    [House Hearing, 115 Congress]
    [From the U.S. Government Publishing Office]

          NOW HIRING: HOW THE OPIOID EPIDEMIC AFFECTS SMALL BUSINESSES

    =======================================================================

                                    HEARING

                                   BEFORE THE

                          COMMITTEE ON SMALL BUSINESS
                                 UNITED STATES
                            HOUSE OF REPRESENTATIVES

                         ONE HUNDRED FIFTEENTH CONGRESS

                                 SECOND SESSION

                                   __________

                                  HEARING HELD
                               SEPTEMBER 13, 2018

                                   __________

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

                Small Business Committee Document Number 115-089
                 Available via the GPO Website: www.govinfo.gov

                                   __________

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                       HOUSE COMMITTEE ON SMALL BUSINESS

                          STEVE CHABOT, Ohio, Chairman
                                STEVE KING, Iowa
                          BLAINE LUETKEMEYER, Missouri
                              DAVE BRAT, Virginia
                 AUMUA AMATA COLEMAN RADEWAGEN, American Samoa
                            STEVE KNIGHT, California
                            TRENT KELLY, Mississippi
                                 ROD BLUM, Iowa
                             JAMES COMER, Kentucky
                     JENNIFFER GONZALEZ-COLON, Puerto Rico
                        BRIAN FITZPATRICK, Pennsylvania
                             ROGER MARSHALL, Kansas
                          RALPH NORMAN, South Carolina
                               JOHN CURTIS, Utah
                   NYDIA VELAZQUEZ, New York, Ranking Member
                           DWIGHT EVANS, Pennsylvania
                           STEPHANIE MURPHY, Florida
                            AL LAWSON, JR., Florida
                            YVETTE CLARKE, New York
                              JUDY CHU, California
                           ALMA ADAMS, North Carolina
                          ADRIANO ESPAILLAT, New York
                            BRAD SCHNEIDER, Illinois
                                     VACANT

                   Kevin Fitzpatrick, Majority Staff Director
          Jan Oliver, Majority Deputy Staff Director and Chief Counsel
                         Adam Minehardt, Staff Director

                                C O N T E N T S

                               OPENING STATEMENTS

                                                                       Page
    Hon. Steve Chabot................................................     1
    Hon. Nydia Velazquez.............................................     2

                                   WITNESSES

    Mr. Ben Gitis, Director of Labor Market Policy, American Action
      Forum, Washington, DC..........................................     4
    Ms. Katie Van Dyke, Director, Ohio Small Business Development
      Center, Cleveland State University, Cleveland, OH, testifying
      on behalf of America's SBDC....................................     5
    Ms. Lisa Allen, President & CEO, Ziegenfelder Company, Wheeling,
      WV.............................................................     6

                                    APPENDIX

    Prepared Statements:
        Mr. Ben Gitis, Director of Labor Market Policy, American
          Action Forum, Washington, DC...............................    17
        Ms. Katie Van Dyke, Director, Ohio Small Business Development
          Center, Cleveland State University, Cleveland, OH,
          testifying on behalf of America's SBDC.....................    31
        Ms. Lisa Allen, President & CEO, Ziegenfelder Company,
          Wheeling, WV...............................................    35
    Questions for the Record:
        None.
    Answers for the Record:
        None.
    Additional Material for the Record:
        None.

