[Senate Hearing 118-665]
[From the U.S. Government Publishing Office]
S. Hrg. 118-665
THE GUN VIOLENCE EPIDEMIC:
A PUBLIC HEALTH CRISIS
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HEARING
BEFORE THE
COMMITTEE ON THE JUDICIARY
UNITED STATES SENATE
ONE HUNDRED EIGHTEENTH CONGRESS
FIRST SESSION
__________
NOVEMBER 28, 2023
__________
Serial No. J-118-44
__________
Printed for the use of the Committee on the Judiciary
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
www.judiciary.senate.gov
www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
60-434 WASHINGTON : 2026
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COMMITTEE ON THE JUDICIARY
RICHARD J. DURBIN, Illinois, Chair
SHELDON WHITEHOUSE, Rhode Island LINDSEY O. GRAHAM, South Carolina,
AMY KLOBUCHAR, Minnesota Ranking Member
CHRISTOPHER A. COONS, Delaware CHARLES E. GRASSLEY, Iowa
RICHARD BLUMENTHAL, Connecticut JOHN CORNYN, Texas
MAZIE K. HIRONO, Hawaii MICHAEL S. LEE, Utah
CORY A. BOOKER, New Jersey TED CRUZ, Texas
ALEX PADILLA, California JOSH HAWLEY, Missouri
JON OSSOFF, Georgia TOM COTTON, Arkansas
PETER WELCH, Vermont JOHN KENNEDY, Louisiana
LAPHONZA BUTLER, California THOM TILLIS, North Carolina
MARSHA BLACKBURN, Tennessee
Joseph Zogby, Chief Counsel and Staff Director
Katherine Nikas, Republican Chief Counsel and Staff Director
C O N T E N T S
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OPENING STATEMENTS
Page
Durbin, Hon. Richard J........................................... 1
Cornyn, Hon. John................................................ 2
WITNESSES
Bryant, Vaughn................................................... 11
Prepared statement........................................... 42
Responses to written questions............................... 47
Cook, Steven H................................................... 9
Prepared statement........................................... 51
Cosey-Gay, Franklin N., Ph.D.,................................... 7
Prepared statement........................................... 59
Responses to written questions............................... 61
Ranney, Megan L., M.D............................................ 14
Prepared statement........................................... 69
Responses to written questions............................... 94
Swearer, Amy..................................................... 12
Prepared statement........................................... 100
APPENDIX
Items submitted for the record................................... 135
THE GUN VIOLENCE EPIDEMIC:
A PUBLIC HEALTH CRISIS
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TUESDAY, NOVEMBER 28, 2023
United States Senate,
Committee on the Judiciary,
Washington, DC.
The Committee met, pursuant to notice, at 10 a.m., in Room
216, Hart Senate Office Building, Hon. Richard J. Durbin, Chair
of the Committee, presiding.
Present: Senators Durbin [presiding], Whitehouse,
Klobuchar, Blumenthal, Hirono, Booker, Padilla, Butler,
Grassley, Cornyn, Lee, Cruz, Hawley, Kennedy, Tillis, and
Blackburn.
OPENING STATEMENT OF HON. RICHARD J. DURBIN,
A U.S. SENATOR FROM THE STATE OF ILLINOIS
Chair Durbin. The Senate Judiciary Committee will come to
order. The hearing on ``The Gun Violence Epidemic: A Public
Health Crisis'' is today's topic. The Committee will hear from
public health experts who've been on the front lines of the gun
violence epidemic.
They understand the pain of a loved one whose family member
has been taken away too soon by the pull of a trigger, and
they've seen the aftermath of bullets tearing through bone like
it's tissue paper. In cities like Chicago, dealing with the
constant drumbeat of gun violence has turned these public
health professionals into battlefield experts.
Chicago faces the same challenges as many other cities and
towns. In fact, many rural areas have even higher rates of gun
violence than the urban areas. Across the country, gun violence
is a public health epidemic, plain and simple. In 2022, there
were more than 48,000 firearm-related deaths in the United
States.
That's 132 Americans every day dying from gun violence.
More than half of firearm-related deaths were suicides. More
than 4 out of 10 were homicides. And guns are now the number
one cause of death among America's children and teenagers--not
auto accidents, not cancer--guns.
I'm going to share a video that shows the devastation left
in the wake of gun violence, and provides a glimpse into heroic
efforts to heal communities and prevent future violence. I'm
going to warn the audience that the video is disturbing and may
be upsetting to some if they wish to avert their eyes. Please
play the video.
[Video is shown.]
Chair Durbin. Collecting data, identifying trends,
developing strategies to prevent harm, reducing risk, sharing
these practices, this is how you combat an epidemic. It's
worked in the past. We use the same public health approach to
dramatically cut automobile fatalities. We still drive where we
need to go, but we have seat belts and speed limits that help
us get there alive. Public health experts are already working
to address gun violence in real time.
Last year, Congress passed the Bipartisan Safer Communities
Act, and I want to salute my colleague, Senator Cornyn, who is
here with us today representing the Minority. It took real
courage, John. We may disagree on a lot of issues, but at a
time when we needed to act, you did your best, and I thank you
for that. It included $250 million in funding for community
violence intervention, and $250 million for States to provide
comprehensive community mental health services.
Let me give one example of the successful innovative
programs underway. In Chicago, I heard from doctors personally
who were sick of treating gunshot victims on the operating
table. They wanted to prevent the gruesome injuries from
happening in the first place.
So, in 2018, I brought together the CEOs of the 10 largest
hospitals serving Chicago. And to understand what they were
doing in the neighborhoods surrounding their hospitals and how
we can do more, we formed the Chicago HEAL Initiative, which
has emerged as a national exemplar of how hospitals can
collaborate and reach outside their walls to prevent gun
violence. These hospitals have increased local hiring by 84
percent in the last 4 years. They have opened 24 school-based
health clinics to serve 11,000 students, and are training
nearly 4,000 local students for careers in healthcare.
Most importantly, these hospitals aren't just stitching up
physical injuries, they're addressing the emotional scars of
their patients through counseling and case management to
prevent retaliation and promote successful recovery. Just 2
percent of over 8,000 participating patients in the--at the
University of Chicago have returned to the hospital.
Without these programs and this Initiative, 45 percent of
patients with a gunshot wound are likely to return within 5
years with another one. That is a stunning statistic--45
percent within 5 years will return shot a second time.
Similar steps are underway across the country to use a
strategy which is known as Community Violence Intervention.
CVIE uses trusted community figures to engage with individuals
at high risk of perpetrating or being victims of violence. They
work to interrupt acts of violence before they happen, and
connect people with treatment and tools that decrease the risk
of future violence.
It's time for us to build on this Bipartisan Safer
Communities Act and ongoing efforts that are working in red and
blue States, and join together. Surely, we can find some common
ground between parties to create real change for the American
people when it comes to this public health crisis of gun
violence. I now turn to Senator Cornyn.
OPENING STATEMENT OF HON. JOHN CORNYN,
A U.S. SENATOR FROM THE STATE OF TEXAS
Senator Cornyn. Thank you, Mr. Chairman. Just a few months
ago, the Democratic Governor of New Mexico, Michelle Lujan
Grisham, issued a, quote, ``public health emergency order to
suspend the right to bear arms in Albuquerque and surrounding
Bernalillo County,'' I think I pronounced that correctly. She
was warned repeatedly by officials in her State that such a
suspension violated the Constitution.
A group of our colleagues here, including Senators Tillis,
Graham, Kennedy, Blackburn, and Cotton, and I, wrote to the
Department of Justice to intervene and protect the
constitutional rights of New Mexicans to carry a firearm
outside of their home. Our request was consistent with the
Second Amendment and the courts' jurisprudence, and I expect
that the court of last resort will find the same.
But unfortunately, that doesn't mark the end of the road
for this latest attack on what is a constitutional right.
That's something some of our colleagues consistently overlook.
And the fact is that a firearm in the hands of a law-abiding
citizen is not a threat to public safety. Indeed, there's a
story, I think it's in The Washington Post today, by Philip
Bump who points out that 52 percent of American households have
a firearm in that household--52 percent.
Washington Democrats have unfortunately chosen to follow
Governor Grisham's lead and are now using public health as a
guise to address their concerns. I wish they had the same
concerns about the number one cause of death for Americans
between the age of 18 and 45, which is fentanyl poisoning--
fentanyl made from chemical precursors from China going to
Mexico, made to look like relatively innocuous pharmaceuticals,
which are then smuggled into the United States. And
unfortunately, many young people end up consuming what they
think is a relatively innocuous drug and die as a result of
fentanyl poisoning.
Well, we don't have to look far to see the examples of
Executive overreach that have relied on so-called public health
emergencies. During the COVID-19 pandemic, too many politicians
were quick to shut down houses of worship and church services
while allowing other businesses and other organizations to
operate.
Here in Washington, DC, for example, Mayor Muriel Bowser
refused to allow the Capitol Hill Baptist Church to hold
outdoor church services because of a public health emergency.
The judge in that case found that the mayor had exceeded her
authority and had substantially burdened the Free Exercise of
Religion.
It's important to note that the application of these so-
called public health precautions was not even-handed. While
many politicians deemed it unsafe for businesses to operate or
churchgoers to attend worship services, they seemed to have no
problem with packed BLM riots, as in ``Black Lives Matter''
riots, in the summer of 2020, that caused millions of dollars'
worth of damages. So, we have a trust issue and a
constitutional issue when we use the public health approach to
attempt to strip away core constitutional rights.
The other problem with the public health approach is the
most effective solution to firearm-related homicides and
assault is effective criminal law enforcement. That means
effective police, prosecutors, courts, and prisons. We know
that these tools actually work. We know they work because we
have historical data in order to prove it.
As law enforcement efforts were stepped up in the early and
mid-1990s, we saw dramatic declines in criminal violence of all
kinds. One of the reasons for this is that the concentration of
gun violence is among small numbers of the population. It's not
the general population. It's a small percentage of the
population where this phenomenon exists.
In Washington, DC, for example, in 2021, a study found that
only 500 people were responsible for up to 70 percent of the
gun violence in the District. In Boston, a 28-year-old study
found that half of the city's homicides were committed by 1
percent of the population, involved with gangs primarily. A
2014 study showed a similar situation in Chicago.
What all of this means, I believe, is that if you empower
law enforcement to selectively investigate and prosecute repeat
offenders, you can dramatically reduce the gun violence in a
community where it's a problem. By removing the worst criminal
elements from the community, everyone is safer.
That's the original purpose of the Project Safe
Neighborhoods program, which passed out of the Senate this
year. That program focuses on investigating and prosecuting the
most dangerous and violent criminals in our communities to
ensure they do not continue to harm other people.
And we've seen over the last two-plus decades, it's had an
overwhelming success rate at reducing violent crime. Successful
programs like Project Safe Neighborhoods require both resources
and political will. You can't simply achieve safer communities
by defunding the police or letting violent offenders out on
bail like, unfortunately, too many prosecutors have been
willing to do in communities across our country.
Today, violent crime is ravaging many of our communities,
and the public is, of course, taking notice as they must. Here
in the District of Columbia, carjackings are up dramatically,
and I have to believe that a lot of this has to do with the
perception that there will not be consequences associated with
committing such crimes against innocent citizens, including
Members of the United States Congress.
A recent Gallup poll showed that 63 percent of Americans
described the gun crime problem in the U.S. is either extremely
serious or very serious. That's the highest level since this
particular poll began in 2000. And 77 percent of Americans
believe there is more crime today in the United States than
there was just a year ago. Again, when we talk about the gun
violence epidemic, it seems as though a substantial part of
that debate is our current crime problem, which is spiked due
to the left's soft-on-crime policies and the defund-the-police
movement.
Of course, we know the other side of the gun violence issue
is mental health. This is especially important when we include
firearm-related suicides, as the Chairman said. About 60
percent of the gun deaths in America are the result of a
suicide, someone taking their own life. And, of course, we know
that the Bipartisan Safer Communities Act, which we did pass,
made the single largest investment in community-based mental
healthcare in American history. A good start.
In 2023, a survey from Mental Health America found that 21
percent of American adults have claimed symptoms of a mental
illness. That's 50 million Americans. A 2015 study published by
the Annals of Epidemiology found mental illness is strongly
associated with increased risk of suicide, which counts, as I
said, for more than half of the gun-related deaths in in this
country.
Suicide is a mental health problem, and we're not going to
fix the issue by denying people their constitutional right to
keep and bear arms, at least among the general population.
Countries like Belgium, Japan, South Korea, all have higher
suicide rates than the United States, but don't have a Second
Amendment.
Mental health problems are also often involved in mass
shootings, as we know. In the wake of the Buffalo and Uvalde
shootings, we looked at the profile of these mass shooters and
found that many of them had serious underlying mental health
problems, mental health issues that were unaddressed and
untreated. Many of our colleagues, including Senators Tillis,
Graham, Durbin, and Coons, and many others, worked together, as
you've heard, to pass the Bipartisan Safer Communities Act.
I think that bill has already saved lives. I get regular
updates of the success of that law's--as it deals with mental
health and violence in our communities. But there are other
parts of the bill that are working as well. Since the law was
enacted in June of 2022, the Bipartisan Safer Communities Act's
new criminal penalties and firearm trafficking had led to more
than a hundred new charges against dangerous cartel members and
firearms traffickers.
