[Congressional Record Volume 162, Number 34 (Wednesday, March 2, 2016)]
[Senate]
[Pages S1171-S1218]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2015

  The PRESIDING OFFICER. Under the previous order, the motion to 
proceed to S. 524 is agreed to.
  The clerk will report the bill.
  The legislative clerk read as follows:

       A bill (S. 524) to authorize the Attorney General to award 
     grants to address the national epidemics of prescription 
     opioid abuse and heroin use.

  Thereupon, the Senate proceeded to consider the bill, which had been 
reported from the Committee on the Judiciary, with an amendment to 
strike all after the enacting clause and insert in lieu thereof the 
following:

                                 S. 524

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the 
     ``Comprehensive Addiction and Recovery Act of 2016''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.

                   TITLE I--PREVENTION AND EDUCATION

Sec. 101. Development of best practices for the use of prescription 
              opioids.
Sec. 102. Awareness campaigns.
Sec. 103. Community-based coalition enhancement grants to address local 
              drug crises.

                TITLE II--LAW ENFORCEMENT AND TREATMENT

Sec. 201. Treatment alternative to incarceration programs.
Sec. 202. First responder training for the use of drugs and devices 
              that rapidly reverse the effects of opioids.
Sec. 203. Prescription drug take back expansion.
Sec. 204. Heroin and methamphetamine task forces.

[[Page S1172]]

                   TITLE III--TREATMENT AND RECOVERY

Sec. 301. Evidence-based opioid and heroin treatment and interventions 
              demonstration.
Sec. 302. Criminal justice medication assisted treatment and 
              interventions demonstration.
Sec. 303. National youth recovery initiative.
Sec. 304. Building communities of recovery.

              TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES

Sec. 401. Correctional education demonstration grant program.
Sec. 402. National Task Force on Recovery and Collateral Consequences.

  TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND 
                                VETERANS

Sec. 501. Improving treatment for pregnant and postpartum women.
Sec. 502. Report on grants for family-based substance abuse treatment.
Sec. 503. Veterans' treatment courts.

  TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS 
                        OPIOID AND HEROIN ABUSE

Sec. 601. State demonstration grants for comprehensive opioid abuse 
              response.