          NOW HIRING: HOW THE OPIOID EPIDEMIC AFFECTS SMALL BUSINESSES

                                  ----------

                          THURSDAY, SEPTEMBER 13, 2018

                      House of Representatives,
                   Committee on Small Business,
                                                        Washington, DC.
        The Committee met, pursuant to call, at 11:00 a.m., in Room
    2360, Rayburn House Office Building. Hon. Steve Chabot
    [chairman of the Committee] presiding.
        Present: Representatives Chabot, Knight, Blum, Fitzpatrick,
    Marshall, Balderson, Velazquez, Evans, and Lawson.
        Chairman CHABOT. The Committee will come to order. I want
    to thank everyone for being here today.
        The American economy is soaring. Significant growth is
    occurring as we speak and Americans, especially entrepreneurs,
    are once again optimistic about the future of their businesses.
    Just two days ago the National Federation of Independent
    Business Small Business Optimism Index soared to a new record
    high in the survey's 45-year history, showing that small
    businesses are finally feeling confident and are ready and
    willing to execute plans to grow their businesses. However,
    many small businesses are now facing a new challenge in
    finding, hiring, and retaining qualified workers. The NFIB also
    noted that 62 percent of small businesses reported trying to
    hire new employees with 89 percent of those businesses
    reporting finding few or no qualified applicants. A record 25
    percent of small businesses cited the difficulty of finding
    qualified workers as their single biggest problem, up 2 points
    from just last month.
        Today, we are here to examine why that might be. In recent
    Small Business Committee hearings, we have heard reports about
    how the opioid epidemic is impacting small businesses across
    this nation. Driven by the rise in opioid prescriptions and the
    influx of illegal opioid drugs into communities, drug addiction
    has grown in the United States in recent years. The opioid
    epidemic touches families and communities all across this
    country, so much so, in fact, that President Trump declared the
    epidemic a public health emergency almost one year ago today.
    We have seen that the opioid crisis has the ability to impact
    businesses, too. Many young working age Americans are not
    working or actively seeking work as a result of opioid
    addiction, impeding the ability of businesses to fill important
    job openings. In 2015, an estimated two million workers were
    not in the labor force due to the opioid epidemic. According to
    a recent report by the National Safety Council, more than 70
    percent of United States employers have been affected by
    employees' prescription drug use.
        We want to hear from our witnesses today and we appreciate
    that they have taken time away from I am sure important
    obligations that they have and their busy schedules to share
    their expertise with us on this very important topic, and we
    look forward to having a very productive discussion here this
    morning. So we want to thank you for being here.
        And I would now want to recognize the Ranking Member, Ms.
    Velazquez, for her opening statement.
        Ms. VELAZQUEZ. Thank you, Mr. Chairman. America's economy
    has improved since the Great Recession and unemployment is at
    an 18 year low. But while most signs of economic gains are
    promising, the labor participation rate has been on a decade's
    long decline.
        As in previous hearings, we have heard what a challenge the
    workforce decline has had on small firms all over the country.
    With low unemployment rates, small employers are reporting
    difficulty finding qualified and skilled workers. Analyzing the
    United States workforce reveals two areas of concern, an
    existing skills gap among workers and a shrinking workforce.
    These problems are magnified by the opioid crisis. More than
    two million people struggle with opioid addiction, which is now
    one of the deadliest public health crises in modern history.
    This epidemic is not only wreaking havoc on our communities but
    also ravaging our workforce. In the last 15 years over 20
    percent of the decrease in labor participation can be
    attributed to the increase in opioid prescriptions. For
    businesses, this reality has real consequences. If we are
    unable to meet the demand for trained workers it will weaken
    our ability to compete globally.
        For individuals this reality has even more devastating
    consequences. In 2016 opioid overdoses killed more than 42,000
    Americans, more than car crashes and guns combined. And those
    addicted to opioids are three times less likely to have
    completed post secondary education, adding an additional
    barrier to reentering the workforce. This epidemic begs the
    question of how we address the skills gap to get qualified
    people back into the workforce to fill these jobs.
        It is critical to reengage adults who have left the labor
    force due to opioid addiction. Access to treatment must be
    widely available from drug rehab and medical interventions to
    non addictive alternatives to pain management. According to
    NIH, the most successful addiction treatment programs teach
    coping skills, mobilize community forces, and instill values
    toward pro social behaviors, such as meaningful jobs. Such
    efforts are a critical part of today's discussion for both
    economic and addiction recovery.
        Too many American workers have been left behind because of
    addiction, to the detriment of small firms and entire families.
    To assemble the workforce that American businesses need to
    thrive, policy makers, educators, and businesses need to
    collaborate to find a solution to the opioid epidemic.
        I look forward to today's hearing and I thank the witnesses
    for being here today. Thank you.
        Mr. Chairman, I yield back the balance of my time.
        Chairman CHABOT. Thank you very much. The gentle lady
    yields back.
        And before I introduce our witnesses and go into our timing
    rules, I would like to recognize we have a new member of our
    Committee, Troy Balderson, who is from the great State of Ohio,
    which happens to be my State. He came to Congress replacing Pat
    Tiberi and prior to that, that District had been held by John
    Kasich, who is the current Governor of Ohio. And Troy was sworn
    in just last week. We are delighted that he was selected for
    the Small Business Committee, a most important Committee in the
    House. And his experience as a State Senator and being involved
    in two family-owned businesses will be a great asset to this
    Committee. So we welcome him here.
        And if Committee members have an opening statement
    prepared, I ask that they be submitted for the record. Without
    objection, so ordered.
        And I will take just a moment to explain our timing rules.
    They are pretty simple. You get 5 minutes. And there is a
    lighting system to assist you. The green light will be on for 4
    minutes, the yellow light will come to let you know you have
    got a minute to wrap up, and then the red light will come on
    and we would ask that you try to end your statement. At that
    time, if you need a little time to wrap up, that is okay.
        And I would now like to introduce the witnesses. And we
    will begin with our first witness, Mr. Ben Gitis, who is the
    Director of Labor Market Policy at the American Action Forum.
    He has written extensively about the opioid crisis and his work
    has been referenced by news publications such as the Wall-
    Street Journal, the Washington Post, and many others. We thank
    you for being here today.
        Our second witness will be Ms. Katie Van Dyke, who is the
    Director of the Ohio Small Business Development Center, or
    SBDC, at Cleveland State University in Cleveland, Ohio. In this
    role, Ms. Van Dyke works to provide free training and advice to
    startups and entrepreneurs and existing businesses seeking to
    scale and grow. And we thank you for being here.
        And I would now like to yield to the Ranking Member for
    introducing our third and final witness.
        Ms. VELAZQUEZ. Thank you, Mr. Chairman. It is my pleasure
    to introduce Ms. Lisa Allen, President and CEO of Ziegenfelder
    Company, a privately held family owned business in Wheeling,
    West Virginia. Her company manufactures and sells Budget Saver
    popsicles. In the past 10 years the company has grown from 75
    employees to over 300 across 3 locations. Ms. Allen has been
    widely recognized for her compassionate hiring practices and
    dedication to her local communities. Welcome, Ms. Allen. Thank
    you for being here.
        Chairman CHABOT. Thank you very much. And we welcome you.
        And, Mr. Gitis, you are recognized for 5 minutes.