The enhanced juvenile records check alone has stopped 400
transactions of people who would ordinarily flunk a background
check were they an adult, and you only check their adult mental
health and criminal history. But now because we have an
enhanced check to include juvenile records, 400 transactions
have been stopped while 98.5 percent of the background check
system is unaffected.
This, of course, builds on the positive changes that came
from a bill we called Fix NICS, the National Instant Criminal
Background Check Act, which was signed into law by President
Trump in 2018. That law has led to the uploading of millions of
new records into the FBI's National Instant Criminal Background
Check database to prevent those who are already legally
prohibited from possessing a firearm under existing law from
obtaining one.
All this was done, both Fix NICS and the Bipartisan Safer
Communities Act, in a bipartisan way without infringing the
rights of law-abiding citizens. The point is, we can find ways
to come together to get things done. But using public health
authorities as a blanket excuse to strip away constitutional
rights, or framing gun violence as an epidemic divides us more
than it unites us and it really kind of misses the point. These
are not autonomously fired weapons. They involve human agency,
and, as we've seen, when we focus on the humans, we can have a
very positive impact.
So, I hope we look at the entire picture of gun violence,
which includes focusing on repetitive acts of violence by a
small percentage of our communities, focusing on mental health
diagnosis and treatment, and finding ways that we can address
gun violence like we did in the Bipartisan Safer Communities
Act, again, all without infringing on the rights of law-abiding
citizens. Thank you, Mr. Chairman.
Chair Durbin. Thank you, Senator Cornyn.
And you've raised some very important issues, like
fentanyl, which we've had hearings in this Committee about the
issue of narcotics and what's happening to America. President
Biden recently raised this issue with the leader of China. I
hope that it leads to something positive in diminishing the
supply on that side of it.
You raised the issues of freedom of religion, which is
important to all of us and is discussed frequently in this
Committee. You've talked about funding the police. I believe
that funding the police is critical. I've never said otherwise.
I hope that on some of the spending bills, that our Republican
friends will start voting for them when they find funding for
the police included. That should be a bipartisan effort.
But the one thing that you don't acknowledge and we
disagree on is the fact that the United States of America is
unique among nations. Unique among nations. There is no other
country, developed economy, in this world where the number one
cause of death among children and teenagers is guns. Period.
We are a unique Nation in many ways, but this is something
we shouldn't take pride in. And to address it at this hearing,
I think, is appropriate and timely. The white coats that are
represented in the audience here are men and women who've given
their life to medicine and have to face the products of these
violent actions and try to keep these poor people alive for
another day. And yet we know that doing nothing means that 45
percent of them are going to return with another gunshot wound.
What is wrong with this picture? Even if it is a limited
number of people who are engaged in it, are we going to turn
our back on the fact that 122 Americans die every single day by
gun wounds? That is a fact in our country and no other country.
When it comes to mental illness, other countries face mental
illness every day as well, but they don't turn to guns or
wanton violence as an alternative in the way they do in the
United States. That is entirely unique to our country.
Before we turn to our witnesses, let me briefly lay out the
mechanics. After I swear the witnesses in, then they'll have 5
minutes each to provide an opening statement, and then around
of questions where each Senator will have 5 minutes to ask. We
welcome the five witnesses, and I'm going to introduce the
Majority witnesses.
Our first witness is Dr. Megan Ranney. Dr. Ranney is the
dean of the Yale School of Public Health, a board-certified
emergency physician and violence prevention researcher. She's
been a leading national voice for addressing firearm injuries
as a public health problem for well over 10 years. Thank you.
We're joined as well by Dr. Franklin Cosey-Gay. Dr. Cosey-
Gay is director of Violence Recovery Program at the University
of Chicago Medicine, which helps trauma patients and their
families with crisis intervention and social service. In 5
years, the program has grown 800 percent, serving over 8,000
participants, and employs more than 20 specialists who are
themselves either gun violence survivors or family members of
gun violence victims.
Our final Majority witness is Vaughn Bryant. Mr. Bryant is
the executive director of Metropolitan Peace Initiatives, which
is based in Chicago. MPI focuses on community violence
intervention by providing trauma-informed behavioral health
service, building a citywide network of outreach workers, and
enhancing community capacity to reduce violence.
I now turn the floor over to Senator Cornyn to introduce
the Minority witnesses.
Senator Cornyn. Thank you, Mr. Chairman.
Now, Ms. Amy Swearer is a senior legal fellow at the
Heritage Foundation. Her areas of scholarship include the
Second Amendment over criminalization, school safety, and the
intersection of mental health and gun violence. She runs
Heritage's Defense Gun Use Database, and is the primary author
of Heritage's recent ebook, ``The Essential Second Amendment.''
She earned her J.D. and undergraduate degrees from the
University of Nebraska.
Mr. Steven Cook, who's been a frequent witness here before
the Committee, served with the Department of Justice for 33
years, including 30 years as a Federal prosecutor in the
Eastern District of Tennessee. Between 2017 and 2019, he served
as Associate Deputy Attorney General and Director of Law
Enforcement Affairs. In that capacity, he led two of DOJs
priority programs, Violent Crime Reduction, and strengthening
the DOJ's relationship with State and local law enforcement.
Before joining the DOJ, Mr. Cook worked as a police officer
for 7 years. Presently, Mr. Cook serves as a general counsel
for both the Major Cities Chiefs Association and the Major
County Sheriffs of America, and he also serves as outside
counsel for the Federal Law Enforcement Officers Association.
Thank you.
Chair Durbin. Thank you, Senator.
I ask the witnesses to please stand and be sworn.
[Witnesses are sworn in.]
Chair Durbin. Let the record reflect that the witnesses
have answered in the affirmative. Dr. Franklin Cosey-Gay is
first.
STATEMENT OF FRANKLIN N. COSEY-GAY, PH.D.,
DIRECTOR, THE VIOLENCE RECOVERY PROGRAM,
THE URBAN HEALTH INITIATIVE, UNIVERSITY
OF CHICAGO MEDICINE, CHICAGO, ILLINOIS
Dr. Cosey-Gay. Chairman Durbin, Senator Cornyn, and
respected Committee Members, I'm deeply grateful to have the
opportunity today to share a personal story that underscores
the vital Violence Recovery Program. My name is Dr. Franklin
Cosey-Gay, the director of this hospital-based violence
intervention program.
As was highlighted today, gun violence is an agonizing
crisis plaguing our Nation, causing immeasurable pain and
suffering. However, there are proactive ways we can respond to
get in front of the problem, and that, through a collaborative
and coordinated approach, a public health prevention and
intervention approach, many of our facets of our society can
come together to be a part of this solution, and hospital-based
violence intervention programs are core to solving this complex
puzzle.
What is the Violence Recovery Program? It's a hospital-
based violence intervention program that consists of highly
trained paraprofessionals, many who are impacted themselves as
survivors of violence, who often come from the community.
They're housed in the hospital 24/7, 365 days a year. They
provide crisis intervention support while the patient is there,
and that continues through a coordinated approach with our
spiritual care team, social work, child life specialists,
mental health specialists, our clinicians in the hospital, as
well as Healing Hurt People Chicago.
Our specialists use intensive long-term case management,
partnering with community violence interventionists in the
community that have special relationships that are core to our
approach for comprehensive recovery and preventing re-injury.
Today, I want to bring the human side of our efforts
through a story that has touched my heart, and captured our
collaborative and coordinated approach, and why that approach
is so critical.
I want to share a story of a 12-year-old patient who
arrived at our trauma center with a gunshot wound to the left
thigh. At that moment, our team moved in swiftly in action
within the hospital walls, not just as healthcare providers,
but as compassionate individuals eager to make a difference. We
provided practical assistance--providing a phone charger, a
blanket, water--but we also consulted with our child life
specialists to provide a comforting presence.
As we delved deeper into the interpersonal risk
assessments, it became painfully clear that this young child
was exceptionally high risk for re-injury after being
discharged. His family safety was also in jeopardy. Through
this juncture, it demanded more than just medical attention. We
connected with shelters, securing temporary emergency funding
resources to meet the family's immediate needs. Our support
continued, understanding that we needed to provide wraparound
services to address the holistic needs around resiliency and
recovery from trauma.
Our collaboration extended with our internal Recovery and
Empowerment After Community Trauma, mental health clinicians
who provide therapeutic sessions for our survivors and
families. We contacted our program partner, Healing Hurt
People, who connected with patients within the trauma
intervention specialist to provide this long-term case
management. Regular calls, regular home visits were conducted
with the patient and his mother providing emotional,
psychological support, and with practical help such as
emergency transportation, counseling, and community-based
activities.
I regret to share that that family's home was rattled with
gunshots. Their home was destroyed in a retaliation event.
However, we secured transitional shelter in Indiana, our
neighboring State, for 10 days, and after that, our team
continued until we were able to establish a permanent home in a
neighboring State.
Collaborating with our street outreach partners that will
be represented here by Mr. Bryant, we made sure that those
leaders that have existing relationships with the individuals
that are causing harm would agree to create a non-aggression
agreement to prevent further violence from happening. That
agreement has been held up for this entire time.
This example is underscored in regarding the complexity of
the work that we're doing. One thing that I want to highlight
is the role that our Chicago Police Department have with our
community violence interventionists. One of my proudest moments
in doing this work is hearing our Chicago police officers
commend CVI, community violence interventionists, for doing
work, for establishing peace in the community and establishing
non-aggression agreements. I'm equally proud when I hear our
community violence interventionists commend the police officers
for treating residents--and those that are causing harm--with
respect and dignity.
Since 2018, the Violence Recovery Program has engaged over
9,000 patients: 85 percent of them have been African American;
70 percent of them have been victims of gunshot wounds; 81
percent males; 86 were involved in community violence; 60
percent between the ages of 22 and 40. Impressively, our
program has accepted--89 percent of the patients have accepted
services through this work, resulting in a re-injury rate of
2.1 percent.
While this outcome speaks to their terrific work, re-injury
rate is only at the program level. Thanks to Senator Durbin's
HEAL Initiative, we are working to establish data sharing
agreements with all of the 10 hospitals that are a part of that
initiative. As we continue to experience the impact of this gun
violence, it is clear that this is a persistent public health
crisis. However, our response to be proactive needs to happen
through a collaborative and coordinated approach.
Hospital-based programs are very important, like our
Violence Recovery Program, to play a perfect role--a critical
role in establishing solutions toward this complex puzzle.
Thank you very much.
[The prepared statement of Dr. Cosey-Gay appears as a
submission for the record.]
Chair Durbin. Thanks very much, Doctor. Steven Cook.
STATEMENT OF STEVEN H. COOK, RETIRED ASSOCIATE DEPUTY ATTORNEY
GENERAL, KNOXVILLE, TENNESSEE
Mr. Cook. Good morning, Chairman Durbin, Ranking Member
Cornyn, Members of the Committee. Thank you very much for the
opportunity to appear before you today. And thank you, Senator
Cornyn, for that introduction. I am serving in the capacities
that you described, but I am here representing views of--the
views that I'm going to express are the views of my own.
And I'd like to just begin with one single observation and
it's this: What this Committee does or does not do will have a
profound impact on violent crime in our country. I'm convinced
of this because I was a Federal prosecutor when our Nation
faced very similar problems in the mid-1980s. Crime was
skyrocketing. Congress responded, and responded with
legislative programs and statutes that allowed Federal
prosecutors to team up with their State and local law
enforcement partners, and to go after the most violent
criminals in our country.
The program worked. Violent crime began to turn around by
1991, as we continued to fill our prisons with violent
offenders from across the country over the next two decades,
and by 2014, violent crime had been cut in half. Then in 2015,
we began to see a rise and an increase in violent crime. To
those of us who were participants in the system, this was no
surprise because we had watched as the Federal criminal justice
system was incrementally weakened by events.
This morning, I'd like to focus on four of those events.
First, DOJ policy handcuffing Federal prosecutors,
beginning with the Attorney General Holder's memo in 2010, and
now followed up by Attorney General Garland's Fed--memo to
Federal prosecutors. Federal prosecutors have been ordered not
to charge offenders, especially drug traffickers, with the most
serious crimes they commit. As a result, the front end of our
criminal justice system has been weakened.
Second, in a series of opinions by the Supreme Court, the
Supreme Court has significantly narrowed the reach of key
statutory provisions designed to take violent offenders off the
street. Among the statutes narrowed has been the Armed Career
Criminal Act. Attempts have been made to pass legislation by
Congress to correct these narrowing effects, but those
statutory provisions have not passed.
Third, the steady drumbeat of anti-police rhetoric premised
on baseless allegations that law enforcement officers across
the country are racist. These are the men and women who are the
backbone of our criminal justice system. Several studies have
determined that the anti-police rhetoric has called caused de-
policing, which in turn has reduced arrests and undermined both
Federal and State criminal justice systems.
The fourth item I'd like to address is the finality of the
Federal criminal justice system and the fact that it has been
completely gutted. The Sentencing Reform Act of 1984 allowed
through a provision called the--most commonly known as the
Compassionate Release Program. It authorized the Bureau of
Prisons to file a motion with a Sentencing court for a
prisoner's early release for--and this language is important--
``extraordinary and compelling reasons.''
Typically, those motions were limited to acts such as, or
incidents such as where a prisoner had a fatal disease and the
Bureau of Prisons filed for early release onto those provisions
about 24 times a year.