                        TITLE VII--MISCELLANEOUS

Sec. 701. GAO report on IMD exclusion.
Sec. 702. Funding.
Sec. 703. Conforming amendments.
Sec. 704. Grant accountability.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) The abuse of heroin and prescription opioid painkillers 
     is having a devastating effect on public health and safety in 
     communities across the United States. According to the 
     Centers for Disease Control and Prevention, drug overdose 
     deaths now surpass traffic crashes in the number of deaths 
     caused by injury in the United States. In 2014, an average of 
     more than 120 people in the United States died from drug 
     overdoses every day.
       (2) According to the National Institute on Drug Abuse 
     (commonly known as ``NIDA''), the number of prescriptions for 
     opioids increased from approximately 76,000,000 in 1991 to 
     nearly 207,000,000 in 2013, and the United States is the 
     biggest consumer of opioids globally, accounting for almost 
     100 percent of the world total for hydrocodone and 81 percent 
     for oxycodone.
       (3) Opioid pain relievers are the most widely misused or 
     abused controlled prescription drugs (commonly referred to as 
     ``CPDs'') and are involved in most CPD-related overdose 
     incidents. According to the Drug Abuse Warning Network 
     (commonly known as ``DAWN''), the estimated number of 
     emergency department visits involving nonmedical use of 
     prescription opiates or opioids increased by 112 percent 
     between 2006 and 2010, from 84,671 to 179,787.
       (4) The use of heroin in the United States has also spiked 
     sharply in recent years. According to the most recent 
     National Survey on Drug Use and Health, more than 900,000 
     people in the United States reported using heroin in 2014, 
     nearly a 35 percent increase from the previous year. Heroin 
     overdose deaths more than tripled from 2010 to 2014.
       (5) The supply of cheap heroin available in the United 
     States has increased dramatically as well, largely due to the 
     activity of Mexican drug trafficking organizations. The Drug 
     Enforcement Administration (commonly known as the ``DEA'') 
     estimates that heroin seizures at the Mexican border have 
     more than doubled since 2010, and heroin production in Mexico 
     increased 62 percent from 2013 to 2014. While only 8 percent 
     of State and local law enforcement officials across the 
     United States identified heroin as the greatest drug threat 
     in their area in 2008, that number rose to 38 percent in 
     2015.
       (6) Law enforcement officials and treatment experts 
     throughout the country report that many prescription opioid 
     users have turned to heroin as a cheaper or more easily 
     obtained alternative to prescription drugs.
       (7) According to a report by the National Association of 
     State Alcohol and Drug Abuse Directors (commonly referred to 
     as ``NASADAD''), 37 States reported an increase in admissions 
     to treatment for heroin use during the past 2 years, while 
     admissions to treatment for prescription opiates increased 
     500 percent from 2000 to 2012.
       (8) Research indicates that combating the opioid crisis, 
     including abuse of prescription painkillers and, 
     increasingly, heroin, requires a multi-pronged approach that 
     involves prevention, education, monitoring, law enforcement 
     initiatives, reducing drug diversion and the supply of 
     illicit drugs, expanding delivery of existing treatments 
     (including medication assisted treatments), expanding access 
     to overdose medications and interventions, and the 
     development of new medications for pain that can augment the 
     existing treatment arsenal.
       (9) Substance use disorders are a treatable disease. 
     Discoveries in the science of addiction have led to advances 
     in the treatment of substance use disorders that help people 
     stop abusing drugs and prescription medications and resume 
     their productive lives.
       (10) According to the National Survey on Drug Use and 
     Health, approximately 22,700,000 people in the United States 
     needed substance use disorder treatment in 2013, but only 
     2,500,000 people received it. Furthermore, current treatment 
     services are not adequate to meet demand. According to a 
     report commissioned by the Substance Abuse and Mental Health 
     Services Administration (commonly known as ``SAMHSA''), there 
     are approximately 32 providers for every 1,000 individuals 
     needing substance use disorder treatment. In some States, the 
     ratio is much lower.
       (11) The overall cost of drug abuse, from health care- and 
     criminal justice-related costs to lost productivity, is 
     steep, totaling more than $700,000,000,000 a year, according 
     to NIDA. Effective substance abuse prevention can yield major 
     economic dividends.
       (12) According to NIDA, when schools and communities 
     properly implement science-validated substance abuse 
     prevention programs, abuse of alcohol, tobacco, and illicit 
     drugs is reduced. Such programs help teachers, parents, and 
     healthcare professionals shape the perceptions of youths 
     about the risks of drug abuse.
       (13) Diverting certain individuals with substance use 
     disorders from criminal justice systems into community-based 
     treatment can save billions of dollars and prevent sizeable 
     numbers of crimes, arrests, and re-incarcerations over the 
     course of those individuals' lives.
       (14) According to the DEA, more than 2,700 tons of expired, 
     unwanted prescription medications have been collected since 
     the enactment of the Secure and Responsible Drug Disposal Act 
     of 2010 (Public Law 111-273; 124 Stat. 2858).
       (15) Faith-based, holistic, or drug-free models can provide 
     a critical path to successful recovery for a great number of 
     people in the United States. The 2015 membership survey 
     conducted by Alcoholics Anonymous (commonly known as ``AA'') 
     found that 73 percent of AA members were sober longer than 1 
     year and attended 2.5 meetings per week.
       (16) Research shows that combining treatment medications 
     with behavioral therapy is an effective way to facilitate 
     success for some patients. Treatment approaches must be 
     tailored to address the drug abuse patterns and drug-related 
     medical, psychiatric, and social problems of each individual. 
     Different types of medications may be useful at different 
     stages of treatment or recovery to help a patient stop using 
     drugs, stay in treatment, and avoid relapse. Patients have a 
     range of options regarding their path to recovery and many 
     have also successfully addressed drug abuse through the use 
     of faith-based, holistic, or drug-free models.
       (17) Individuals with mental illness, especially severe 
     mental illness, are at considerably higher risk for substance 
     abuse than the general population, and the presence of a 
     mental illness complicates recovery from substance abuse.

     SEC. 3. DEFINITIONS.

       In this Act--
       (1) the term ``medication assisted treatment'' means the 
     use, for problems relating to heroin and other opioids, of 
     medications approved by the Food and Drug Administration in 
     combination with counseling and behavioral therapies;
       (2) the term ``opioid'' means any drug having an addiction-
     forming or addiction-sustaining liability similar to morphine 
     or being capable of conversion into a drug having such 
     addiction-forming or addiction-sustaining liability; and
       (3) the term ``State'' means any State of the United 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico, and any territory or possession of the United States.

                   TITLE I--PREVENTION AND EDUCATION

     SEC. 101. DEVELOPMENT OF BEST PRACTICES FOR THE USE OF 
                   PRESCRIPTION OPIOIDS.