       STATEMENTS OF BEN GITIS, DIRECTOR OF LABOR MARKET POLICY
      AMERICAN ACTION FORUM; KATIE VAN DYKE, DIRECTOR, OHIO SMALL
     BUSINESS DEVELOPMENT CENTER LAKELAND COMMUNITY COLLEGE; LISA
              ALLEN, PRESIDENT & CEO, ZIEGENFELDER COMPANY

                         STATEMENT OF BEN GITIS

        Mr. GITIS. Chairman Chabot, Ranking Member Velazquez, I am
    pleased to be here.
        A few months ago I was in Boston for an opioid event and
    there was a construction business owner who told us the story
    where he was at a job fair and he told a room full of people if
    you can pass a drug test you have a job. Half the room left. We
    have heard stories like these from small business owners
    countless times. And it has made me interested in gauging just
    how many workers could be out of the labor force due to opioid
    dependence.
        And so my work at the American Action Forum has focused on
    three main areas. First, I just wanted to identify what is the
    source of this crisis and why are overdose fatalities rising.
    And I found from 1999 to 2010 prescription opioids were really
    the source of rising dependence and rising overdose fatalities.
    The supply of prescription opioids grew, and along with it was
    a growth in prescription opioid involved overdoses. But in 2010
    there as a pretty major shift in response to several policy and
    private sector initiatives. The supply of prescription opioids
    peaked and then began to decline. Along with it, overdose
    fatalities caused by those drugs flat lined, but overdose
    fatalities caused by illegal drugs like heroin and illegal
    synthetic opioids both spike. And that is why today we are
    seeing an acceleration in the total number of opioid overdose
    fatalities.
        Second, my research has quantified the number of workers
    nationwide who are out of the labor force and what that means
    for the U.S. economy. I estimate that between 1999 and 2015 the
    prime age labor force participation rate--that is people 25-
    54--that rate declined by 1.6 percentage points. That means
    that in 2015 two million workers were absent from the labor
    force due to opioids. It also means that it was a major drag on
    U.S. economic growth. The figure suggests that during that time
    period the U.S. economy lost out on $1.6 trillion in real
    economic output. In other words, had these workers been in the
    labor force, the economy would have grown about 30 percent
    faster.
        The research also indicates that female workers left the
    labor force slightly more frequently than male workers due to
    opioids. And it also suggests that small businesses were
    particularly heavily impacted by this crisis.
        The third point that my research has focused on is
    estimating just how many workers are out of the labor force and
    what is the impact on the economy in every state due to the
    opioid crisis. And I found that the impact varies considerably
    by state. The two states that are by far the most severely
    impacted by this crisis are West Virginia and Arkansas. Their
    prime age labor force participation rates fell by 3.8
    percentage points due to opioids. To put that in perspective,
    remember that the nationwide decline was 1.6 percentage points.
    So it is pretty clear that these states are being ravaged by
    the crisis.
        Other states that are being negatively affected are
    Missouri, Kentucky--and then if you look at the states across
    the country, the states that tend to be more negatively
    affected are located in the southeast and the Midwest. So you
    have states like Ohio, where the participation rate declined by
    2 percentage points, and also Louisiana, Tennessee are seeing a
    pretty negative effect. And I should also mention that New York
    also experienced a pretty significant decline in labor force
    participation, about 3 percentage points, due to opioids.
        Now, I have a lot of data on a lot of states, but I will
    leave it there. And I am happy answer any questions you have.
        Thank you.
        Chairman CHABOT. Thank you very much. Ms. Van Dyke, you are
    recognized for 5 minutes.

                      STATEMENT OF KATIE VAN DYKE

        Ms. VAN DYKE. Thank you Mr. Chairman , Ranking Member
    Velazquez, and members of the Committee. It is an honor to be
    here to speak with you today about how the opioid epidemic
    affects small businesses.
        I am Katie Van Dyke, Director of the Ohio Small Business
    Development Center at Cleveland State University. I am proud of
    the work that we at the Small Business Development Centers do
    to support our local small businesses, who are the critical
    components and major contributors to the strength of our local
    economies.
        The Small Business Development Center program provides
    assistance to small businesses and aspiring entrepreneurs
    through no cost business advising around business plan
    development, financial packaging, lending assistance,
    exporting, and market research. The SBDC Program is made
    possible through a collaborative partnership between our
    Congressional champions, the Small Business Administration, and
    state hosts. Last year alone the Ohio SBDC Program helped 722
    entrepreneurs start their business. We worked with existing
    business owners to access $230 million in capital. Our clients
    created or retained nearly 14,000 jobs, and we worked with more
    than 500 companies to increase export sales by $99 million. But
    a significant challenge to Ohio's current business operations,
    in both the urban or rural communities, is Ohio's opioid
    crisis.
        Here are the statistics, which is a snapshot of Ohio. In
    Ohio, from 2016-2017 overdose deaths due to opioids increased
    39 percent and Ohio was the third largest increase among the
    states. Fourteen people die a day from opioid addiction. These
    deaths aren't the stereotypical ``junkie'' on the street, they
    are people involved in the community, your average American,
    workforce age. Sixty-eight percent of Ohio's injured workers
    were prescribed narcotics in 2016. Unintentional drug overdoses
    that may have started as a prescription for a surgery or
    injury, cost an average of $5.4 million each day in medical and
    work loss costs in Ohio. Over 2,500 people of employment age,
    between ages 25 and 64, in Ohio died of an opioid overdose in
    2017 alone. Half of Ohio businesses reported suffering
    consequences due to substance abuse, including absenteeism and
    decreased productivity of their employees, and a shortage of
    workers who can pass drug tests.
        There are many more examples of clients who are wondering
    just how to deal with the opioid crisis. It goes beyond the
    addicted employee or the shortage of applicants that can pass a
    drug test. Opioid addition is affecting employees and their
    families. This is happening everywhere. This is a problem all
    businesses are facing, or will face, in the near future at the
    rate we are going in Ohio.
        Thankfully, there are many great resources that are on the
    ground working to educate employers and employees alike. But,
    there is a lot of work to do. Getting the information out
    quickly and reaching the small business owner is a challenge we
    face. The Ohio SBDC at Lakeland Community College created a
    workshop called ``The Opioid Crisis in the Workplace: The
    Proactive Role Employers Can Take''. This workshop was built to
    be easily replicable for each SBDC in the different counties to
    offer and customize with local subject matter experts.
        We are also partnering with our local Chamber to hold this
    workshop in Cuyahoga County in October, and we can even offer
    continuing education credit to the HR professionals that
    attend. We are also working to share the resources from
    partners that are available to small businesses when we advise
    them. There is a drug free workplace training program offered
    by The Ohio Bureau of Worker's Compensation. And the Ohio
    Chamber of Commerce collaborated with WorkingPartners in Anthem
    to develop a free opioid toolkit containing webinars for
    customizable printable resources for use in the workplace.
        The most important thing we as a community can do is to get
    everyone to talk about the facts, the staggering statistics,
    and breakdown the stigma that this is someone else's problem.
    It affects us all, whether directly or indirectly. As business
    advisors, if we can face this problem with as much knowledge as
    possible, we will be better armed for changing the statistics
    and creating a healthier workforce.
        Chairman CHABOT. Thank you very much. Ms. Allen, you are
    recognized for 5 minutes.