In 2018, Congress changed the procedure, but not the
applicable standard, by permitting defendants to file motions
for compassionate release. Although the common meaning of
extraordinary and compelling reasons--the statutory definition
or the statutory language suggests a very narrow limited
circumstances, the courts have taken a much broader approach
and a much more expansive view of their authority.
By 2019--between 2019 and today, they have granted
thousands of early release motions. Recently released
statistics have shown that some inmates have filed numerous
motions, and collectively in 1 month alone filed 2,000 motions,
and in some months, 20 percent of those motions were granted.
And it gets worse.
In April, the Sentencing Commission in a 4-to-3 vote
promulgated a further definition--or, a further reading of
extraordinary and compelling grounds for early release. That
broader definition included among other things, allowing courts
to consider changes in the law not made retroactive by
Congress.
Collectively, the actions by the Sentencing Commission and
the expansive court readings have resulted in a systemic
structural change to our criminal justice system without
congressional authorization or directive, and it has removed
any finality in sentencing by allowing prisoners to file an
unlimited number of motions re-litigating their sentences
endlessly.
I see my time has expired. I welcome your questions.
[The prepared statement of Mr. Cook appears as a submission
for the record.]
Chair Durbin. Thank you, Mr. Cook. Mr. Bryant.
STATEMENT OF VAUGHN BRYANT, EXECUTIVE DIRECTOR, METROPOLITAN
PEACE INITIATIVES, CHICAGO, ILLINOIS
Mr. Bryant. Good morning, Chairman Durbin, Senator Cornyn,
and Members of the Senate Judiciary Committee. My name is
Vaughn Bryant. I'm the executive director of Metropolitan Peace
Initiatives, also known as MPI, a division of Metropolitan
Family Services.
I come to this work growing up in Detroit, Michigan. I'm a
son of a Detroit police officer, and growing up, all of the
sports I played were coached by police officers. I went on to
become a fourth-round draft pick by the Detroit Lions in 1994,
and I've spent half of my professional career serving the
community.
MPI coordinates, supports, and sustains a cross-agency
community safety infrastructure, made up of local community-
based organizations rooted in neighborhoods hardest hit by gun
violence in the City of Chicago. For the first time in
Chicago's history, organizations with proven CVI outcomes
across the City's geographies have come together to build a
civilian infrastructure dedicated to preventing violence,
delivering a comprehensive set of services to heal communities
at highest risk for violence, and providing opportunities for
individual rehabilitation.
In 2015, Chicago endured the Laquan McDonald saga. In 2016,
we saw 762 individuals killed by guns, and 4,580 individuals
shot. Increases of 58 and 47 percent, respectively. That led to
a group of local leaders establishing Communities Partnering 4
Peace, or CP4P. Convened by MPI, we began to partner with 8
organizations working in 9 communities across the City of
Chicago.
Today, that coalition includes 13 partner agencies active
in 27 Chicago communities. The program targets individuals most
at risk for perpetrating gun violence or becoming a victim. Key
services include street outreach, engaging individuals at the
high likelihood of shooting or being shot, case management
services to address social determinants of health, victim
services to provide supports and safety planning for victims of
gun violence, and community-based events aimed at building
community safety and solidarity known as ``Light The Night.''
We administer the Metropolitan Peace Academy, a
multidisciplinary platform that trains, professionalizes, and
strengthens the field of street outreach and community violence
intervention. The MPA features a curriculum that is 18 weeks,
144 hours of intensive curriculum, shaped and taught by street
outreach workers, subject matter experts, and is guided by 14
professional standards.
MPI's model also includes behavioral health, workforce
development, civil legal aid, and organizational capacity
building. In addition, MPI partners with Southland Resilience
Initiative to Strengthen and Empower, also known as Southland
RISE, a collaborative of the University of Chicago Medical
Center and Advocate Christ Medical Center, formed in response
to the Chicago HEAL Initiative, launched by Senator Dick
Durbin.
It urges healthcare providers to bolster their efforts to
reduce gun violence and address healthcare needs associated
with violence recovery. Southland RISE was created to
strengthen collaboration between hospitals and street outreach
organizations with the goal of improving trauma-informed care
and support for gun violence survivors and their families on
the Chicago's South Side and South suburbs.
The MPI, along with the two hospitals together, developed
two 4-day cross trainings that brought together the
perspectives and knowledge of both street outreach and hospital
frontline staff. We completed our first cohort in June, and
begin our next one in February 2024. Since starting CP4P in
2017, members of organizations have provided over 200,000
direct services to 5,500 participants, most acutely at risk of
gun violence.
Leading research by Northwestern University's Center for
Neighborhood Engaged Research & Science estimates that between
July 2017 and December 2021, a time rise of--rising crime in
Chicago and the country, communities where CP4P was operating,
saw statistically significant and favorable changes of rates of
homicide and non-violent shootings compared to areas without
CP4P. CP4P's work resulted in 383 fewer homicides and non-fatal
shootings than would've been expected without CP4P.
I want to go now to the importance of Federal funding for
this work. It has a national impact. Gun violence is a national
epidemic. We can address root causes for systemic issues like
poverty, and equity, and equality, and lack of educational and
employment opportunities. And giving a resource allocation can
create standards of practice across the country that are
important for this work. Thank you.
[The prepared statement of Mr. Bryant appears as a
submission for the record.]
Chair Durbin. Thank you very much, Mr. Bryant. Ms. Amy
Swearer.
STATEMENT OF AMY SWEARER, SENIOR LEGAL FELLOW,
EDWIN MEESE III CENTER FOR LEGAL AND JUDICIAL
STUDIES, THE HERITAGE FOUNDATION, WASHINGTON, DC
Ms. Swearer. Chairman Durbin, Ranking Member Cornyn, and
distinguished Senators. My name is Amy Swearer. I'm a senior
legal fellow at the Heritage Foundation's Edwin Meese Center
for Legal and Judicial Studies.
Here we are, once again, holding a congressional hearing on
gun violence. This time, the chosen lens is that of public
health. Despite the slightly different title, it's effectively
the same hearing as the last several gun hearings to which I've
been called to testify. To be completely honest, I don't have
much to say that's different from what I've said in my previous
testimonies. Believe me, I'm not being flippant. It's just that
using a public health lens hasn't changed the discussion.
Put aside that the end goal of many of those pushing the
public health framing is often either to use crisis language as
an end run around the Constitution, or to pathologize the right
to keep and bear arms. Put aside, too, that the public health
lens is not particularly useful for understanding and
addressing a problem that stems at its core, not so much from a
lack of insight into how violence affects health as from a lack
of adequately enforcing criminal laws and utilizing existing
mental health frameworks.
If we take the issue of gun violence seriously from a
public health perspective, none of the problems or solutions
have changed. A public health framework doesn't change, for
instance, the fact that most gun crimes are perpetrated not by
ordinary lawful gun owners, but by a small subset of repeat
offenders who are already prohibited from owning guns. It's
still the case that if our policing, bail, and prosecutorial
policies immediately spit these repeat violent offenders back
into the community without pursuing criminal prosecution or
punishment, they will predictably keep committing violent
crimes.
A public health lens doesn't change the fact that most gun
deaths are suicides, but half of suicides are carried out with
something other than a firearm. So pathologizing a specific
weapon remains far less useful than talking about all lethal
means during a personal crisis, and dealing with hard
underlying truths about the nationwide mental health crisis.
It certainly doesn't change the fact that most of the gun
control restrictions commonly proposed to deal with criminal
violence and suicide, things like assault weapons bans,
magazine capacity restrictions, punitive public carry laws and
so on, are not even remotely designed to meaningfully address
any major factors underlying crime or suicide. And a public
health lens doesn't fix the constitutional or practical
concerns about implementing these policies, nor does it erase
the fundamental importance of the right to keep and bear arms
to the natural right of self-defense.
And so, my proposals for how Congress should move forward
may sound pretty familiar. Among other things that I've
outlined in my 35 pages of written submission, Congress can and
should pursue the following.
First, Congress can start right here in Washington, DC,
where the DC City Council's reform efforts have created a crime
tsunami under which the District's residents are currently
drowning. Congress should exercise its plenary authority in
passing modern, comprehensive criminal code for the District,
including a mandatory sentencing scheme for the superior court
judges. It should strip the DC Office of Attorney General, the
authority to prosecute all crimes and give that to the DC U.S.
Attorney's office. It should Federalize the DC Crime Lab and
give that to the FBI.
Second, Congress can and should reign in Federal agencies
like ATF when they shift their time and attention to
overregulating peaceable citizens instead of targeting violent
criminals who actually threaten public safety.
Third, Congress can compel the military branches to better
share with civilian authorities all relevant information about
service members who clearly pose a danger to themselves or
their communities. Last month's shooting by a mentally ill Army
Reservist in Lewiston, Maine, was not the first time the
military's failure to share such information resulted in
preventable tragedy. Congress can ensure that it is the last.
Fourth, instead of spending so much time pathologizing and
demonizing specific mechanisms of violence, Congress can turn
its attention toward promoting economic growth and easing
crushing inflation rates. No, that's not nearly as sexy as
calling for an assault weapons ban. But reducing economic
stress, poverty and family instability lowers a person's
overall risk of suicide far more than requiring his or her
rifle to be featureless.
Senators, if today is an average day, by the time we finish
this hearing, in about 3 hours, roughly 8 Americans will have
been murdered, about twice as many will have killed themselves,
and countless others will have been violently victimized. Much
of that violence will involve firearms. This is antithetical to
human flourishing, to the rule of law, and to civil society.
It's a problem worth understanding accurately and addressing
meaningfully.
And so I am happy to come back and repeat the same
testimony as many times as you ask me to. And I will explain
the same potential courses of action as often as it takes for
Congress to do not just something, but the right things. And
once again, I look forward to your questions.
[The prepared statement of Ms. Swearer appears as a
submission for the record.]
Chair Durbin. Thank you, Ms. Swearer. Dr. Ranney.
STATEMENT OF MEGAN L. RANNEY, M.D., DEAN, YALE SCHOOL OF PUBLIC
HEALTH, NEW HAVEN, CONNECTICUT
Dr. Ranney. Chair Durbin, Senator Cornyn, and Members of
the Committee, thank you for conducting this hearing and
recognizing gun violence as a health crisis. I am a board-
certified emergency physician and dean of the Yale School of
Public Health. I've spent nearly 20 years working as an
emergency physician in a top tier trauma center.
Here in the U.S., treating firearm injuries is a routine
part of emergency medicine. During our training, we learn how
to identify who must go right to an operating room, how to
crack the chest of someone who's bleeding out, and how to
notify family members of a death. While in training though, we
rarely, if ever, learned to ask what could be done to prevent a
gunshot wound in the first place.
That changed for me about 15 years ago, after I cared for a
young man, the son of a first responder who had shot himself
with his parents' firearm. He was the first patient I cared for
who had intentionally shot himself. I couldn't save him, but he
changed my perspective on gun violence.
First, his death drove me to learn more about firearm
suicide, to realize that in the emergency department, we rarely
saw suicide attempts from a gun, not because they were rare,
but because they were so often fatal.
Second, his death led me to question why we didn't think
about gunshot wounds the same way we think about drunk driving
or heart disease as something we can and should prevent.
Most disturbingly, I noticed the difference in how my
colleagues responded to the suicide compared to the everyday
toll of community gun violence.
Since that case, I have treated people for every type of
firearm injury, from domestic violence to victims of drive-bys.
I've saved some lives, but not all, and have informed countless
families of the loss of their loved ones. And it is because I
have had a front row seat to our Nation's growing firearm
injury epidemic that I have worked to define and implement a
public health approach to this crisis.
To clarify, this is how a public health approach works.
First, we gather data on the problem. How common is it and
who is affected?
Second, we define risk and protective factors. What
increases or decreases the chance of someone being hurt or
dying?
Third, we figure out programs that work to change those
patterns to avert injury, hospitalization, or death.
And finally, we scale what works. We have example after
example of how this 4-step approach when applied systematically
can improve human health without abrogating rights.
For example, we decreased car crash deaths, as Chairman
Durbin mentioned, by more than 70 percent over the last few
decades--despite more cars being on the road--by quantifying
the problem, identifying risk factors, developing multifaceted
solutions, ranging from reducing drunk driving to putting
airbags in cars, and then by scaling what worked.
Unfortunately, we have not yet consistently applied this
approach to firearm injury. As a result, we are facing a
growing epidemic. America's total number of gun deaths is the
highest on record, and our rate nears its peak. Firearm deaths
have surpassed breast cancer deaths in America. Firearms are
now the leading cause of death for American children, age 1
through 19.
Although mass shootings get the most media attention, two-
thirds of firearm deaths are preventable suicides averaged over
the last decade, like that young man I cared for 15 years ago.
The remainder are mostly community violence and, to a lesser
extent, domestic violence.
Although there are clear risk factors and disparities, it
is a problem that affects all of us. More than half of American
adults say that they or a family member has been involved in a
shooting. More than three-quarters say the fear of gun violence
has led them to change something in their lives.
The effects of this epidemic are wide and long, ranging
from immediate medical costs estimated by the Government
Accountability Office at $1 billion dollars a year to long-term
mental health, economic, and educational impacts. Mothers,
fathers, friends, as well as first responders, all experience
anxiety, depression, and post-traumatic stress after a nearby
shooting.