       (a) Definitions.--In this section--
       (1) the term ``Secretary'' means the Secretary of Health 
     and Human Services; and
       (2) the term ``task force'' means the Pain Management Best 
     Practices Inter-Agency Task Force convened under subsection 
     (b).
       (b) Inter-Agency Task Force.--Not later than December 14, 
     2018, the Secretary, in cooperation with the Secretary of 
     Veterans Affairs, the Secretary of Defense, and the 
     Administrator of the Drug Enforcement Administration, shall 
     convene a Pain Management Best Practices Inter-Agency Task 
     Force to review, modify, and update, as appropriate, best 
     practices for pain management (including chronic and acute 
     pain) and prescribing pain medication.
       (c) Membership.--The task force shall be comprised of--
       (1) representatives of--
       (A) the Department of Health and Human Services;
       (B) the Department of Veterans Affairs;
       (C) the Food and Drug Administration;
       (D) the Department of Defense;
       (E) the Drug Enforcement Administration;
       (F) the Centers for Disease Control and Prevention;
       (G) the National Academy of Medicine;
       (H) the National Institutes of Health; and
       (I) the Office of National Drug Control Policy;
       (2) physicians, dentists, and non-physician prescribers;
       (3) pharmacists;
       (4) experts in the fields of pain research and addiction 
     research;
       (5) representatives of--
       (A) pain management professional organizations;
       (B) the mental health treatment community;
       (C) the addiction treatment community;
       (D) pain advocacy groups; and
       (E) groups with expertise around overdose reversal; and
       (6) other stakeholders, as the Secretary determines 
     appropriate.
       (d) Duties.--The task force shall--
       (1) not later than 180 days after the date on which the 
     task force is convened under subsection (b), review, modify, 
     and update, as appropriate, best practices for pain 
     management (including chronic and acute pain) and prescribing 
     pain medication, taking into consideration--
       (A) existing pain management research;
       (B) recommendations from relevant conferences;
       (C) ongoing efforts at the State and local levels and by 
     medical professional organizations to develop improved pain 
     management strategies, including consideration of 
     alternatives to opioids to reduce opioid monotherapy in 
     appropriate cases;
       (D) the management of high-risk populations, other than 
     populations who suffer pain, who--

[[Page S1173]]

       (i) may use or be prescribed benzodiazepines, alcohol, and 
     diverted opioids; or
       (ii) receive opioids in the course of medical care; and
       (E) the Proposed 2016 Guideline for Prescribing Opioids for 
     Chronic Pain issued by the Centers for Disease Control and 
     Prevention (80 Fed. Reg. 77351 (December 14, 2015)) and any 
     final guidelines issued by the Centers for Disease Control 
     and Prevention;
       (2) solicit and take into consideration public comment on 
     the practices developed under paragraph (1), amending such 
     best practices if appropriate; and
       (3) develop a strategy for disseminating information about 
     the best practices to stakeholders, as appropriate.
       (e) Limitation.--The task force shall not have rulemaking 
     authority.
       (f) Report.--Not later than 270 days after the date on 
     which the task force is convened under subsection (b), the 
     task force shall submit to Congress a report that includes--
       (1) the strategy for disseminating best practices for pain 
     management (including chronic and acute pain) and prescribing 
     pain medication, as reviewed, modified, or updated under 
     subsection (d);
       (2) the results of a feasibility study on linking the best 
     practices described in paragraph (1) to receiving and 
     renewing registrations under section 303(f) of the Controlled 
     Substances Act (21 U.S.C. 823(f)); and
       (3) recommendations for effectively applying the best 
     practices described in paragraph (1) to improve prescribing 
     practices at medical facilities, including medical facilities 
     of the Veterans Health Administration.

     SEC. 102. AWARENESS CAMPAIGNS.

       (a) In General.--The Secretary of Health and Human 
     Services, in coordination with the Attorney General, shall 
     advance the education and awareness of the public, providers, 
     patients, and other appropriate entities regarding the risk 
     of abuse of prescription opioid drugs if such products are 
     not taken as prescribed.
       (b) Drug-Free Media Campaign.--
       (1) In general.--The Office of National Drug Control 
     Policy, in coordination with the Secretary of Health and 
     Human Services and the Attorney General, shall establish a 
     national drug awareness campaign.
       (2) Requirements.--The national drug awareness campaign 
     required under paragraph (1) shall--
       (A) take into account the association between prescription 
     opioid abuse and heroin use;
       (B) emphasize the similarities between heroin and 
     prescription opioids and the effects of heroin and 
     prescription opioids on the human body; and
       (C) bring greater public awareness to the dangerous effects 
     of fentanyl when mixed with heroin or abused in a similar 
     manner.

     SEC. 103. COMMUNITY-BASED COALITION ENHANCEMENT GRANTS TO 
                   ADDRESS LOCAL DRUG CRISES.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.) is amended by 
     striking section 2997 and inserting the following:

     ``SEC. 2997. COMMUNITY-BASED COALITION ENHANCEMENT GRANTS TO 
                   ADDRESS LOCAL DRUG CRISES.