                        STATEMENT OF LISA ALLEN

        Ms. ALLEN. Good morning, Chairman Chabot and members of The
    Small Business Committee. Thank you for the opportunity to
    testify before you to discuss the opioid epidemic and to share
    our culture and our solutions for change in our business and in
    our communities. I hope that by sharing our story we can make a
    dent in this terrible drug epidemic.
        My name is Lisa Allen; I am the President and CEO of The
    Ziegenfelder Company, a privately held, family owned business
    located in Wheeling, West Virginia. We ``make people smile with
    really cool treats'' manufacturing Budget Saver twin pops and
    other frozen items.
        Since 2003, Ziegenfelder has averaged 12 percent year-over-
    year growth in a grocery category that has been flat to
    declining, making Budget Saver products the market disrupter.
    With three manufacturing facilities in West Virginia,
    California, and Colorado, operating continuously, our Budget
    Saver products can be found in grocery stores in nearly every
    community across the country. Last year we proudly sold over 40
    million bags of pops into homes in America.
        While we are proud of this growth, the source of my pride
    comes from our team we call a Tribe. We are individuals,
    families, and a community linked by our culture, our practices,
    and our vivid vision. All members of our Zieggy Tribe benefit
    from our committed, compassionate hiring practices. Our doors
    are open to nearly anyone who is willing to work hard, grow and
    develop, and can commit to our Zieggy Essentials.
        Perhaps our hiring practices emerged from our culture and
    our commitment to our Tribe. Yet, we intentionally refocused
    our hiring practices from the harsh reality of our shrinking
    workforce caused by the devastating effects of drug addiction,
    which knows no bounds. Addicts are our sons, our daughters, our
    mothers, our fathers, and our friends. Diversity of potential
    talent and intellect are interrupted and hijacked by drug
    addiction. Yet with hope, recovery, and connections, a person's
    resilient spirit can rise again.
        At Ziegenfelder we offer a safe environment where Tribe
    members have a place to recover and prosper. We feel validated
    when our employees are in trouble, they look inward to each
    other and our leaders and ask for help. When our Tribe is
    hurting, we are hurting too. We take an active role in
    developing connections with people in our Tribe, demonstrating
    our care for each person. Intentionally connecting, asking
    about their lives, and building relationship with people who
    feel isolation or have lost connections can make the difference
    in addiction relapse and re-incarceration.
        Just this last Saturday, I subtly honored one person
    celebrating three years clean and another who had their ankle
    bracelet removed, with a hug and a high five. Hugely meaningful
    milestones in recovering and in their changing lives.
        In our Zieggy Tribe, loosely structured peer groups have
    emerged, addressing issues they surface and work together to
    solve. We work with social service agencies, our medical
    community, law enforcement, parole and probation officers on a
    case by case basis, working to employ and assist recovery and
    reentry. We have visited state and federal prisons, we have
    participated in job fairs inside jails, in re-entry
    simulations. And in partnership with the West Virginia Division
    of Corrections and Rehabilitation, members of our Tribe have
    become certified Addict Recovery Coaches. We work closely with
    the halfway houses in Denver, Colorado. We are working with the
    West Virginia Department of Corrections on a pilot work release
    project with our Northern Regional Jail. Currently incarcerated
    men with excellent conduct records at the tail end of their
    sentences, walk three blocks to our facility, work an eight
    hour shift and walk back to the jail. A win-win.
        While we are compassionate and have open hearts, we are not
    foolish. We have customers and a business to run. We are
    grateful that most of our Tribe is also committed to protecting
    our business and each other. We are a close-knit, trusting
    community and people look out for each other. Inclusion is our
    strength and our competitive advantage.
        Standing idle, often in judgment of others, doing little
    but measuring and analyzing statistics does not erase mistakes
    nor change the spiraling impact of addiction. Even worse, it
    may perpetuate crime and other debilitating problems. We
    believe a job and connections are the best antidote. And this
    belief has been affirmed over and again by our Tribe members.
        The drug epidemic is devastating, yet we believe in the
    resiliency of the human spirit. It takes courage to stand up
    and make change, it takes courage to believe, and it requires
    courage to take the first step. We will continue to embrace the
    opportunity to demonstrate and reward this courage.
        Our results are not without failures. This is messy, and
    unfortunately we have many failures. However, we learn from
    those disappointing circumstances and we know the next person
    deserves our open hearts just as much as the last. I am proud
    of our Tribe. Drug addiction and associated social problems
    know no bounds. We are working to combat this enemy one person,
    one family at a time. We know to each person that we touch and
    we can help, we make a difference.
        Thank you for this opportunity to share our story and I
    look forward to your questions.
        Chairman CHABOT. Thank you very much. And I will recognize
    myself to begin the questioning for 5 minutes
        And, Mr. Gitis, I will begin with you. You had mentioned in
    you testimony that you felt that small businesses were
    particularly affected as opposed to larger companies by this
    opioid addiction. Why is that and how is that affecting small
    business across this country?
        Mr. GITIS. So small businesses, by the sheer quantity of
    them, a lot of workers are employed by small businesses. So
    just on that basis alone, they will be negatively affected by
    this crisis. A rough estimate suggests that about 45 percent of
    these absent workers, or about 900,000 of them would have been
    employed by a business with under 50 workers.
        And it is also important to keep in mind that small
    businesses have fewer resources in terms of attracting