These dismal statistics aside, as an ER doc and public
health dean, I have confidence we can turn the tide. Four
things are needed to help us apply this public health approach
successfully: improved data; improved research funding;
improved training of healthcare and public health professionals
and community members to help us recognize and act on risk;
and, most of all, improved collaboration with the most affected
communities, whether rural or urban.
And this is where we need your help. First, help us get
better data so Americans can better measure, predict, and
evaluate this health crisis. You can make this happen, whether
by funding data modernization for the CDC or by removing
barriers to data sharing amongst State, territorial, and local
partners, as Utah has done.
Help us with Federal funding for research to develop and
evaluate solutions. At a minimum, continue current levels of
appropriations for the NIH and CDC, but ideally appropriate
more. Help us by supporting our scaling up and training of
folks on things that do work, I'm happy to talk about this in
Q&A. And finally, help our country have hope by demonstrating
collaborative action, as you have done before.
We are turning into a Nation of traumatized survivors. But
I have story after story of public health collaborations
between gun owners and non-gun owners, hospital workers and
community violence interrupters, faith leaders and survivors.
We have shown we can reduce the risk of a shooting long before
someone picks up a gun with intent to harm. Through your
bipartisan commitment to this public health approach, our
country can reduce firearm injury and death for all. Thank you.
[The prepared statement of Dr. Ranney appears as a
submission for the record.]
Chair Durbin. Thank you, Dr. Ranney. I'm going to start
with 5 minutes of questions, and then turn over to my
colleagues, each having the same opportunity.
I listen to those who are critical of our even having this
hearing and talking about this. There's so many more important
things we can talk about, and yet I just wonder if there's
anything more important than life or death in your average
neighborhood. Is there anything more important than knowing
that that little boy or little girl that you sent to school
this morning is safe in the classroom, doesn't have to hide
under his desk--active shooter drills and exercises?
You know, that really gets down to the basics. If you want
to know about the safety of your family, it starts with the
knowledge that when that child goes to school, it's going to
come home safe at the end of the day. If you can't answer that
question affirmatively, what in the hell are the rest of the
questions worth?
This, to me, is a fundamental issue, and it is a public
health issue. It involves not hairstyles, it involves death.
Death by gunshot. And it's going on in America every single
damn day. And we have a responsibility to do something up here,
not just to say we need to fund the police more. I'll sign up
for that. We need to deal with mental health counseling. I'll
sign up for that as well.
But are we going to do some basic things like safety locks
on guns so the kids can't play with them? Are we going to do
anything basic like identifying people who should not even be
considered owners of guns and take advantage of the gun store
loophole? That to me is an example of what we can do that's
just common sense.
Some States have taken a lead on this, and some may be
surprising. Is there any restriction on buying a gun in the
State of Wyoming, one of the most Republican States in the
United States? Yes. It turns out they have a State law that
says you have to be 21 years of age. We're still debating this
on a national basis. Even a conservative Republican State like
Wyoming thinks that makes common sense. I agree with them.
I want to ask a you question. I have so many I could ask,
but Dr. Cosey-Gay and Mr. Bryant, and it really gets down to an
experience I had thanks to Children's Memorial Hospital--Lurie
Children's Memorial Hospital in Chicago. They gathered some
gunshot victims together, and I met with them in private and
said to them, ``Okay, close the doors. This is off the record.
What is it this old white guy ought to know about what's really
happening in the streets of Chicago? ''
Finally, when they loosened up and started giving a
response, it was a great day in my life. I learned a lot in a
very short period of time. I'll never forget two, who talked
about the homes they grew up in. One young man, African-
American man, said, ``Senator, I grew up in a house with no
rules. When I woke up this morning and opened my eyes, I
decided what time I'd get out of bed and whether I'd go to
school. I decided whether I'd stay out on the streets all day
and all night. I decided whether I'd buy drugs or guns. That
was my decision. There were no rules in my house.''
I contrasted that with my own life. From the minute I
opened my eyes in the morning until I closed them at night,
there were rules flying at me in every direction. ``Get up,
make your bed, brush your teeth, make your lunch. Take care of
your little sister. Make sure that we have the dog out for a
walk.'' And when you get to school, there's a nun waiting there
with a hundred more rules----
[Laughter.]
Chair Durbin [continuing]. And the penalty is to burn in
hell if you didn't follow them. What a contrast in formative
years.
The second thing was a young woman who said she was a
mother--she was probably in her twenties, she said, ``I was a
mother at the age of 14. It's the best thing that ever happened
to me.'' I said, ``Why? '' She said, ``My mother was a junkie.
She brought boyfriends home, took advantage of her, and then
turned to me. Finally with that baby, I got out of that house
and had a chance. I made something of my life as a result.''
Those are contrasting life experiences, which I don't know
personally, but are part of this calculation.
So let me ask the two of you. Can we reach young people
who've gone through those traumatic experiences and turned
their lives around from violence? Doctor?
Dr. Cosey-Gay. Thank you, Senator Durbin. First of all,
thank you for sharing this story. And there's a phrase that I
like to use that's connected to individuals that have lived
similar lives. It's, ``that no one person should be judged by
the worst thing that they've done in their lives.'' The work
that we use, focusing on individuals that are survivors of
violence, that have actually caused harm themselves, either in
the hospital or in the community-based side, these are
individuals that have desisted from that, but they've learned
from that. They understand the impact that trauma has. That mom
that was a junkie, there's a reason why that mom was a junkie.
What the role that trauma has on the household impacts
parental practices, monitoring how parents and families monitor
their children. We need to uplift the role that trauma plays in
our society. I believe in this room, we both agree the impact
that trauma has in terms of suicide rates. We take that same
frame, we humanize, but we understand that the individuals that
should be trusted to intervene are individuals that have led
that life themselves, and they're asking individuals to walk on
the same path that they've walked, on because they understand
that path.
When it comes to addressing issues connected to trauma, you
have to really understand the role of trust. A lot of our
systems, over time, trust has been eroded. And so having
individuals that understand that life is an important first
step.
Chair Durbin. Thank you. Mr. Bryant, you've got 30 seconds.
Mr. Bryant. Yes, I would agree. I would add not only people
with the lived experience, but also trained experts in mental
health, paired with those folks to work, to heal our
communities. The average age of the folks that we work with is
about 31. So imagine a 31-year-old, Black male who hasn't
finished high school, never had a formal job.
You know, a lot of those times they've grown up similarly
with no rules, and if we can get to those people and help heal
those people, then they're going to be not only better for
their communities, but they're going to be better for their
families because typically they're going to have kids as well.
And a lot of times that when we see youth getting shot, it's
related to an adult in their lives that is living a life that,
you know, is not necessarily dignified. And all of our work is
really around engaging, healing, and help putting people on a
path to live in a dignified life.
Chair Durbin. Thank you, Mr. Bryant. Senator Cornyn.
Senator Cornyn. The longer I've been in Washington, DC, and
worked in the United States Congress, the more I have come to
believe that what divides us is not our goals so much as the
means to achieve our goals. And here, obviously, we all would
want to diminish and reduce violence in our communities.
Mr. Cook, years ago, there was a Project Exile in Richmond,
Virginia, I guess it was the first place that a concentrated
effort between Federal, State, and local law enforcement
efforts to focus on, essentially, repeat criminals, felons,
possessing firearms, using firearms to committing other
offenses to target that aspect of violence in our communities.
That's now become Project Safe Neighborhoods, which I mentioned
has passed the Senate earlier this year.
Given your experience as a Federal prosecutor, can you
describe the importance of focusing our time and resources on
those--that small microcosm really of our communities that are
committing most of the violent acts using firearms in our
communities?
Mr. Cook. Yes, sir, I can. Let me first begin by thanking
you for championing the Project Safe Neighborhoods
Reauthorization and to the Members of this Committee who voted
for that. Project Safe Neighborhoods, which was a spinoff from
the wildly successful Exile Project in Richmond has--that
project itself has continued with the cornerstone being exactly
what you said. And that is to take partnerships with Federal
prosecutors, State, and local law enforcement, take those
partnerships, identify the worst of the worst, and put them in
Federal prison.
But Project Safe Neighborhoods really is more comprehensive
than that. It also has other components. In our district, it
was very successful. We had a 23 percent reduction in the first
4 years of the project, but it was more than just putting
people in prison. That was the cornerstone. But we also had a
reentry program. We also had an educational component. We also
had a community interface component. So, Project Safe
Neighborhoods has continued to produce great results across the
country, varying as high as 41 percent reductions in violent
crime.
Senator Cornyn. In addition to reauthorizing Project Safe
Neighborhoods, what, in your opinion, what else should Congress
be focusing on to make sure that we're dealing with this
identifiable, recalcitrant criminal element that are
responsible for most of the violent crimes in our communities?
Mr. Cook. Federal prosecutors need the tools back that I
mentioned, that have been taken away. First of all, as I said,
finality in the Federal criminal justice system has been
gutted, and it's been gutted because the courts and the
Sentencing Commission have taken the authority that Congress
has given it through [Sec. ] 3582, and they have run with it.
And I think they've far outstripped the authority that Congress
intended.
So first, I would suggest that Congress put guardrails on
[Sec. ] 3582--serious guardrails. Second, I think that that
Congress needs to look at the Armed Career Criminal Act and the
related statutes, and make amendments that, that correct the
narrowing that the Supreme Court has taken over the years,
because those tools are fundamental to our ability to put those
trigger pullers, those violent criminals who are the key to
reducing violent crime. Those are the tools we need to put them
in prison and keep them there.
Senator Cornyn. Dr. Ranney, I applaud the efforts that
you're undertaking. As you've heard, I have some questions
about framing this as a public health crisis, but we'll leave
that for discussion at another time. Let me ask you, in 2022,
you did an interview with the American Medical Association
where you said that mental illness is not a predictor of
hurting others. Hatred is. Would you apply that to violent
street gangs that are competing for territory and profits in
communities across the country? Do you think it's hatred? Or do
you think it's something else?
Dr. Ranney. Thank you, Senator Cornyn, and thank you again
for your leadership with Senator Murphy on the Bipartisan Safer
Communities Act. As I outlined in my written testimony, studies
have shown that people with serious mental illness are more
likely to be victims of violence than perpetrators of violence.
Substance use and antisocial personality disorder are risk
factors for being perpetrators of violence. And, of course, as
you outlined, mental illness is deeply connected to firearm
suicide, which is the leading type of suicide--excuse me, of
firearm death in this country.
Senator Cornyn. Do you, in your experience, do people
suffering mental health crises tend to frequently self-
medicate, which exacerbates their dangerousness to themselves
and others?
Dr. Ranney. That can happen if there's inadequate access to
mental health treatment. I think it is worth noting that when
you actually look at mass shooters, the vast majority of them
were in an identifiable crisis prior to that mass shooting. But
only slightly more than the average American population have
been identified as having serious mental illness. An awful lot
of them are suicidal. And so, there is an element of getting
folks treatment and access to care, it's also about limiting
access to lethal means at that moment of a crisis.
Senator Cornyn. Thank you, Mr. Chairman.
Chair Durbin. Thank you. Senator Blumenthal.
Senator Blumenthal. Thanks, Mr. Chairman. Thank you, to the
Chairman and Ranking Member, for having this hearing. It may
seem repetitive, but we need to continue this work because we
face a public health crisis that is only expanding as you have
demonstrated, and we all know simply measured in deaths and
injuries. I've been working on it since the early 1990s when I
first became Attorney General of the State of Connecticut, and
we advocated then for an assault weapon ban, which was passed.
It was challenged in court. I defended it as Attorney General.
And we have expanded in Connecticut on the types of gun
violence prevention laws that we have showing that these laws
actually work. They've reduced deaths and injuries: assault
weapon ban, background checks, Ethan's Law, providing for safe
storage, and other kinds of measures like the ``Red Flag''
statute--Connecticut was the first in the Nation to adopt it.
So, if we take the public health approach that Dr. Ranney
has advocated, and we are data driven, as the medical
professionals in this room wearing the white coats use every
day, respecting facts, making decisions based on science, I
think that we will continue to build on the Bipartisan Safer
Communities Act, which we passed and show that we can defeat
the gun lobby, that the NRA and its allies are not implacable,
invulnerable foes.
Dr. Ranney, in your testimony, you mentioned the importance
of violent crime as an indicator of potential additional gun
violence. I'm struck by the statistic that 41 percent of
patients treated for violent injury are re-injured within 5
years.
In other words, there is a cycle here. There is a
repetitive phenomenon. I think we can, and we should ensure
that more victims of violent crimes do not become repeat
victims. And the Yale New Haven Hospital's Violence
Intervention Program has been very effective in a number of
ways in preventing the kinds of repeat injury after trauma.
In your firsthand experience, can you describe for us how
these programs work in practice? And how maybe we can have some
common ground here in supporting violence intervention programs
like the one that Yale New Haven has in practice right now?
Dr. Ranney. We're tremendously grateful for the Yale New
Haven Health Violence Intervention Program, which was started
in 2020. I also sit on the board of the Nonviolence Institute
in Providence, Rhode Island, and have worked closely with folks
in Chicago, and elsewhere, in community violence intervention
programs.
These are some of the programs with growing data behind
them. I'll particularly highlight the CRED program led by
former Secretary of Education Arne Duncan, in Chicago. They
provide life skills training and mental health support, as well
as community mentorship. And rigorous research has shown that
that program correlates with decreased arrests for violent
crime, as well as decreased likelihood of participants being
shot. Similar statistics are available from programs in
Missouri, from programs in DC, and from elsewhere across the
country.