       ``(a) Definitions.--In this section--
       ``(1) the term `Drug-Free Communities Act of 1997' means 
     chapter 2 of the National Narcotics Leadership Act of 1988 
     (21 U.S.C. 1521 et seq.);
       ``(2) the term `eligible entity' means an organization 
     that--
       ``(A) on or before the date of submitting an application 
     for a grant under this section, receives or has received a 
     grant under the Drug-Free Communities Act of 1997; and
       ``(B) has documented, using local data, rates of abuse of 
     opioids or methamphetamines at levels that are--
       ``(i) significantly higher than the national average as 
     determined by the Attorney General (including appropriate 
     consideration of the results of the Monitoring the Future 
     Survey published by the National Institute on Drug Abuse and 
     the National Survey on Drug Use and Health published by the 
     Substance Abuse and Mental Health Services Administration); 
     or
       ``(ii) higher than the national average, as determined by 
     the Attorney General (including appropriate consideration of 
     the results of the surveys described in clause (i)), over a 
     sustained period of time; and
       ``(3) the term `local drug crisis' means, with respect to 
     the area served by an eligible entity--
       ``(A) a sudden increase in the abuse of opioids or 
     methamphetamines, as documented by local data; or
       ``(B) the abuse of prescription medications, specifically 
     opioids or methamphetamines, that is significantly higher 
     than the national average, over a sustained period of time, 
     as documented by local data.
       ``(b) Program Authorized.--The Attorney General, in 
     coordination with the Director of the Office of National Drug 
     Control Policy, may make grants to eligible entities to 
     implement comprehensive community-wide strategies that 
     address local drug crises within the area served by the 
     eligible entity.
       ``(c) Application.--
       ``(1) In general.--An eligible entity seeking a grant under 
     this section shall submit an application to the Attorney 
     General at such time, in such manner, and accompanied by such 
     information as the Attorney General may require.
       ``(2) Criteria.--As part of an application for a grant 
     under this section, the Attorney General shall require an 
     eligible entity to submit a detailed, comprehensive, multi-
     sector plan for addressing the local drug crisis within the 
     area served by the eligible entity.
       ``(d) Use of Funds.--An eligible entity shall use a grant 
     received under this section--
       ``(1) for programs designed to implement comprehensive 
     community-wide prevention strategies to address the local 
     drug crisis in the area served by the eligible entity, in 
     accordance with the plan submitted under subsection (c)(2); 
     and
       ``(2) to obtain specialized training and technical 
     assistance from the organization funded under section 4 of 
     Public Law 107-82 (21 U.S.C. 1521 note).
       ``(e) Supplement Not Supplant.--An eligible entity shall 
     use Federal funds received under this section only to 
     supplement the funds that would, in the absence of those 
     Federal funds, be made available from other Federal and non-
     Federal sources for the activities described in this section, 
     and not to supplant those funds.
       ``(f) Evaluation.--A grant under this section shall be 
     subject to the same evaluation requirements and procedures as 
     the evaluation requirements and procedures imposed on the 
     recipient of a grant under the Drug-Free Communities Act of 
     1997.
       ``(g) Limitation on Administrative Expenses.--Not more than 
     8 percent of the amounts made available pursuant to 
     subsection (i) for a fiscal year may be used by the Attorney 
     General to pay for administrative expenses.''.

                TITLE II--LAW ENFORCEMENT AND TREATMENT

     SEC. 201. TREATMENT ALTERNATIVE TO INCARCERATION PROGRAMS.