    employees, so they have to rely on things like job fairs and
    all that. And so that would also be difficult for them.
        Chairman CHABOT. Thank you. Ms. Van Dyke, I will go to you
    next. If a client comes to the Ohio SBDC and has a problem with
    opioids in the workplace, could you walk us through the steps
    that you would take in trying to help them?
        Ms. VAN DYKE. Sure. My biggest role in that situation would
    be to connect them with the resources available. Unfortunately,
    small businesses do not have a lot of resources for maybe an in
    hours HR, but there are quite a few resources in Ohio. For
    example, Working Parners is a consulting firm that would help
    them. And the Ohio Bureau of Worker's Compensation could help
    them to implement a drug free workplace. Maybe not at that
    point, but we could also educate them and educate the other
    employees. We would also need to walk them through
    understanding, possibly helping that employee to get into rehab
    and offering them a second chance based on getting clearance
    from a counselor and going through some rehab and recovery.
        Chairman CHABOT. Okay. Thank you very much. Ms. Allen, I
    will go to you next. Your story and your commitment to your
    community is very inspiring. What are the most rewarding and
    most challenging parts of hiring recovering addicts and others
    reentering our community?
        Ms. ALLEN. Well, thank you for your question. Rewarding is
    seeing success, it is watching people who feel like they have
    no hope, came from a bad situation, are reentering and have no
    home to go to, finding a home with us, finding a work home with
    us, the opportunity to earn an income and to make connections.
    Fortunately, just by chance just outside of my office is the
    time clock for our business, and so I get to see our folks
    every single day and I can have conversations and build
    relationships. That is incredibly rewarding. And I think it
    gives people the connection that they need that they don't
    have.
        The most difficult is knowing that somebody didn't come
    back to work, didn't show back up to work, to know that we have
    lost the life of past co-workers due to this addiction. That is
    the hardest part, but we plug through.
        Chairman CHABOT. Thank you.
        Ms. ALLEN. You are welcome.
        Chairman CHABOT. Would anybody like to cover any concerns
    that companies might have, liability issues if they are hiring
    folks who may have struggled in the past and have been facing
    challenges of addiction?
        Ms. Van Dyke, would you like to talk about that?
        Ms. VAN DYKE. Sure. As a small business owner, like I said
    before, you have limited funds to spend on an HR or HR
    policies, but there are, like I said, free resources out there
    so that you can develop programs so that when you are bringing
    someone on board that maybe has some previous history with drug
    abuse or drug addiction, that you can put them into a program
    and know that all of your employees are educated. And they are
    also affecting their families by bringing the education home
    and talking to their kids and learning more about the addiction
    and possible--who of your employees could be more addicted than
    others.
        It is also about not only educating your employees, but
    having, like I said, the policies in place, things that are
    going to protect you as a business so that there are no
    liability issues. If an employee does injure someone because of
    the addictions, the come to work addicted, maybe they are high
    or something and they have an accident at work, knowing how to
    deal with that in a legal--and having your HR policies is
    really important.
        Chairman CHABOT. Thank you very much. My time is about to
    expire, so I will turn to the gentleman from Florida, Mr.
    Lawson, who is the Ranking Member of the Subcommittee on Health
    and Technology for five minutes.
        Mr. LAWSON. Thank you, Mr. Chairman. And this question will
    be to everyone on the Committee. How can the federal government
    provide support to small businesses who hire those recovering
    from addiction? And what other resources exist for those
    companies outside of the government? And I would like to have
    all of you all to respond for that, respond to it.
        Mr. GITIS. I am not sure what is available for small
    businesses in order to help their employees treat addiction. I
    am not an expert on health issues. I am more focused on the
    workers themselves. But that is something I can look into.
        Mr. LAWSON. Well, from the standpoint of federal
    government, you have no recommendations?
        Mr. GITIS. Well, just in general overall, there needs to be
    a more comprehensive approach than what has been employed so
    far. Around 2010 there was just a focus on prescription opioids
    and now we have accelerating overdose tests with other types of
    drugs. And so there needs to be more focus on treating actual
    addiction and also addressing the unlawful drugs, like illegal
    synthetic opioids and heroine.
        Mr. LAWSON. I will go to Ms. Van Dyke.
        Ms. VAN DYKE. There are many things the government can do,
    especially focusing on spreading the word. Small businesses
    sometimes have a hard time approaching or asking for help, so
    just supporting the education and getting the word out there
    and talking about the issues is very helpful. Having easy
    access to resources is very helpful for small businesses so
    that they can begin to understand the addiction and education
    around it and get it out there to their employees.
        Mr. LAWSON. Okay. Ms. Allen?
        Ms. ALLEN. So my answer might be a little bit different. I
    think as a small business owner, I think small businesses--for
    us speaking specifically--I would much rather the federal
    government rather than support us, I think the problem is so
    pervasive that I would rather whatever money you would be
    interested in giving us, put into education, into the education
    system, and into mental health issues because addiction is an
    outcome to me in a lot of cases. Addiction is the result of
    isolation, of mental health issues, of lack of education, a
    lack of connections, a lack of the humanness that need to exist
    in our world. So I think our education is a great place to
    start and then more emphasis on another great place, in the
    corrections system. Preparing people who are leaving the