Again, because of those limitations on the public health
approach, which I outlined at the beginning, we do--can still
have limited data on how effective they are. We don't have
those formal randomized controlled trials, but this combination
of providing a caseworker, mental health support, and substance
use treatment when needed, and helping get folks into safe
housing, help them get an education, has a demonstrated effect
on both future injury, but also long-term life success.
Senator Blumenthal. I was very moved by your description
and your testimony of the suicide victim that you tried to
save, one of your first cases involving suicide by the use of
firearms. There are loaded and unlocked guns in the homes of
4.6 million American children, like the son of that law
enforcement officer you described.
I've been an advocate of Ethan's Law, passed in Connecticut
legislature, and introduced it here in Congress along with
Representative Rosa DeLauro on the House side, which would
prohibit unsecured storage of firearms. Could you speak to how
secured storage helps reduce suicides or other supposedly
accidental shooting?
Dr. Ranney. Absolutely. So, the majority of youth suicides
and school shootings perpetrated by youth, including an article
that actually just came out today in JAMA, are committed with a
family member's firearm. Obviously, youth can't legally
purchase firearms, and so they find a parent's firearm, which
many of us think is stored safely.
But when you actually ask kids, they all know where their
parent has stored their firearm, the same way that our kids all
know where their birthday presents are stored, and studies have
shown that they actually can access it quite quickly.
States that have put safe storage laws in place see a 20 to
25 percent decrease in child firearm fatalities, but I will
emphasize that the legislation alone is not enough. It needs to
be matched with community engagement, with enforcement, with
education. Many of the firearm groups that I work with are
tremendous advocates for safer storage of firearms, and there
are ways to do this, again, without abrogating gun owners
rights.
Senator Blumenthal. Thank you very much, Mr. Chairman.
Chair Durbin. Thank you very much, Senator Blumenthal.
Senator Grassley.
Senator Grassley. Ms. Swearer, in February, I reintroduced
a bill that I call the EAGLES Act, focusing on using behavioral
threat assessment model to identify individuals showing pre-
attack behavior, and manage the threat to prevent targeted
violence. How does behavioral threat assessment model prevent
gun violence, if you think it does, and is this something worth
expanding?
Ms. Swearer. Thank you, Senator, for that question. I think
when we're talking about behavioral threat assessment, the most
often aspect in which it comes up is preventing, like you said,
targeted acts of specifically mass violence, and I think it can
be incredibly useful in that capacity.
As Dr. Ranney mentioned, a lot of these perpetrators of
mass violence, while they may not be diagnosed seriously
mentally ill, a lot of them are in some sort of crisis. Most
often it is noticeable in the weeks, sometimes months, and
years leading up to that incident.
It's fairly rare that you have a perpetrator of mass
violence who, when all is said and done, people turn around and
say, ``Oh, we never saw that coming.'' Most of the time it is
fairly identifiable beforehand. And so that training in
professional threat assessment, helping people identify those
factors, and then knowing what to do about those factors, how
to assess them and what proper steps to take, that's all very
important when we're talking, specifically, about targeted
violence.
But also there's a lot that we can do with that in terms of
suicide, as well, because a lot of people who are suicidal,
again, that is noticeable. That lead-up to crisis is
noticeable, and so it allows us to intervene before we reach
that crisis point, or before that crisis point becomes violent
or fatal.
Senator Grassley. Again, for you. Going to the problems
we've talked about here in Washington, DC, the average homicide
suspect has been arrested 11 times prior to their committing a
homicide. What role do progressive prosecutors who refuse to
charge gun offenses, and other violent crimes committed by
criminals, play in gun violence epidemic?
Ms. Swearer. Yes, so I will note that my colleagues, Cully
Stimson and Zach Smith, have written extensively on this issue,
as well. Again, when we're talking about the small sort of
repeat offenders who are overwhelmingly responsible, either
directly or indirectly, for facilitating that crime, when you
just release them back into their communities without
prosecution, without any sort of detaining of them, you're
releasing them to continue committing the exact same crimes
over and over.
And in some cases, it actually emboldens them because now
they realize, ``Well, I can probably get away with it.
Statistically, even if I am arrested, I'm not going to be
prosecuted. And if I am prosecuted, they're gonna let me right
back out.'' That's not deterrence at all. There is no
deterrence factor. We are essentially eliminating any perceived
reason for criminals to stop committing criminal actions.
Senator Grassley. Again, for you. In August, the Justice
Department issued a proposed rule that would increase the
number of folks who have to register for a Federal firearm
license in order to do business that way. The rule says, quote,
``Even a single firearm transaction or offer to engage in a
transaction when combined with other evidence may be sufficient
to require a license,'' end of quote.
In April, Director Dettelbach told the House Judiciary
Committee that when ATF writes its proposed rule, it, quote,
``looks at the law that Congress passes and the public safety
threat to America,'' end of quote. In your opinion, does this
new rule apply to the law as written by Congress? And if not,
explain why you feel that way?
Ms. Swearer. Thank you, Senator. And no, I think anytime
you have a very slight wording change, and the proposed
regulations are essentially 108 pages explaining how it was
sort of way more significant, that should be a red flag
immediately, that it's not actually consistent with the change
in the law.
I think most concerning are some of the, sort of,
presumptions that ATF wants to now write into to say, look, if
you do X, Y, and Z, it's presumed you needed an FFL, even if
you did it once. Because it includes things like selling the
firearm with the original manufacturer's packaging. That
packaging includes things that are essential for gun safety,
including the user's manual and the original trigger locks that
had to have been sold with it.
To say that selling those items now means that you are
suddenly an FFL when you would not have otherwise been,
disincentivizes private, unlicensed individuals from including
that important safety. So, when we're looking at that sort of
absurdity, we have a problem with the law, even above and
beyond. Do I think it reflects the Federal statute? I don't
think it does.
Senator Grassley. Thank you. Thank you, Mr. Chairman.
Chair Durbin. Thank you, Senator Grassley. Senator Hirono.
Senator Hirono. Thank you, Mr. Chairman.
I think that I heard my colleague, Senator Cornyn, say that
we have a shared goal, and I would say that our shared goal is
to decrease gun violence in our country, or the number one
killer of young people in our country. And how do we do that?
One of the ways is to, I suppose, lock up the violent
criminals. Although I'm not so sure that that's what we're
doing--that our prisons are populated, have been populated for
a long time with maybe nonviolent drug cases. Be that as it
may, for Dr. Ranney, you've worked in this area. Are there
other things that Congress can do to decrease the easy access
to guns, which results in the deaths of our young people?
Dr. Ranney. One of the biggest things, which I know is
partly addressed in the Bipartisan Safer Communities Act, is
around domestic violence and domestic violence restraining
orders. We know that if a perpetrator of domestic violence has
access to a gun, you see a 500 percent increase in the risk of
the victim being killed by that gun.
We know that most murder-suicides are partner violence.
Most mass shootings are domestic violence-related, and domestic
violence is a leading cause of pregnancy death. We also know
that States with limits on firearm access by people under a
domestic violence restraining order have a significant decrease
in firearm partner violence. So that's a significant thing that
Congress can do.
Extreme Risk Protection Orders or Red Flag laws are also,
the data suggests, tremendously effective in decreasing suicide
death in particular, and there's some anecdotal evidence that
they may help in reducing mass shooting deaths.
And then last, of course, data and accurate assessments of
whether or not these things work matter deeply. The American
public deserves us to spend money in legislation on programs
that work, and funding both data and research helps with that
enterprise.
Senator Hirono. Thank you for noting that domestic violence
situations are among the worst things leading to gun violence.
And I'm sure you're familiar with the Fifth Circuit case based
on Bruen, where in a domestic violence situation, the Fifth
Circuit tossed out the use of a gun because of a person who was
under a domestic violence order, I think.
Anyway, this case is before the Supreme Court. What are
your concerns about if the court sustains the Fifth Circuit in
terms of the ability of the Federal Government or anybody else
to limit gun accessibility from people who have domestic
violence orders?
Dr. Ranney. So, there's two sides to this. One is the
personal. I've taken care of multiple victims of domestic
violence shootings, and they are like, those firearm suicides
just horrifying.
Senator Hirono. Mm-hmm.
Dr. Ranney. They almost never come out of the blue. Folks
know before they happen that they are at risk. I lost a
colleague, a fellow emergency physician in 2018, who was shot
and killed as she walked out of a shift at a Chicago hospital
by her ex-fiance. So, this is something that has tremendous
personal resonance to me.
The other side of it is that domestic violence is one of
those very well-established risk factors for violence against
self and others. Again, not just against the partner, but also
against children, family members, and society at large.
And so, there is tremendous concern on the part of the
health and public health community that should--that Rahimi
case be decided to overturn the prohibitions on firearm
ownership by folks with a history of conviction of domestic
violence. It will have tremendous negative downstream effects
for Americans in general, in terms of the number and severity
of firearm injuries.
Senator Hirono. And you are referring to the Rahimi case,
which is just before the Supreme Court. Now, thank you for
making the connection between domestic violence situations and
gun violence.
But the Bruen decision is leading to unexpected
consequences, I would say. And in many criminal proceedings,
the criminals--or the people who are being tried are using the
Bruen decision for the proposition that they cannot be
prevented from owning a gun. So, the Bruen decision is going to
continue to create a lot of questions. In fact, in Hawaii, for
example, we have some of the strictest gun laws, and many of
these laws are being challenged under the Bruen decision.
So, I think that this is--the Bruen decision is one that, I
think, Congress could, should look at. I realize that the--that
decision is based on a constitutional right to bear arms, but
it is not an unfettered right. And I think that there is
probably more that we can do to limit the impact of the Bruen
decision. Thank you, Mr. Chairman.
Chair Durbin. Thank you, Senator Hirono. Senator Kennedy.
Senator Kennedy. Thank you, Mr. Chairman. Dr. Ranney,
welcome, first. You are an ER doc. Is that right? Okay?
Dr. Ranney. Correct.
Senator Kennedy. And I understand you've been on television
a lot?
Dr. Ranney. A fair amount.
Senator Kennedy. Okay. And I understand you've built a home
television studio. Is that right?
Dr. Ranney. That's a bit of an exaggeration. I had a laptop
on a stool.
Senator Kennedy. Your husband didn't build you a home
studio?
Dr. Ranney. He did not build me a home studio. No.
Senator Kennedy. Okay. Let me ask you this. Why do you
think that Chicago has become America's largest outdoor
shooting range? Do you think it's because of Chicago citizens
who have no criminal record, but who have a--awfully, a gun in
their home for protection or perhaps for hunting? Or do you
think it's because of a finite group of criminals who have rap
sheets as long as King Kong's arm?
Dr. Ranney. So, Mississippi, Louisiana, and Missouri,
actually have higher firearm death rates. Obviously, there's
certain----
Senator Kennedy. What about Chicago?
Dr. Ranney. So, I don't live in Chicago. It's not my
primary area of research.
Senator Kennedy. You don't have an opinion on that?
Dr. Ranney. I think there's easy access to firearms,
combined with environmental conditions, lack of great
education. There have actually been studies showing that when
you green vacant lots and repair abandoned buildings in urban
neighborhoods, you see decreases in gunshots, and violence, as
well as in stress and depression in the neighborhoods around
them.
Senator Kennedy. No disrespect doc, but that sounds a lot
like word salad to me. Let me ask you this. In September of
this year, our New Mexico Governor issued a public health
emergency order, and she suspended the right to bear arms in
Albuquerque and the surrounding county. Do you support that?
Dr. Ranney. I do not. What I do support is the work that
New Mexico has done with----
Senator Kennedy. Yes, but do you support that?
Dr. Ranney. No.
Senator Kennedy. You don't. Okay. Let's see. During his
first 2 years as the D.A. in Philadelphia, District Attorney
Krasner lost or dropped 47 percent of all the illegal firearms
cases in the city. Do you agree with that?
Dr. Ranney. I'm not a lawyer. I'm a physician and a public
health professional. I can say that New Mexico has done amazing
work in trying----
Senator Kennedy. I'm asking----
Dr. Ranney [continuing]. To address suicide and gun
violence.
Senator Kennedy [continuing]. I'm asking about
Philadelphia.
Dr. Ranney. I don't have----
Senator Kennedy. The D.A.----
Dr. Ranney [continuing]. An opinion.
Senator Kennedy [continuing]. Dropped 47 percent of all the
illegal firearms cases. Did he do the right thing there?
Dr. Ranney. I don't have an opinion. However, I will say
that justice with fentanyl, it's the spread of illicit
substances----
Senator Kennedy. I'm sorry to cut you off, but I'm----
Dr. Ranney. That's okay.
Senator Kennedy [continuing]. Running out of time.
Dr. Ranney. I understand.
Senator Kennedy. The L.A. District Attorney George Gascon
said that he would not prosecute any sentencing enhancements
for guns or gang-related activity. Do you think he did the
right thing?
Dr. Ranney. Again, I am neither a lawyer nor a prosecutor.
Senator Kennedy. You don't have an opinion on that?
Dr. Ranney. I honestly don't know enough about it to have
an opinion on.
Senator Kennedy. You don't think gangs should be prosecuted
for having illegal guns?
Dr. Ranney. I'm neither a lawyer nor a prosecutor, and I
don't--that's not my area of research.