       (a) Definitions.--In this section:
       (1) Eligible entity.--The term ``eligible entity'' means a 
     State, unit of local government, Indian tribe, or nonprofit 
     organization.
       (2) Eligible participant.--The term ``eligible 
     participant'' means an individual who--
       (A) comes into contact with the juvenile justice system or 
     criminal justice system or is arrested or charged with an 
     offense that is not--
       (i) a crime of violence, as defined under applicable State 
     law or section 16 of title 18, United States Code; or
       (ii) a serious drug offense, as defined under section 
     924(e)(2)(A) of title 18, United States Code;
       (B) has a current--
       (i) substance use disorder; or
       (ii) co-occurring mental illness and substance use 
     disorder; and
       (C) has been approved for participation in a program funded 
     under this section by, as applicable depending on the stage 
     of the criminal justice process, the relevant law enforcement 
     agency or prosecuting attorney, defense attorney, probation 
     or corrections official, judge, or representative from the 
     relevant mental health or substance abuse agency.
       (b) Program Authorized.--The Secretary of Health and Human 
     Services, in coordination with the Attorney General, may make 
     grants to eligible entities to--
       (1) develop, implement, or expand a treatment alternative 
     to incarceration program for eligible participants, 
     including--
       (A) pre-booking, including pre-arrest, treatment 
     alternative to incarceration programs, including--
       (i) law enforcement training on substance use disorders and 
     co-occurring mental illness and substance use disorders;
       (ii) receiving centers as alternatives to incarceration of 
     eligible participants;
       (iii) specialized response units for calls related to 
     substance use disorders and co-occurring mental illness and 
     substance use disorders; and
       (iv) other pre-arrest or pre-booking treatment alternative 
     to incarceration models; and
       (B) post-booking treatment alternative to incarceration 
     programs, including--
       (i) specialized clinical case management;
       (ii) pre-trial services related to substance use disorders 
     and co-occurring mental illness and substance use disorders;
       (iii) prosecutor and defender based programs;
       (iv) specialized probation;
       (v) programs utilizing the American Society of Addiction 
     Medicine patient placement criteria;
       (vi) treatment and rehabilitation programs and recovery 
     support services; and
       (vii) drug courts, DWI courts, and veterans treatment 
     courts; and
       (2) facilitate or enhance planning and collaboration 
     between State criminal justice systems and State substance 
     abuse systems in order to more efficiently and effectively 
     carry out programs described in paragraph (1) that address 
     problems related to the use of heroin and misuse of 
     prescription drugs among eligible participants.
       (c) Application.--
       (1) In general.--An eligible entity desiring a grant under 
     this section shall submit an application to the Secretary of 
     Health and Human Services--
       (A) that meets the criteria under paragraph (2); and
       (B) at such time, in such manner, and accompanied by such 
     information as the Secretary of Health and Human Services may 
     require.
       (2) Criteria.--An eligible entity, in submitting an 
     application under paragraph (1), shall--
       (A) provide extensive evidence of collaboration with State 
     and local government agencies overseeing health, community 
     corrections, courts, prosecution, substance abuse, mental 
     health, victims services, and employment services, and with 
     local law enforcement agencies;
       (B) demonstrate consultation with the Single State 
     Authority for Substance Abuse;
       (C) demonstrate consultation with the Single State criminal 
     justice planning agency;
       (D) demonstrate that evidence-based treatment practices, 
     including if applicable the use of medication assisted 
     treatment, will be utilized; and
       (E) demonstrate that evidenced-based screening and 
     assessment tools will be utilized to place participants in 
     the treatment alternative to incarceration program.
       (d) Requirements.--Each eligible entity awarded a grant for 
     a treatment alternative to incarceration program under this 
     section shall--

[[Page S1174]]

       (1) determine the terms and conditions of participation in 
     the program by eligible participants, taking into 
     consideration the collateral consequences of an arrest, 
     prosecution, or criminal conviction;
       (2) ensure that each substance abuse and mental health 
     treatment component is licensed and qualified by the relevant 
     jurisdiction;
       (3) for programs described in subsection (b)(2), organize 
     an enforcement unit comprised of appropriately trained law 
     enforcement professionals under the supervision of the State, 
     tribal, or local criminal justice agency involved, the duties 
     of which shall include--
       (A) the verification of addresses and other contacts of 
     each eligible participant who participates or desires to 
     participate in the program; and
       (B) if necessary, the location, apprehension, arrest, and 
     return to court of an eligible participant in the program who 
     has absconded from the facility of a treatment provider or 
     has otherwise violated the terms and conditions of the 
     program, consistent with Federal and State confidentiality 
     requirements;
       (4) notify the relevant criminal justice entity if any 
     eligible participant in the program absconds from the 
     facility of the treatment provider or otherwise violates the 
     terms and conditions of the program, consistent with Federal 
     and State confidentiality requirements;
       (5) submit periodic reports on the progress of treatment or 
     other measured outcomes from participation in the program of 
     each eligible participant in the program to the relevant 
     State, tribal, or local criminal justice agency;
       (6) describe the evidence-based methodology and outcome 
     measurements that will be used to evaluate the program, and 
     specifically explain how such measurements will provide valid 
     measures of the impact of the program; and
       (7) describe how the program could be broadly replicated if 
     demonstrated to be effective.
       (e) Use of Funds.--An eligible entity shall use a grant 
     received under this section for expenses of a treatment 
     alternative to incarceration program, including--
       (1) salaries, personnel costs, equipment costs, and other 
     costs directly related to the operation of the program, 
     including the enforcement unit;
       (2) payments for treatment providers that are approved by 
     the relevant State or tribal jurisdiction and licensed, if 
     necessary, to provide needed treatment to eligible 
     participants in the program, including medication assisted 
     treatment, aftercare supervision, vocational training, 
     education, and job placement;
       (3) payments to public and nonprofit private entities that 
     are approved by the State or tribal jurisdiction and 
     licensed, if necessary, to provide alcohol and drug addiction 
     treatment and mental health treatment to eligible 
     participants in the program; and
       (4) salaries, personnel costs, and other costs related to 
     strategic planning among State and local government agencies.
       (f) Supplement Not Supplant.--An eligible entity shall use 
     Federal funds received under this section only to supplement 
     the funds that would, in the absence of those Federal funds, 
     be made available from other Federal and non-Federal sources 
     for the activities described in this section, and not to 
     supplant those funds.
       (g) Geographic Distribution.--The Secretary of Health and 
     Human Services shall ensure that, to the extent practicable, 
     the geographical distribution of grants under this section is 
     equitable and includes a grant to an eligible entity in--
       (1) each State;
       (2) rural, suburban, and urban areas; and
       (3) tribal jurisdictions.
       (h) Priority Consideration With Respect to States.--In 
     awarding grants to States under this section, the Secretary 
     of Health and Human Services shall give priority to--
       (1) a State that submits a joint application from the 
     substance abuse agencies and criminal justice agencies of the 
     State that proposes to use grant funds to facilitate or 
     enhance planning and collaboration between the agencies, 
     including coordination to better address the needs of 
     incarcerated populations; and
       (2) a State that--
       (A) provides civil liability protection for first 
     responders, health professionals, and family members who have 
     received appropriate training in the administration of 
     naloxone in administering naloxone to counteract opioid 
     overdoses; and
       (B) submits to the Secretary a certification by the 
     attorney general of the State that the attorney general has--
       (i) reviewed any applicable civil liability protection law 
     to determine the applicability of the law with respect to 
     first responders, health care professionals, family members, 
     and other individuals who--