    Department of Corrections so that they know how to get out and
    when they get out what to do, where to do, how to get a job,
    how to hold a job, all those kinds of things.
        Mr. LAWSON. Okay. And it is obvious from what you have
    stated that--do you find any help that comes from SBA?
        Ms. ALLEN. We don't specifically, no.
        Mr. LAWSON. You don't specifically know? Do any of you all
    know whether SBA provides any educational opportunities for
    small businesses besides just applying for a loan or something
    of this nature?
        Ms. VAN DYKE. I can answer that. We are powered by the SBA.
    Basically our funding provides us to provide free technical
    support. So we feel like we are the soldiers on the ground
    because of our SBA grant. So we are out here as small business
    advisors working with small businesses and finding those
    resources for them to make their lives a little easier. Because
    there are quite a few resources for small businesses. It is
    just that we have a hard time marketing, obviously, from our
    funding. We are focused on working.
        Mr. LAWSON. So with the few seconds I have left, do you
    think there will need to be more emphasis from SBA to small
    businesses educational, the emphasis on how to help small
    businesses with this crisis?
        Ms. VAN DYKE. It should be an initiative for sure.
        Mr. LAWSON. Okay. Mr. Chairman, I yield back.
        Chairman CHABOT. The gentleman yields back. Thank you very
    much. The gentleman from California, Mr. Knight who is the
    Chairman of Subcommittee on Contracting and the Workforce,
    recognized for 5 minutes.
        Mr. KNIGHT. Thank you, Mr. Chairman. This is a good
    hearing. I wish we didn't have to have this hearing, but it is
    a good hearing to see what is happening in America.
        You know, in my district we have a lot of aerospace and the
    number one thing is when you get your DoD clearance, obviously
    you cannot have any drug addictions, use, or anything. Living
    in California we have new laws and new things that are going on
    out there that are different--and I can probably always say
    that--but they are making it so that some of our young folks
    think that it is okay to do a certain drug and then they can
    get their clearance. Obviously that cannot happen. So we are
    trying to educate young folks.
        We are also having a problem, especially in my district and
    others in southern California, to find people that can pass a
    drug test to just show up for work. And that is one of the
    biggest issues when we go out on a job fair or something like
    that is the first thing is we want you to pass a drug test for
    certain jobs.
        So my questions are more on line with that. And, Ms. Allen,
    I liked your testimony and I liked the way that you framed it.
    We want to help people and we want to give them a chance and if
    they take that chance, then great. If they don't, we also know
    we have got to run a business, we have got to make sure the
    business makes money for all the people that are employed here.
    And it continues on. So if you take advantage of that chance,
    then great.
        So I would like to hear some of the kind of the stories--
    not the stories, but tell me what you have done when you have
    found somebody who has come into work and now you have found
    that they haven't exactly followed the rules. What is the
    process there?
        Ms. ALLEN. Well, thank you, Mr. Knight, for your question.
    The process is typically those things surface for us--as I
    stated the kind of ad hoc peer groups that have developed, the
    people helping people--the information surfaces, it works its
    way through our organization, typically gets quickly to our
    plant management and our HR department and if the person is
    willing and interested in assistance we work with our social
    service agencies, we work with counselors. Sometimes once it
    comes up they just disappear, they don't come back. That
    happens a lot, unfortunately. But there are connections. We are
    in a small community. We are in little Wheeling, West Virginia.
    We have a population that is, you know, 25-35,000 people and so
    a lot of people know each other. And so the connections are
    there. Typically----
        Mr. KNIGHT. And you might be the biggest employer.
        Ms. ALLEN. Pardon me?
        Mr. KNIGHT. You might be the biggest employer. Is that
    close?
        Ms. ALLEN. Well, we are not because we have two other
    facilities. But we are a large employer in the community, about
    150 people locally. And people connect. So we rehire as well.
    So if somebody leaves, disappears, you know, we don't know
    where they are for a few weeks and then they come back and they
    share their story and we talk. And we don't drug test on the
    front end anymore. What we do though is we have done a lot of
    training on reasonable suspicion. So we know what to look for,
    we know signs to look for and we pay attention. And there is
    word, you know, amongst our Tribe. So we kind of self-regulate.
        Mr. KNIGHT. So it is interesting to hear business owners
    talk about trying to help people with a drug addiction, and
    what you do and what you can't do. Obviously if somebody came
    in and they were working for me and I caught them stealing
    something I would fire them right there. With a drug addiction
    you can hear--and I hear this from businesses all the time--we
    are trying to help you, you have got to help yourself. So if
    you, you know, leave for those two weeks you come back and you
    explain what went on and we are still going to have some
    compassion for you, but understand that we want you to get
    moving. And so there is some tough love there to.
        Ms. ALLEN. There has to be.
        Mr. KNIGHT. In my previous life I was a Los Angeles police
    officer and we had the DARE program. And when I started in 1990
    the DARE program had been going for five, or six, or seven
    years, or something like that. It was very heavy into the
    school districts and making sure the kids knew if you do this
    you have already put yourself in a difficult situation. So
    don't start, don't think that you can just do it and then
    everything will be okay, you will just not do it again.
        I think that we should go back to a lot of these types of
    programs in America, whether they are local or some big just
    say no DARE program that gets kind of a universal American look
