during their first 2 weeks back into the community than the general population. The risk of overdose is elevated during this period due to reduced physiological tolerance for opioids among the incarcerated population, a lack of effective addiction treatment options while incarcerated, and perhaps poor care transitions back into their given community. According to the Bureau of Justice Statistics, roughly 60 percent of our incarcerated population has a substance use disorder, yet only around one-quarter of those are receiving any type of treatment. Even for those receiving treatment, out of the roughly 5,000 jails and prisons in our country, fewer than 40 provide medication-assisted addiction treatment using methadone or buprenorphine, which, along with naltrexone, is considered the gold standard in treating opioid use disorder. Those that do offer full-scale MAT services are seeing results. I have seen firsthand the success of a MAT program called SHARP at the Albany County Correctional Facility in upstate New York where individuals shared anecdotes with me about how access to treatment has transformed their lives for the better. We have seen even more compelling data from the State of Rhode Island, where a comprehensive addiction treatment program offering access to all FDA-approved forms of medication-assisted treatment in State corrections facilities was able to lower deaths in the first year post-release by a staggering 61 percent. My legislation would open the door to more of these success stories and is designed to increase State flexibility in the Medicaid program to address the vulnerable population during the 30 days prior to an individual's release. As amended, the Medicaid Reentry Act would require the Secretary of Health and Human Services to release guidance to State Medicaid Directors on demonstration opportunities that would allow States to waive the current Medicaid inmate payment restriction during this prerelease period so that individuals could better access mental health and addiction care and have an improved care transition back into the community. By passing this bill, we can allow States to expand innovative approaches to reentry that are already underway in places such as New York, Ohio, New Mexico, and Rhode Island. I thank Energy and Commerce Chair Greg Walden and Ranking Member Pallone and their staffs for the constructive collaboration on this bill. I also thank my Republican colleague Representative Mike Turner for his efforts to help shine a light on this vulnerable population. In closing, Mr. Speaker, while I would have liked to have gone even further with this effort, I believe that this smart-on-crime legislation will plant the seeds for meaningful change and will help to give individuals reentering society a fighting chance to live a healthier, drug-free life. Mr. Speaker, I urge my colleagues to support this legislation.

Mr. TONKO

Mr. TONKO. Mr. Speaker, on June 15, 2018, I was not present and voting in the House of Representatives. Had I been present for roll call vote 267, I would have voted no. Had I been present for roll call vote 268, I would have voted no.

Mr. TONKO

Mr. TONKO. Mr. Speaker, I thank Representative Pallone for yielding. Mr. Speaker, I rise in support of the TEACH to Combat Addiction Act, which I joined with my friend from Ohio, Representative Bill Johnson, in introducing. One of the biggest challenges that is facing us in the midst of this opioid epidemic is the lack of high-quality addiction treatment in many parts of our country. Only one in five individuals with opioid use disorder is able to access any type of treatment. In many instances, individuals struggling with addiction can be placed on waiting lists for months or years before they are able to see an addiction professional. That is simply not right. When we place barriers and roadblocks between patients and their care, we know that these delays can be deadly. We need to move toward a system of treatment on demand so that, when an individual is crying out for assistance, when that person has that moment of clarity, there is a helping hand ready to meet them. This legislation helps us in a way that moves us in that direction by investing in our addiction infrastructure. The TEACH to Combat Addiction Act would create centers of excellence in substance use disorder education that would be charged with developing and disseminating model curricula to train our next generation of medical professionals on the practice of addiction. Empowering our healthcare workforce to better understand and effectively prevent and treat substance use disorder will yield dividends in our fight against the opioid epidemic. I am proud to work with Representative Johnson on this critical legislation that will strengthen the tools and information we use to educate the next generation of healthcare professionals, and I strongly urge all Members to support this critical legislation.