       (I) have received appropriate training in the 
     administration of naloxone; and
       (II) may administer naloxone to individuals reasonably 
     believed to be suffering from opioid overdose; and

       (ii) concluded that the law described in subparagraph (A) 
     provides adequate civil liability protection applicable to 
     such persons.
       (i) Reports and Evaluations.--
       (1) In general.--Each fiscal year, each recipient of a 
     grant under this section during that fiscal year shall submit 
     to the Secretary of Health and Human Services a report on the 
     outcomes of activities carried out using that grant in such 
     form, containing such information, and on such dates as the 
     Secretary of Health and Human Services shall specify.
       (2) Contents.--A report submitted under paragraph (1) 
     shall--
       (A) describe best practices for treatment alternatives; and
       (B) identify training requirements for law enforcement 
     officers who participate in treatment alternative to 
     incarceration programs.
       (j) Funding.--During the 5-year period beginning on the 
     date of enactment of this Act, the Secretary of Health and 
     Human Services shall carry out this section using funds made 
     available to the Substance Abuse and Mental Health Services 
     Administration for Criminal Justice Activities.

     SEC. 202. FIRST RESPONDER TRAINING FOR THE USE OF DRUGS AND 
                   DEVICES THAT RAPIDLY REVERSE THE EFFECTS OF 
                   OPIOIDS.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 103, is amended by adding at the end the following:

     ``SEC. 2998. FIRST RESPONDER TRAINING FOR THE USE OF DRUGS 
                   AND DEVICES THAT RAPIDLY REVERSE THE EFFECTS OF 
                   OPIOIDS.