    at drug use. Drug use in America has been one of our greatest
    black eyes, as it is, and we have got to figure out new and
    innovative ways. And I think some of these programs that
    infiltrate locals and go around the whole country is the way to
    do it.
        Thank you, Mr. Chairman. I yield back.
        Chairman CHABOT. Thank you. The gentleman's time has
    expired. The gentleman from Pennsylvania, who is the Ranking
    Member of the Subcommittee on Growth, Tax, and Capital Access.
    You are recognized for 5 minutes.
        Mr. EVANS. Thank you, Mr. Chairman. Mr. Chairman, I would
    like to thank you and the Ranking Member for just organizing
    this panel. It could not be more appropriate at this time.
        Ms. Allen, what supports have you found to be the most
    useful in decreasing the likelihood of relapse?
        Ms. ALLEN. Connections. Making, building relationships. In
    my experience, what we have seen and what I have heard, drug
    addiction creates isolation. A lot of what Mr. Knight was
    talking about, about stealing, the two kind of go together a
    lot of times. So people find themselves very isolated. They
    don't feel connected to anybody. So by building connections it
    makes people feel important, they feel loved, they feel
    included. And with that, they ask themselves--I just had this
    conversation the other day--they ask themselves, do I want this
    life or do I want this life. These people are nice to me and
    they take care of me and they care about me. I think I will go
    another clean day, I will go another clean day.
        And it is a flywheel, it is truly a flywheel. We find
    support with our counseling services in our community, we find
    support with the social service agencies. But I think it is
    really just helping people with connections and letting them
    know that people care about them. One of the things that I feel
    very strongly, and we feel very strongly in our business, is
    those words that haven't always been hard business terms, like
    care and commit and compassion, those are true leadership
    skills and those are true business terms. And we use them often
    and frequently and I think it helps with the connections and it
    helps people overcome
        Mr. EVANS. As sort of a follow up, obviously you cannot
    legislate connections. That is the rumor I hear. I don't know,
    maybe somebody who has been around here longer than I can
    figure that one out. Then what are the conditions that sets it
    up to just understand what you just expressed, which I assume
    you learned from experiences?
        Ms. ALLEN. Gosh, I wish I had a good answer for that. I
    think it is conversations like this, to be honest. I think it
    is conversations that recognize that this is a human issue and
    people are resilient. And addicts don't want to be addicts. I
    mean I have never experienced it myself, thank goodness, but I
    don't believe that somebody in such a miserable state is there
    by choice. So I think it is incumbent upon all of us to
    recognize the humanness of it and to help people through
    funding sources, through, as I said before, helping people who
    are leaving incarceration after whatever their length of term
    was. Most of them, a lot of them, the ones I have experienced,
    really do want to change, really do want to change. I spoke
    about the work release program we have with our local jail. We
    have one gentleman, I just learned yesterday or the day before,
    I approached him and he told me that he has two bachelor's
    degrees and a master's degree in chemical engineering. And he
    is a pretty good mechanic too. And he gets out soon, and he
    likes his job.
        Mr. EVANS. Thank you.
        Ms. ALLEN. So they are no different than you and I, other
    than that they made a bad choice, a lot of bad choices. But
    they are human and they are intelligent and they have value and
    they are labeled for life. And I don't know that that is
    necessarily fair.
        Mr. EVANS. Thank you. Mr. Chairman, I wonder if with Ms.
    Van Dyke I can get a question in or?
        Chairman CHABOT. Sure.
        Mr. EVANS. Thank you.
        Chairman CHABOT. Yeah, you have got time.
        Mr. EVANS. You discuss efforts that the SBDC is taking to
    assist employers who are struggling with employees impacted by
    the opioid crisis. What, if any, supports are you providing to
    assist in filling the skills gap problem that small business
    have because of the opioid epidemic.
        Ms. VAN DYKE. Thank you for your question, Mr. Evans. That
    is a tough one. We rely heavily on Ohio Means Jobs. They have a
    wonderful massive data base full of employees seeking jobs. So
    when our small businesses are looking for employees we work
    with Ohio Means Jobs to help them kind of sift through the data
    base of people looking. But, again, I just think it goes back
    to education around our small businesses and what they are
    looking for in skills versus what is available.
        Mr. EVANS. Thank you, Chairman.
        Chairman CHABOT. Thank you, thank you. The gentleman's time
    now has expired. The gentleman from Kansas, Dr. Marshall, is
    recognized for 5 minutes.
        Mr. MARSHALL. Okay, thank you, Mr. Chairman. Maybe I want
    to focus on prevention for a second, see if you all have any
    suggestions. You know, I am a physician myself. It is said that
    80 percent of people on opioid addiction problems started off
    with a legal physician prescription. I think that number is
    pretty high, but I am going to assume it is right. So across my
    district I am seeing clinics, physicians develop protocols how
    to handle chronic pain. That kind of keeps some of the patients
    from doctor shopping, bouncing around. And the next sort of
    protocol is how to handle acute pain, post-operative pain,
    those types of things.
        Are you all seeing that happening in any of your home
    states, doctors are taking responsibility to do this? Ms. Van
    Dyke, are you seeing some of that?
        Ms. VAN DYKE. Yes. And I am not a medical official at all,
    but in Ohio I know we use the AORRS system, which a doctor can
    get information on previous prescriptions and other things for
    each client that they have so that they are better
    understanding what they have been taking and who they have been
    seeing. I think that is very helpful. And I think that the
    changes in the medical community and the knowledge that they
    have of the addictions that are happening because of the