Senator Kennedy. But yet, you want to take guns away----
Dr. Ranney. I've never said that----
Senator Kennedy [continuing]. From the law-abiding
citizens.
Dr. Ranney [continuing]. I want to take guns away. Mm--I
think that you are saying something that I've not said in my
written or oral testimony, sir.
Senator Kennedy. Okay. You equated gun deaths to heart
disease in your opening statement?
Dr. Ranney. Yes, sir.
Senator Kennedy. Which is a greater public health problem,
gun deaths or heart disease?
Dr. Ranney. So, heart disease does kill more folks across
the United States, largely in the end of their----
Senator Kennedy. Like, 700,000?
Dr. Ranney. Mm-hmm.
Senator Kennedy. Yes. Gun deaths about 50,000?
Dr. Ranney. Correct.
Senator Kennedy. Do you support outlawing fried foods?
Dr. Ranney. I'm sorry. How does that relate to----
Senator Kennedy. Because fried foods contribute to heart
disease. Don't they?
Dr. Ranney. Again, I have not written or said----
Senator Kennedy. But you're----
Dr. Ranney [continuing]. That I support outlawing----
Senator Kennedy [continuing]. A physician. Right?
Dr. Ranney. I am. Have I said that I support outlawing
anything in my testimony today?
Senator Kennedy. Okay. Let me ask one more question. I'm
sorry, I cannot see that far, Doctor--on the very end.
Mr. Cosey-Gay. Cosey-Gay, thank you.
Senator Kennedy. Yes, sir. You said, I wrote it down, you
said that no one should be judged by the worst thing they have
done in their lives. Correct?
Mr. Cosey-Gay. Yes, sir.
Senator Kennedy. If one of these young doctors sitting
behind you, God forbid, walks out on the streets of Washington,
DC, and is raped or sodomized, you don't think the rapist
should be judged?
Mr. Cosey-Gay. I don't think it should be terminal. It
shouldn't be for the rest of their lives.
Senator Kennedy. You think we should forgive them and not
give them any punishment?
Mr. Cosey-Gay. I believe----
Senator Kennedy. You don't----
Mr. Cosey-Gay [continuing]. In forgiveness.
Senator Kennedy [continuing]. Think nobody's responsible
for their actions?
Mr. Cosey-Gay. I believe in responsibility. I believe in,
in forgiveness.
Senator Kennedy. Thank you--wow. Thank you, Mr. Chairman.
Chair Durbin. Thank you, Senator Kennedy. Senator Butler.
Senator Butler. Thank you, Chair Durbin, Ranking Member
Cornyn, for convening the Committee on such an incredibly
important topic. I want to also appreciate our witnesses for
joining us today, offering such incredible testimony. Most
importantly, Mr. Chair, I'd like to appreciate the physicians
and clinicians who've joined us today for their dedication in
helping us to protect our members of our community, and also
for your dedication in helping our country combat this
important crisis.
Mr. Chair, I agree with the words that you offered. This is
a conversation that is about our children. It's a conversation
that, in my opinion, is very much about the future of our
democracy.
Dr. Ranney, I'd like to direct my first question to you.
For decades, Congress has refused to allow CDC to use Federal
dollars to research gun violence prevention. Finally, in
December 2019, Congress passed the Gun Violence Prevention
Research Act, which granted $25 million per year to the CDC and
the National Institutes of Health to study gun violence
prevention from 2020 to 2022.
For those who feel like they know everything and that we
keep having the same conversation, Dr. Ranney, can you tell us
what this money has been used to help us learn? And what more
do we still have to understand relative to gun violence
prevention?
Dr. Ranney. So that money is currently being used to study
things such as projects working with the National Guard to try
to decrease firearms suicide through lethal means counseling,
projects working with families to improve safe storage of
firearms when someone has dementia to reduce the chance of
intentional or unintentional injury or death. It's being used
for projects to describe risk factors to evaluate programs like
the one that I mentioned around putting gardens in vacant lots,
which has shown to decrease gun violence in surrounding
neighborhoods to see if we can expand that work.
There are projects that are being--I mean, I could go on.
It's a whole bunch of things like that where we try to identify
what are the patterns of injury, how do we identify risk and
protective factors. And then how do we intervene, again, in the
same way that we intervene for heart disease. Maybe there are
medications, maybe there are counseling efforts, like teaching
people about obesity or smoking. And then potentially there may
be legislation. But legislation alone is never sufficient.
Senator Butler. Thank you. Mr. Vaughn Bryant, I'd love to
now turn my next question to you. In a related topic brought by
Senator Hirono, gun violence really does sit at the
intersection of another public health crisis, that being
intimate partner violence.
Mr. Bryant. Mm-hmm.
Senator Butler. In the United States, approximately 1 in 5
women and 1 in 7 men have experienced severe physical violence
by an intimate partner. On average, 3 women in this country are
killed each day by a current or former intimate partner. When
an abusive intimate partner has access to a firearm, that
victim is 5 times more likely to be killed, as has been noted.
My question to you, based on your community violence
prevention approach, have you seen and what has been the impact
of your particular approach--the approach that your
organization offers as it relates to intimate partner violence?
Mr. Bryant. So, we would say that interpersonal conflict in
general is one of the, you know, precepts to gun violence, and
oftentimes is either intimate partner violence or conflict
between intimate partners in general, often leads to a larger
conflict, which also leads to death.
So, for us, we have partnered with local domestic violence
organizations to learn more about intimate partner violence.
All of our clinicians are trained in domestic violence as well,
so that their understanding of that as they work with the
people that we're really trying to seek and, you know, we will,
on an ongoing basis, continue to strengthen that relationship
so that we're aware, but that we're also teaching the domestic
partner--domestic violence partners about our work so that we
can continue to, to strengthen what we know is a precipitant to
gun violence.
Senator Butler. Thank you. Thank you, Mr. Chair.
Chair Durbin. Thank you very much. Senator Blackburn.
Senator Blackburn. Thank you, Mr. Chairman. And I want to
say thank you to each of you for being here today for your
thoughtful answers. And I think, Mr. Chairman, we can all say,
we want to make certain that children are safe when they go to
school. And I want to start with that.
Ms. Swearer, let me come to you. I'm a mom. I'm a grandmom.
I've spent so much of my work on making certain that we protect
children, and that they have an environment where they can
learn whether it's there at school or in community activities.
And I think we all know that there are violent criminals that
are in our communities. And we know that our schools need
training, and they need security tools to keep children safe.
And that's why I introduced the SAFE School Act. This is a
concept I've worked on for years. It would be a $900 million
grant program that would allow schools to harden, and to have
the technology that they need to keep children safe, and to
increase their physical security. And it would also allow
schools to work with the local law enforcement, and train and
hire former police officers to work as school security
officers. So, I'd like for you to talk for just a moment about
the immediate need that we have to make certain that children
are safe at school.
Ms. Swearer. Sure. Well, thank you for your question,
Senator. First, I think it's important to acknowledge that,
statistically speaking, our schools are actually pretty safe
places for children. It's not, statistically speaking, where
they are most likely to be shot. It's outside of school. That
said, there's still a lot of work we can do. No child should
have to go to school, no parent should have to send their child
to school asking that question, ``Is my child going to come
home today? '' And that's a very real fear, even if
statistically not the biggest part of the problem.
And so, by securing our schools, that's essentially what
we're, we're trying to do--this is not some unique thought.
This is what we just walked into, say, all of us today into
this building with basic measures of security. We know that in
terms of the mass public shootings at schools, for example, the
time that it takes for armed confrontation that the good guy
with the gun to get there----
Senator Blackburn. Mm-hmm.
Ms. Swearer [continuing]. That is the difference between
life and death for a lot of people. We saw a lot----
Senator Blackburn. Okay. Let's talk a little bit about
those mass shooters, because we know that 25 percent of the
mass shooters have been diagnosed with a mental health
disorder. And we know 55 percent of American adults with mental
illness have never sought treatment and never received any
treatment. And we also know that 42 percent of mass shooters
experienced physical abuse, sexual abuse, parental suicide, or
severe bullying----
Ms. Swearer. Mm-hmm.
Senator Blackburn [continuing]. As children.
And Tennessee has a phenomenally successful program to
address and alleviate childhood trauma that serves as a model
for the Nation. And Senator Shaheen and I have introduced a
bill that would make those services available nationwide and
the dollars to fund that--Dr. Ranney, it speaks a little bit to
your work. But Ms. Swearer, if you will talk for a moment about
the importance of addressing mental illness, I would appreciate
that. And Mr. Cook, I'm going to come to you for the wrap up
after her comment.
Ms. Swearer. Addressing untreated mental illness in
particular, including early intervention, getting people
treatment before it becomes a crisis, this is important, not
just for suicide or for mass public shooting. So, it certainly
is important there. It's important for human flourishing.
It's important even far beyond the scope of firearms.
Again, we're talking about half of suicides--roughly half of
suicides being with something other than a firearm. And so, to
the extent that we can get people in crisis help, especially
lethal means counseling--all lethal means, not just firearms,
that saves lives. And it also, again, promotes human
flourishing. It promotes better communities and healthier
families, and that is important on a grand scale.
Senator Blackburn. Thank you. Mr. Cook, and welcome. Glad
to see my fellow Tennessean here today.
Mr. Cook. Pleased to be here. Thank you for having me.
Senator Blackburn. Sure. I'd like your response on the
intervention, and the mental health component of mass shootings
and suicides.
Mr. Cook. Well, if I could also touch on this, the school
issue that you raised----
Senator Blackburn. Sure.
Mr. Cook [continuing]. Because part of the Project Safe
Neighborhoods program that we had, and it was so successful in
Knoxville, included interfacing with, as you may know, we had
school resource officers, and that was attacked nationally as
part of the defund the police.
It was an important program as part of our comprehensive
approach to reduce violent gun crime, because those individuals
brought a very positive influence into the schools. They made a
good impression on the children of all ages, mostly high
schoolers in connection with our program, and proved to be a
critical component in educating them on the need to avoid gun
violence and the resources that are available to them in the
community to avoid getting drawn into gang violence.
Senator Blackburn. Right. I appreciate that. My time has
expired. Thank you, Mr. Chairman.
Chair Durbin. Thank you, Senator Blackburn.
I'm going to take a moment here, on the prerogative as
Chair of the Committee in light of the testimony and questions
earlier, to note that the two of the three Majority witnesses
are from Chicago, which I'm honored to represent. And I thank
them for being here. And to also note that is not unusual for
my colleagues on the other side of the table to talk in
negative terms about that city. I'm honored to represent it. It
has many challenges as most American cities do, and I'm going
to work to make things better.
But the question was asked of Dr. Ranney about Chicago,
which she answered and then proceeded with the question from
the Senator from Louisiana to talk about other areas facing
challenges of gun violence that show that they're struggling
even more than Chicago. I'd like to give you an opportunity to
complete that answer.
Dr. Ranney. Thank you. I think I was talking about
Louisiana, and New Mexico, Utah, other States with quite high
rates of gun deaths and talking about the beautiful
collaborations between community members, law enforcement, and
the legislature in those States to both set up great data
tracking, and then to work with community groups to put in
place programs to decrease gun deaths both in the cities and in
rural areas.
Chair Durbin. Thank you for that. And I would say that any
Member of this panel who is naive enough to believe that his
State, her State will never be touched by gun violence, should
consider what's happened just recently in the State of Maine
where the whole population of the State was asked to stand
down.
No one would have chosen Maine as the next target for gun
violence, but the fact is, with 400 million guns in this
country, every State, every city, every locality has that
threat facing them.
Senator Booker.
Senator Booker. Thank you, Mr. Chairman.
It is a difficult issue for me because I live in Newark,
New Jersey. I'm the only Senator that lives in a urban
community that is--I live in a community below the poverty
line, and I see--I've had experiences with gun violence that
is, will chill me for the rest of my life.
But one of the things frustrates me is often the racial
tinge that this has, that we often talk about this as an urban
problem. It actually infuriates me because I think it makes it
harder for us to come together and realize this is an American
problem affecting all American communities.
And just so we can be factual. From 2016 to 2020, 13 of the
20 counties with the most gun homicides per capita, were rural
communities. It is very frustrating that the talk about Chicago
that I've heard so demonizes a city that actually doesn't have
the highest murders per capita of American cities or even in
American counties. And it really obscures the strategies to do
something about this.
Now, what urban communities like mine have which frustrates
me, and I think this was said by Ms. Swearer and others, is
that there are a whole bunch of other attendant problems that
are correlative of violence: high lead poisoning levels, high
poverty levels, inadequate housing--I could go on, and on, and
on of issues that I've heard people on the conservative side of
the aisle, to the conservative side of the country, to the more
progressive side. Understand that we are not often getting at
the root problems that really create environments where
violence proliferates.
And so, I'm so happy to have this conversation. But I've
had decades of frustration living in my community and seeing
evidence-based examples of things that lower violence. Mr.
Cook, I wish you and I got to work together when I was a mayor
to have you as a prosecutor in my city. I think you and I
would've done a lot of good, in all sincerity.
Because what frustrates the hell out of me is cities like
mine have too much of the policing we don't need, where I watch
kids getting arrested for doing things that kids at Yale and
Stanford did when I was there. Now they've got records, now
they can't get jobs because they were arrested on marijuana
charges when we have had Presidents and Senators bragging about
their pot usage. And what that does economically to a city is
stunning when you have mass incarceration for low-level,
nonviolent drug crime.