       ``(a) Definition.--In this section--
       ``(1) the terms `drug' and `device' have the meanings given 
     those terms in section 201 of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 321);
       ``(2) the term `eligible entity' means a State, a unit of 
     local government, or an Indian tribal government;
       ``(3) the term `first responder' includes a firefighter, 
     law enforcement officer, paramedic, emergency medical 
     technician, or other individual (including an employee of a 
     legally organized and recognized volunteer organization, 
     whether compensated or not), who, in the course of 
     professional duties, responds to fire, medical, hazardous 
     material, or other similar emergencies; and
       ``(4) the term `Secretary' means the Secretary of Health 
     and Human Services.
       ``(b) Program Authorized.--The Secretary, in coordination 
     with the Attorney General, may make grants to eligible 
     entities to allow appropriately trained first responders to 
     administer an opioid overdose reversal drug to an individual 
     who has--
       ``(1) experienced a prescription opioid or heroin overdose; 
     or
       ``(2) been determined to have likely experienced a 
     prescription opioid or heroin overdose.
       ``(c) Application.--
       ``(1) In general.--An eligible entity seeking a grant under 
     this section shall submit an application to the Secretary--
       ``(A) that meets the criteria under paragraph (2); and
       ``(B) at such time, in such manner, and accompanied by such 
     information as the Secretary may require.
       ``(2) Criteria.--An eligible entity, in submitting an 
     application under paragraph (1), shall--
       ``(A) describe the evidence-based methodology and outcome 
     measurements that will be used to evaluate the program funded 
     with a grant under this section, and specifically explain how 
     such measurements will provide valid measures of the impact 
     of the program;
       ``(B) describe how the program could be broadly replicated 
     if demonstrated to be effective;
       ``(C) identify the governmental and community agencies that 
     the program will coordinate; and
       ``(D) describe how law enforcement agencies will coordinate 
     with their corresponding State substance abuse and mental 
     health agencies to identify protocols and resources that are 
     available to victims and families, including information on 
     treatment and recovery resources.
       ``(d) Use of Funds.--An eligible entity shall use a grant 
     received under this section to--
       ``(1) make such opioid overdose reversal drugs or devices 
     that are approved by the Food and Drug Administration, such 
     as naloxone, available to be carried and administered by 
     first responders;
       ``(2) train and provide resources for first responders on 
     carrying an opioid overdose reversal drug or device approved 
     by the Food and Drug Administration, such as naloxone, and 
     administering the drug or device to an individual who has 
     experienced, or has been determined to have likely 
     experienced, a prescription opioid or heroin overdose; and
       ``(3) establish processes, protocols, and mechanisms for 
     referral to appropriate treatment.
       ``(e) Technical Assistance Grants.--The Secretary shall 
     make a grant for the purpose of providing technical 
     assistance and training on the use of an opioid overdose 
     reversal drug, such as naloxone, to respond to an individual 
     who has experienced, or has been determined to have likely 
     experienced, a prescription opioid or heroin overdose, and 
     mechanisms for referral to appropriate treatment for an 
     eligible entity receiving a grant under this section.
       ``(f) Evaluation.--The Secretary shall conduct an 
     evaluation of grants made under this section to determine--
       ``(1) the number of first responders equipped with 
     naloxone, or another opioid overdose reversal drug, for the 
     prevention of fatal opioid and heroin overdose;
       ``(2) the number of opioid and heroin overdoses reversed by 
     first responders receiving training and supplies of naloxone, 
     or another opioid overdose reversal drug, through a grant 
     received under this section;
       ``(3) the number of calls for service related to opioid and 
     heroin overdose;
       ``(4) the extent to which overdose victims and families 
     receive information about treatment services and available 
     data describing treatment admissions; and
       ``(5) the research, training, and naloxone, or another 
     opioid overdose reversal drug, supply needs of first 
     responder agencies, including those agencies that are not 
     receiving grants under this section.
       ``(g) Rural Areas With Limited Access to Emergency Medical 
     Services.--In making grants under this section, the Secretary 
     shall ensure that not less than 25 percent of grant funds are 
     awarded to eligible entities that are

[[Page S1175]]

     not located in metropolitan statistical areas, as defined by 
     the Office of Management and Budget.''.

     SEC. 203. PRESCRIPTION DRUG TAKE BACK EXPANSION.

       (a) Definition of Covered Entity.--In this section, the 
     term ``covered entity'' means--
       (1) a State, local, or tribal law enforcement agency;
       (2) a manufacturer, distributor, or reverse distributor of 
     prescription medications;
       (3) a retail pharmacy;
       (4) a registered narcotic treatment program;
       (5) a hospital or clinic with an on-site pharmacy;
       (6) an eligible long-term care facility; or
       (7) any other entity authorized by the Drug Enforcement 
     Administration to dispose of prescription medications.
       (b) Program Authorized.--The Attorney General, in 
     coordination with the Administrator of the Drug Enforcement 
     Administration, the Secretary of Health and Human Services, 
     and the Director of the Office of National Drug Control 
     Policy, shall coordinate with covered entities in expanding 
     or making available disposal sites for unwanted prescription 
     medications.

     SEC. 204. HEROIN AND METHAMPHETAMINE TASK FORCES.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 202, is amended by adding at the end the following:

     ``SEC. 2999. HEROIN AND METHAMPHETAMINE TASK FORCES.

       ``The Attorney General may make grants to State law 
     enforcement agencies for investigative purposes--
       ``(1) to locate or investigate illicit activities through 
     statewide collaboration, including activities related to--
       ``(A) the distribution of heroin or fentanyl, or the 
     unlawful distribution of prescription opioids; or
       ``(B) unlawful heroin, fentanyl, and prescription opioid 
     traffickers; and
       ``(2) to locate or investigate illicit activities, 
     including precursor diversion, laboratories, or 
     methamphetamine traffickers.''.