    prescriptions is definitely really impacting and lessening the
    opioid prescriptions that are just going out to everybody. It
    has definitely made a difference in Ohio.
        Mr. MARSHALL. Okay. Mr. Gitis, are you seeing anything
    happening and improving in that area?
        Mr. GITIS. Yes, you can see it in the data, changing
    behaviors, and also in response to changing attitudes and
    policies. The supply of prescription opioids in the United
    States has been declining each year since 2010 by about a 5
    percent rate. So that is good news. And I think it would help
    limit the number of folks who are exposed to opioids in the
    first place. The tricky part is addressing those who are
    already addicted and those who are using the illegal
    substances.
        Mr. MARSHALL. Okay. Is there anything else that you all can
    think, whether it would require--I don't care where the--I
    actually would prefer staying away from the federal government
    dictating new rules. What else can the medical folks do that
    they are not doing now to decrease the number of people
    becoming addicted to narcotics? Are you seeing any better
    practices out there? Anything else that you are seeing?
        Go ahead, Ms. Allen.
        Ms. ALLEN. I can only speak from personal family
    experience, that it appears that it is well regulated and well
    controlled. So that possibly, you know, obviously it doesn't
    create addiction or cause addiction. I think in our family
    case, you can see the process working. I think what is
    happening though is it is to Mr. Gitis' point, it is not the
    prescription opioids anymore, it is the synthetics that are on
    the street. It is the synthetics that are on the street that
    are causing the greatest devastation at this point. I can't
    speak to that statistically, but that is what I feel.
        Mr. MARSHALL. Yeah, I think that is absolutely right. You
    know, fentanyl is the big synthetic drug that China is making
    and shipping over by our U.S. Postal Service and for some
    reason our U.S. Postal Service doesn't know where the package
    is coming from. And one of the things we have recently done is
    passed legislation to hold them accountable as well. And people
    just don't realize how powerful fentanyl is, 50-100 times
    stronger. And that is why most of the people are dying, they
    are used to taking 5 or 10 percocets to get high, and you take
    5 fentanyls and you are done. It is so strong that drug dog
    walking by and sniffing it can kill the dog itself. So I think
    we are all becoming more and more aware of that as well.
        I guess we will spend the last minute on treatment plans.
    What is the most effective thing that you are seeing? Ms. Allen
    already mentioned relationships, having relationships. You
    know, we are funding telemedicine more, we certainly do think
    mental health is a big culprit here. I think we are doing more
    in this Congress to reorganize mental health than since John F.
    Kennedy. So I am proud of that. Do you guys see any other thing
    succeed, what is working? Ms. Van Dyke, what do you think is
    working?
        Ms. VAN DYKE. Sure. I think on the small business side of
    things getting small businesses to understand that you don't
    have to fire that person that has the addiction problem. If
    they go through proper rehab through an accredited source and
    they work with a counselor they are less likely to use again.
    And you don't have to retrain them, you can bring them back
    once they have, you know, been cleared through a counselor. And
    they are ready to go again. And giving second chances and
    helping small businesses to understand that giving second
    chances to people is the way to go, for the most part.
        Mr. MARSHALL. All right. I think my time is expired. I
    yield back. Thank you.
        Chairman CHABOT. Thank you very much. The gentleman's time
    has expired. The gentleman from Ohio, Mr. Balderson. It gives
    me great pleasure to yield 5 minutes to you if you would like
    to ask questions. Don't screw it up.
        Mr. BALDERSON. Mr. Chairman, thank you very much. I really
    don't have any questions. I will comment on what Ms. Van Dyke
    says and some of the things that we have done in the State of
    Ohio. And Ms. Allen is only approximately about 45 minutes away
    from my home county, also, so down in Wheeling, West Virginia.
    But, you know, just mostly what Ms. Van Dyke said about what we
    have done in the state legislature since 2009 with the OARRS
    system and many things. And I think we need to continue doing
    that.
        As far as relationships that Ms. Allen said, it is
    something that we don't talk about in communicating with our
    employees, and the importance of that and to help them. I mean
    employers want their employees to be successful, because if
    they are successful the business is successful also. So those
    relationships and to communicate with those employees and
    getting them the help that they need I think is vital. And that
    is what makes it all work.
        So I look forward and I am glad to be honored to sit on
    this panel and hear this. I think it was very interesting this
    morning. So thank you all very much for being here.
        Chairman CHABOT. Thank you very much. The gentleman yields
    back. And, again, we welcome him to the Committee. And I want
    to thank our panel here this morning for your testimony. I
    think it has been very helpful to all the members that were
    here in sharing your valuable insights. The opioid crisis is
    affecting communities really in every corner of our nation. It
    is clear that this epidemic is a monumental problem, but our
    witnesses today have demonstrated how small businesses can work
    with our communities to be a part of the solution. So we thank
    you for helping us to deal with this. The Committee will use
    today's conversation as a way that we can continue to examine
    potential ways to help small businesses find the qualified
    workers that they need to grow their businesses.
        So, again, thank you.
        I would ask unanimous consent that members have five
    legislative days to submit statements and supporting materials
    for the record. Without objection, so ordered.
        And if there is no further business to come before the
    Committee, we are adjourned.
        Thank you very much.
        [Whereupon, at 11:54 a.m., the Committee was adjourned.]

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