But I do know when we target the small percentage of people
in my city who have records of violence, we've been able to
have incredible results. That's why I think you and I, if I was
mayor and you were my U.S. attorney, we could have done some
good by targeting what the problem is.
But then, Mr. Cook, you said something else which stunned
me when I became mayor, was how we were able to drive down
recidivism rates by having substantive programs that helped
people come home. First of all, just getting identification, or
housing and a job, dropped recidivism rates--not to mention all
the other things that we can do. But we can't find funding for
those programs to expand them to scale.
Mr. Bryant, if you can just please--like, we know violence
intervention programs work. It's not even any more like there's
no debate here. Could you just tell me that the funding issue,
if we were able to take programs like this to scale, what kind
of results do you think we could see?
Mr. Bryant. Thank you for the question. I think we could
see major results. We had to do something in Chicago where we
identify, you know, our population in each community, you know,
all 77 neighborhoods in those top 30 neighborhoods. We're
looking at who are the identified people, what do we have
currently in terms of funding and what funding would be
necessary for us to get to 75 percent of the people who are at
risk of being a perpetrator or a victim of gun violence.
And we're doing all of the things that everyone has said
here. We're putting social supports around them. We're
subsidizing people getting a GED. We're giving people
transitional jobs, supporting them through jobs, paying for
their them to get to and from their job without having to pay
for it.
So, we all agree on the things that matter most. And I
think the other, you know, some people would say that intact
families are important. Well, we've got to have intact families
that are healthy mentally, financially, and are well housed as
well to be an intact family.
Senator Booker. And let's just be clear, and this is
something I don't think most Americans know: rural area, urban
area, that the cost of a shooting--I went to my hospital,
University Hospital in Newark, and just said, how much does a
non-fatal gunshot wound cost taxpayers? Hundreds of thousands
of dollars.
Not to mention what that trauma does to a family or
community. I've seen businesses close just because they've had
shootings at them--the ripple effect of one shooting
economically, yet we can't come up with the investments in
evidence-based programs that are actually working to lower
violence.
We're being pennywise and pounds and pounds foolish in this
country, and there's enough bipartisan opportunity here in this
room. It's shown that we can do bipartisan things when actual
stuff that works to lower violence, but communities that are so
suffering from the trauma is incredible.
If I can just have for Mr. Whitehouse one last degree of
indulgence on a personal level----
Senator Whitehouse [presiding]. It's Senator Lee is who is
entitled to the indulgence here, since he's up.
Senator Booker. I appreciate that. Well, this is actually
about Senator Lee. It's very personal because as much as he's
my friend, he doubts me.
And so, Mr. Bryant, you're on under oath here. You and I
played football together. You were on the wrong side of the
ball. Just for Mr. Lee's benefit, am I a former great tight end
or the greatest tight end you've ever played with?
[Laughter.]
Senator Booker. Please, for my colleague, just let him
know.
Mr. Bryant. Yes, I guess, at Stanford. Yes, I think on our
particular team, he would've been the greatest on our team.
Senator Booker. Thank you very much. That's for the record
forever in the American congressional record.
Senator Lee. And I----
Senator Whitehouse. That stands. Senator Lee.
Senator Lee. I stand corrected now. I'm never going to
doubt you, again.
Senator Booker. Thank you very much.
Senator Lee. I mean, after that we've been arguing about
this for years. So thanks for putting that to rest, Mr. Bryant.
Ms. Swearer, I'd like to start with you. Tell us a little
bit about how many people in the United States every year are
using--how many times each year does an American use a firearm
in self-defense?
Ms. Swearer. So, we don't have an exact number, but when
you look at, sort of, the conglomerate of studies, they mostly
find that with a couple of very limited exceptions that are
outliers, somewhere between 500,000 to several million times a
year.
And I would note that the most extensive study on this
issue, the 2021 National Firearms Survey further validated some
of those earlier studies, and came to a conclusion of about 1.6
million. And, again, that was the most extensive survey ever
conducted of firearms owners.
Senator Lee. Okay. What would that tell us about risk
associated with putting legal restrictions on the books to the
extent that those legal restrictions might impair the ability
of the law-abiding to use those for lawful purposes, given that
it's normally law-abiding people who are most likely to comply
with a new law. What would that do to those people?
Ms. Swearer. Well, so it shows us, generally, that it's all
about understanding where the risk is. For your ordinary, law-
abiding, peaceable citizen who is mentally stable and not
experiencing extreme stressors, which is, you know, most
American gun owners at any given point, right, their biggest
benefit is that they can now protect themselves against their
biggest, most substantial threat, which is external crime.
But I think most people on this panel would agree when you
flip that, there are cases, right, where if you are now
mentally unstable or if you are experiencing crisis, you
statistically might be the bigger threat to yourself, or if you
are the one perpetuating crime. Right? Well, now you are
statistically the threat that needs to be solved.
So it's about understanding where that threat is. And
again, for your ordinary, law-abiding gun owner, that threat is
external, it's not internal. And that ability to possess that
firearm is actually a net benefit to them. Again, assuming that
they are not, you know, leaving guns under their couch cushion
for their 6-year-old to find and that sort of thing--that can
be problematic. But in the net, yes, it's, it's a positive for
them.
Senator Lee. And that's helpful, and that's helpful to a
point that one of my colleagues made earlier in the hearing,
which is that, you know, I think we all want to get to a
similar place in so far as we're focused on wanting to protect
human life. We want fewer deaths. And dangerous things can
happen if we assume that when we pass a law, it's going to
affect--it's going to be a net life savings, when that's not
necessarily always the case.
So, when you had the Governor of New Mexico issue a public
health emergency declaration, and put in place his executive
order dramatically restricting the ability of law-abiding
persons to possess firearms in certain places, that's
significant.
Now, when you look at the New Mexico case in particular,
you've researched that and you found some fascinating
information. Is it true that you discovered that in New Mexico
only 0.002 percent of concealed carry permit holders in New
Mexico had their permits revoked for any reason?
Ms. Swearer. So, I don't remember the number off the top of
my head, but that sounds correct. And it is generally the case
when you look at permit revocations in any State. They are
minuscule. And that's, again, for any violation.
That doesn't necessarily mean that it was revoked because
they used their weapon violently. Sometimes it can be they had
a DUI or any sort of non-weapon-related offense. But, on the
whole, when you look at those numbers, conceal carry permit
holders are amongst, if not the most law-abiding segment of the
population,
Senator Lee. And yet, Governor Grisham's executive order
would've affected them disproportionately. Meanwhile, you've
got new research that's been done, and a lot of experts in the
field from across the political spectrum and across the country
have weighed in on this.
Earlier this year, the chief of the DC Police Department,
Chief Robert Contee, said, quote, ``If we really want to see
homicides go down,''--which I think we've established here, we
want to save lives, we really want to see homicides go down--
``keep bad guys with guns in jail.'' He went on to say, quote,
``Right now, the average homicide suspect has been arrested 11
times prior to them committing a homicide.''
In 2021, there was a study commissioned by the National
Institute for Criminal Justice Reform that found gun violence
in DC to be tightly concentrated on a very small number of
high-risk individuals. In fact, they estimate that within a
year there are 500 identifiable people considered to be very
high risk, and these very high-risk individuals comprise 60 to
70 percent of all gun violence in the District.
So there, again, we have the problem. If what we focus on
is rules that are going to be new rules, separate and apart
from the dozens of laws that have normally been broken, the
minute someone commits a gun crime, the minute someone kills
another human being with a gun, if by adding another gun law, a
gun law of much wider applicability, and if what we're doing is
restricting and restraining the rights of the law abiding and
hence their ability to defend themselves, will that necessarily
save lives?
Ms. Swearer. No, Senator. And that's actually one of the
things that I'm talking about in my testimony when I referenced
this idea of a lot of our commonly proposed gun control laws
they're not actually designed to get at any of the underlying
factors.
And so, if you just tag on another law, well whatever, now
it's a universal background check, or a magazine capacity
restriction, the people who were already illegally possessing
those firearms to commit illegal crimes are not going to
suddenly say, oh, it's what's triply illegal, so now I won't do
it.
All you're doing is sort of expanding the likelihood that
an otherwise ordinary peaceable citizen is going to get caught
up in sort of a ``tic-tac'' offense, or even worse, it could
actually undermine their ability to defend themselves in the
most acute sort of self-defense scenarios.
Senator Lee. And of the 250,000 gun criminals incarcerated
surveyed, only 1 percent of them bought them from a retail
source. The rest of them bought them through some underground
illegal avenue or on the street or something like that. So,
we've got to be very careful. Let's not punish the law abiding
and thereby restrict their ability to protect themselves. That
will cost lives not save them.
Senator Whitehouse. I told Senator Tillis that he could
have my spot because I was going to be here for a while, while
Chairman Durbin was off and voting. So, I'll recognize Senator
Tillis, and I'll take the next Democratic spot that lines up.
Senator Tillis. Thank you, Senator Whitehouse.
Thank you, all for being here. I, along with Senator
Cornyn, joined with Senator Sinema, and Senator Murphy to
negotiate the Bipartisan Safer Communities Act. I stand by it,
I think it's policy is going to age well. Just for an update,
full implementation was January of last year. There have been
168,971 purchase transactions for under 21 since then--1,200
were denied not based on the Safer Communities Act, but based
on a prior policy, 428 were denied based on the Safer
Communities Act.
So, to the Second Amendment advocates who said this was
going to lead to a mass confiscation, they're patently wrong.
More importantly, if they see the basis for the 400 or so that
were rejected under the Safer Communities Act, no reasonable
person would think that that was their day to buy a gun.
So, I would really encourage people to take a look at this
bill, but not just look at the gun safety or the NICS
processing. Take a look at school hardening. Take a look at
investment and mental health. Take a look at a generational
opportunity to address what I believe is the root cause behind
many of these mass shootings, and quite honestly, many of the
deaths related to guns. Take a look at the number of suicides
that are committed through a gun that was legally purchased.
It's a behavioral health challenge that we need to look at.
I supported the bipartisan effort because I thought the policy
was going to good be good policy and age well. What I don't
like, are people that are making it harder to get people back
to the table and get something done. And you don't get anything
done on gun violence around here without bipartisan
cooperation, which is why I was very frustrated with President
Biden on the day that he signed the Safer Communities Act.
One of the reasons I didn't go to that signing is I fully
expected he was going to use it, despite the football, and talk
about more that he needs to get done, that he knows damn well
it doesn't have bipartisan support. That is at the expense of
where areas where we can work together. Similarly, Governor
Grisham, you want to push us further back from coming up with a
reasonable policy passed or implement an executive order that's
patently unconstitutional. That takes people away from the
table, doesn't solve the problem.
Now, let's talk about gun--or, let's talk about violence in
our communities. And I won't have time, but I would like--
actually, I would like to go back and ask States, conservative
and liberal States, help us help your communities. Get right
with providing information to the NICS processors so that they
have the best available information about the backgrounds of
these.
If you're a Second Amendment advocate, you should be
providing information to the NICS processing centers so those
under-21s can get their guns sooner. If you're a gun control
advocate, you should. And incidentally, Senator Booker, New
Jersey's among one of the worst offenders in providing
background information that we need to actually process and
identify people who are at risk. It has to do with behavioral
health adjudications and criminal--juvenile criminal arrest
records.
We've got to get this implementation right, but we've also
got to look at the mental health and other components on the
bill. I promised myself I wasn't going to take most of my time
on it, but here I go.
It's an important bill. People need to understand it.
Instead of looking past it to the next thing we should do here,
which is oftentimes dividing us, every single Senator should
understand that bill and do what I do--is have meeting, after
meeting, after meeting in our State to make North Carolina the
best implementation of the Safer Communities Act, and hopefully
other States will follow.
Now, I got to get to the ``Broken Windows Theory.'' I
believe that we're going through it. I believe I'm living it at
Eastern Market. I bought a condo there about 5 years ago, felt
good for about 3 years now. I promised my wife after vote-a-
rama--or when we get out of here at midnight--I will not walk
home. It's a 15-minute walk that now feels different.
And it's because local mayors and town councils have lost
sight of the fact that, I believe, the Broken Windows Theory is
real. And I believe where we prove that someone who's up for
nomination in Baltimore--former Baltimore mayor, over 50
percent African-American population elected a white mayor in
the form of Martin O'Malley because they were fed up with what
they were experiencing in Baltimore.
And by stepping up, he reduced crime. And you could debate
the number, but by about 30 percent, as much as 42 percent. And
it wasn't because he was letting people get a pass on
jaywalking or anything else, he was holding people responsible
and drawing the margins around what was acceptable behavior.
Mr. Cook, do you believe in the Broken Windows Theory?
Mr. Cook. Absolutely.
Senator Tillis. Ms. Shearer--or, Swearer, do you?
[Cell phone rings at the witness panel's table.]
Senator Tillis. I'll get that if you want me to.
[Laughter.]
Ms. Swearer. I believe it is one of a number of theories
that is helpful to understanding crime.
Senator Tillis. I firmly believe that the resurgence of
crime that we're seeing, the feeling that I have now in
Washington, DC, has more to do with people mixing up--Dr.
Cosey-Gay, I believe that people deserve forgiveness. You are a
lot further along in your faith journey than I am in forgiving
mass murderers and a number of other people, but good on you
for being there.
But hopefully, we can both agree that these mass murderers
need to redeem themselves while they spend the rest of their
lives in prison when we're talking about those sorts of
offenses. But until we start recognizing that our communities
are less safe, Governor's orders taking away guns, like New
Mexico, are forcing more people to buy guns. Gun ownership is
at an all-time high now, and it's going to get higher if you
keep doing this kind of crap, Governor from New Mexico.
We need people to sit around the table and act like adults.
Go back and have unpleasant conversations with people that are
in our parties, but get to the table and solve problems. And
we're not going to do it by talking about take all the guns
away or give them all guns. And we're not going to do it by
making any of this--increase in crime and reduction in safety
in these communities excusable. Whether it's Chicago,
Charlotte, New York, Portland, it doesn't matter.
We all know what safe feels like, and you can't tell me you
can walk the streets of San Francisco at night now and feel
safe. Local-elected, State-elected, everybody else need to
recognize they have a responsibility to the people of those
communities to make them safer, and they are going in the wrong
direction now. And gun violence is only one piece of the
puzzle.
Thank you, Mr. Chairman.
Chair Durbin [presiding]. Thank you, Senator Tillis.
Senator Cruz.
Senator Cruz. Thank you, Mr. Chairman.
We are at yet at another hearing called by Democrats on gun
control. Understand that today's Democrats in the Senate's--
these are not your father's Democrats. There are no moderate
Democrats left in Congress. Today's Democrats, when it comes to
guns, their objective is to disarm law-abiding citizens. They
simultaneously embrace policies that release violent criminals
from jails.
They're not interested in locking up murderers. They're not
interested in locking up gangbangers. They're not interested in
locking up violent criminals. Instead, they systematically
support policies that release violent criminals.
By the way, if you are hesitant to believe me when I say
this, perhaps you'll believe the mayor of Dallas. The Mayor of
Dallas Eric Johnson, who's a friend, is a lifelong Democrat.
He's an African-American mayor, elected in Dallas, been a
Democrat his whole life. Until just recently, he left the
Democratic party and became a Republican.
Now, let me read you why Mayor Johnson became a Republican,
quote: ``Unfortunately, many of our cities are in disarray.
Mayors and other local-elected officials have failed to make
public safety a priority or to exercise fiscal restraint. Most
of these local leaders are proud Democrats who view cities as
laboratories for liberalism rather than as havens for
opportunity and free enterprise.
``Too often, local tax dollars are spent on policies that
exacerbate homelessness, coddle criminals, and make it harder
for ordinary people to make a living. And too many local
Democrats insist on virtue signaling, proposing half-baked
government programs that aim to solve every single societal ill
and on finding new ways to thumb their noses at Republicans at
the State and Federal level.''
It's--I have to say to an ordinary person, the political
ideology of today's Democrats makes no sense why your priority
is disarming a law-abiding citizen, but not going after the
violent criminal. And to be clear, it is the radical left that
advocates abolishing the police and defunding the police.
And when I say there are no moderate Democrats left, the
Biden administration has nominated, not one, not two, but three
of the leading advocates of abolishing the police to senior
positions at the U.S. Department of Justice. Every single
Democrat on this Committee voted to confirm every single one of
them, but not just on this Committee.
Every single Democrat in the United States Senate voted to
confirm all three of the Biden nominees, including Rachael
Rollins, nominated to be the U.S. Attorney in Massachusetts--
one of the leading advocates of abolishing the police--as a
local prosecutor. She put out a list of violent crimes that she
wouldn't prosecute.
You know what? We're not having a hearing on the impact of
``Soros Prosecutors'' releasing violent criminals from jail.
We're not having a hearing on carjacking in Washington, DC,
because the Democrat City Council lowered the penalty for
carjacking, lowered the penalty for murder. We're not having a
hearing on Congressman Henry Cuellar, a Democrat from Texas,
who was carjacked in Washington, DC, at 9:30 at night.
We are also not having a hearing on the Antifa and Black
Lives Matter riots across the country because to Democrats,
when stores are being looted, when police cars are being
firebombed, when police officers are being murdered, that's not
a crisis if they agree with the ideology of the criminals.
Instead, their objective is they want to take away the firearm
from the single mom who's taking the subway home at night, who
that is the only prevention she has against the violent
criminals that the Democrats are unleashing.
And by the way, to give you an underscoring of it, look, we
have a mental health crisis in this country. I've repeatedly
introduced legislation to improve school safety, to invest and
double the number of police officers in schools. Democrats
objected. To invest $15 billion in mental health counselors in
schools. Democrats objected. Their priority is not stopping the
criminals. Their priority is disarming law-abiding citizens.
And by the way, they call it a public health crisis because
they want to put supposed experts in charge of disarming you.
The Second Amendment in the Bill of Rights is not a public
health crisis. What is a public health crisis is the crime
rates that are skyrocketing because Democrats keep letting
murderers and violent criminals out of jail. But Dr. Ranney,
let me ask you a question in terms of public health. Right now,
today, what's the leading cause of death for Americans age 18
to 45?
Dr. Ranney. I believe that it's opioids.
Senator Cruz. It is. It is drug overdoses. Last year, more
than 100,000 Americans died of drug overdoses--70 percent of
that came from Chinese fentanyl that is flooding across our
Southern Border because this administration has opened up our
Southern Border to 8.6 million illegal immigrants, has enriched
the drug traffickers.
Do you think, Dr. Ranney, that fentanyl flooding across our
open Border on the South, that it killed collectively 100,000
overdoses last year? Do you think that's a public health
crisis?
Dr. Ranney. Absolutely. Synthetic fentanyl is a major
crisis, and Senator Reed from my home State of Rhode Island has
been a leader in trying to stop the supply of synthetic----
Senator Cruz. Except he hasn't----
Dr. Ranney [continuing]. Fentanyl in the United States.
Senator Cruz [continuing]. Because Senator Reed, along with
every other Democrat, supports Joe Biden's open Borders because
when we try to secure the Borders, they block it over, and
over, and over, again. And the criminals who come across who
are taking people's lives, that is because the Democrats refuse
to enforce the law.
Dr. Ranney. Senator Cruz, equally important is harm
reduction to ensure that those who use opioids have access to
things like Suboxone, or buprenorphine, and methadone to help--
so that they don't use illicit substances off the street. Thank
you.
Chair Durbin. Thank you. Senator Whitehouse.
Senator Whitehouse. Thanks very much. Let me welcome Dr.
Ranney back here, and thank her for all of her good work in
Rhode Island. Dr. Ranney, did you have occasion in the
emergency rooms of Rhode Island to treat gunshot patients?
Dr. Ranney. I did.
Senator Whitehouse. And did you have occasion to observe
the difference between gunshot injuries from what you might
call regular ammunition versus gunshot injuries from,
essentially, weapons of war where the projectile, the bullet,
travels at particularly high speed as it hits the human body?
Dr. Ranney. It's difficult to know in the emergency
department what type of ammunition is used. We have seen an
increasing number of patients with multiple gunshot wounds at
once, which is obviously much more difficult to save.
Senator Whitehouse. What are the--what is the experience
like of the ambulance pulling up into the bay and somebody
coming into your hands with gunshot wounds, particularly
multiple gunshot wounds, and perhaps if you can identify it,
even high-speed projectile, AR-15-type gunshot wounds?
Dr. Ranney. So, when we get an alert from EMS that they're
coming in with a gunshot wound--which we often but not always
do--we mobilize not just emergency physicians, but also trauma
surgeons, social workers, medical students, respiratory
therapists and so on. So, there's radiology techs, there's
somewhere between 15 and 20 folks who go into a room.
We mobilize blood supplies in order to have that at the
ready, bring a lot of different equipment ranging from chest
tubes to the tools that we use to crack a chest if needed, and
have these standard algorithms that we follow as we take care
of a patient.
Sometimes those are successful, often they are not. The
likelihood of saving someone's life depends on both where they
are shot and how many times they are shot. I have seen, again,
although I cannot identify types of ammunition or types of
firearms in the emergency department, that's not my training,
and we don't know that at the time. I have seen organs
shredded, aortas bisected, and obviously, have seen folks with
gunshots to the brain as well.
Senator Whitehouse. Suffice it to say that knife wounds and
beating injuries are customarily easier to treat than gunshot
wounds and particularly multiple gunshot wounds?
Dr. Ranney. That is correct. I'll also say that--another
Senator made a point about suicide. Most suicide attempts we
can also save. Suicide attempts by a firearm are almost
universally lethal.
Senator Whitehouse. And not to belabor the point too much,
but have you ever witnessed multiple injuries by musket, which
was the firearm of choice at the time the Second Amendment was
drafted?
Dr. Ranney. I don't know that I've ever seen a musket
wound.
Senator Whitehouse. Yes. And I think the Founders may well
have had enough common sense to understand that in the time it
takes to reload a musket, if somebody were going berserk in a
tavern or at a musical performance, there'd be plenty of time
to intervene, and that something categorically different takes
place when an individual has access to weapons that either are
or can be configured to fire rapid fire and to fire ammunition
of an entirely different and more destructive nature because of
the speed with which the projectile flies.
So, thank you for being here. So sorry we lost you to our
Connecticut neighbors. But thank you for your service in Rhode
Island, and I'm glad you still tell everybody that you're a
Rhode Islander.
Dr. Ranney. It's still my home address, sir. Thank you.
Chair Durbin. Thank you, Senator Whitehouse.
Well, I'd like to say a word to particularly those at the
witness table, but especially those with white coats. Now,
you've seen it. You've seen the debate in the American
political scene over something from your perspective that seems
so obvious.
I would imagine if your professional responsibilities take
you into a surgery or a treatment room for a gunshot victim,
that after it's over, when you finally get a chance to relax
for a moment with a colleague, you think, what are those
politicians thinking? Why don't they take a look at what we're
seeing every single day in virtually every hospital across
America? And why don't they do something?
Well, there are two or three different approaches, as you
probably noted and listened to the Senators ask their
questions. I can recall one approach. I was a Member of the
House--it was almost 30 years ago.
That's a long time, 30 years ago, and along came a new
narcotic called crack cocaine. It scared the hell out of us. It
was a form of cocaine, but it was a form that was dirt cheap,
highly addictive, and devastating to pregnant women carrying
babies.
We decided to do something. We passed the drug bill. What
we did was this, we got tough. I mean, really tough. We
increased the penalty for crack cocaine over powder cocaine by
a 100-to-1--100-to-1, which you could hold in your hand, could
put you in prison for the rest of your life. And that was our
answer to it, to finally put an end to it.
Well, what happened? Exactly the opposite of what we
expected. The price of crack cocaine on the street went down
instead of up, and the use of crack cocaine in our country went
up instead of down. Then we filled the Federal prisons for
almost 20 years, primarily with African-American defendants who
were sentenced to long sentences, sometimes over 20 years, for
that handful of crack cocaine. Ultimately, we came to our
senses, at least partially, several years ago and reduced it
from a 100-to-1, to 18-to-1.
Now, let me add from a pharmacological viewpoint, there is
literally no difference of the impact crack cocaine on your
system over powdered cocaine. But we were getting tough, really
tough. Finally, under President Donald Trump--I mean that,
under President Donald Trump, he signed a bipartisan bill that
Senator Grassley and I co-sponsored called The First Step Act,
which basically said we're going to take away the mandatory
minimum aspects of some of these provisions relating to
narcotics.
So, this debate's been going on as long as I've been in
Congress. We've learned and we've forgotten, and we've learned
again and forgotten, again. And that's what we face today. To
think that people don't recognize what guns are doing to
America just is amazing to me. When that fellow got up on the
roof of the business in Highland Park, Illinois, in 60 seconds,
he fired off 83 rounds--83 rounds from a military assault
weapon.
Tell me that the average American needs a military assault
weapon to protect themselves or their family. I don't buy it. I
just don't buy it. Whatever my view of the Second Amendment, it
didn't include anything even envisioned by our Founding Fathers
that looked like an assault weapon.
So the question is, will we do anything as a result of
these hearings? Some of you, as witnesses, have expressed a
weariness that we keep returning to this topic. It is
intentional, it's not accidental. I'm coming back to this topic
as long as it is a threat to America. And it's certainly a
threat. A special guest from Chicago, thank you for coming.
Thanks for what you do with your lives. You don't give up on
people, and that really makes a difference. You're turning
lives around. We've got to do more of it.
So at this point, we've learned that hospital- and
community-based violence programs, violence prevention
programs, partnerships with law abiding gun owners, and more,
are all steps that can prevent firearm injuries and deaths. It
bears repeating that we are going to continue to tackle this
topic because that is why we were sent here. That is the
province and responsibility of the Senate Judiciary Committee.
The hearing record is going to remain open for 1 week for
submission of materials for the record. And with that, the
Senate Judiciary Committee stands adjourned. Thank you.
[Whereupon, at 12:16 p.m., the hearing was adjourned.]
[Additional material submitted for the record follows.]
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
A P P E N D I X
The following submissions are available at:
https://www.govinfo.gov/content/pkg/CHRG-118shrg60434/pdf/CHRG-
118shrg
60434-add1.pdf
Submitted by Chair Durbin:
American Academy of Pediatrics, statement....................... 2
National Education Association, November 27, 2023, letter....... 5
Submitted by Senator Booker:
American Conservative Union, statement.......................... 6
Center for Justice and Human Dignity, July 10, 2023, letter to
U.S. Sentencing Commission.................................... 9
Families Against Mandatory Minimums, statement.................. 18
[all]