                   TITLE III--TREATMENT AND RECOVERY

     SEC. 301. EVIDENCE-BASED OPIOID AND HEROIN TREATMENT AND 
                   INTERVENTIONS DEMONSTRATION.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 204, is amended by adding at the end the following:

     ``SEC. 2999A. EVIDENCE-BASED OPIOID AND HEROIN TREATMENT AND 
                   INTERVENTIONS DEMONSTRATION.

       ``(a) Definitions.--In this section--
       ``(1) the terms `Indian tribe' and `tribal organization' 
     have the meaning given those terms in section 4 of the Indian 
     Health Care Improvement Act (25 U.S.C. 1603));
       ``(2) the term `medication assisted treatment' means the 
     use, for problems relating to heroin and other opioids, of 
     medications approved by the Food and Drug Administration in 
     combination with counseling and behavioral therapies;
       ``(3) the term `Secretary' means the Secretary of Health 
     and Human Services; and
       ``(4) the term `State substance abuse agency' means the 
     agency of a State responsible for the State prevention, 
     treatment, and recovery system, including management of the 
     Substance Abuse Prevention and Treatment Block Grant under 
     subpart II of part B of title XIX of the Public Health 
     Service Act (42 U.S.C. 300x-21 et seq.).
       ``(b) Grants.--
       ``(1) Authority to make grants.--The Secretary, acting 
     through the Director of the Center for Substance Abuse 
     Treatment of the Substance Abuse and Mental Health Services 
     Administration, and in coordination with the Attorney General 
     and other departments or agencies, as appropriate, may award 
     grants to State substance abuse agencies, units of local 
     government, nonprofit organizations, and Indian tribes or 
     tribal organizations that have a high rate, or have had a 
     rapid increase, in the use of heroin or other opioids, in 
     order to permit such entities to expand activities, including 
     an expansion in the availability of medication assisted 
     treatment and other clinically appropriate services, with 
     respect to the treatment of addiction in the specific 
     geographical areas of such entities where there is a high 
     rate or rapid increase in the use of heroin or other opioids.
       ``(2) Nature of activities.--The grant funds awarded under 
     paragraph (1) shall be used for activities that are based on 
     reliable scientific evidence of efficacy in the treatment of 
     problems related to heroin or other opioids.
       ``(c) Geographic Distribution.--The Secretary shall ensure 
     that grants awarded under subsection (b) are distributed 
     equitably among the various regions of the United States and 
     among rural, urban, and suburban areas that are affected by 
     the use of heroin or other opioids.
       ``(d) Additional Activities.--In administering grants under 
     subsection (b), the Secretary shall--
       ``(1) evaluate the activities supported by grants awarded 
     under subsection (b);
       ``(2) disseminate information, as appropriate, derived from 
     the evaluation as the Secretary considers appropriate;
       ``(3) provide States, Indian tribes and tribal 
     organizations, and providers with technical assistance in 
     connection with the provision of treatment of problems 
     related to heroin and other opioids; and
       ``(4) fund only those applications that specifically 
     support recovery services as a critical component of the 
     grant program.''.

     SEC. 302. CRIMINAL JUSTICE MEDICATION ASSISTED TREATMENT AND 
                   INTERVENTIONS DEMONSTRATION.

       (a) Definitions.--In this section--
       (1) the term ``criminal justice agency'' means a State, 
     local, or tribal--
       (A) court;
       (B) prison;
       (C) jail; or
       (D) other agency that performs the administration of 
     criminal justice, including prosecution, pretrial services, 
     and community supervision;
       (2) the term ``eligible entity'' means a State, unit of 
     local government, or Indian tribe; and
       (3) the term ``Secretary'' means the Secretary of Health 
     and Human Services.
       (b) Program Authorized.--The Secretary, in coordination 
     with the Attorney General, may make grants to eligible 
     entities to implement medication assisted treatment programs 
     through criminal justice agencies.
       (c) Application.--
       (1) In general.--An eligible entity seeking a grant under 
     this section shall submit an application to the Secretary--
       (A) that meets the criteria under paragraph (2); and
       (B) at such time, in such manner, and accompanied by such 
     information as the Secretary may require.
       (2) Criteria.--An eligible entity, in submitting an 
     application under paragraph (1), shall--
       (A) certify that each medication assisted treatment program 
     funded with a grant under this section has been developed in 
     consultation with the Single State Authority for Substance 
     Abuse; and
       (B) describe how data will be collected and analyzed to 
     determine the effectiveness of the program described in 
     subparagraph (A).
       (d) Use of Funds.--An eligible entity shall use a grant 
     received under this section for expenses of--
       (1) a medication assisted treatment program, including the 
     expenses of prescribing medications recognized by the Food 
     and Drug Administration for opioid treatment in conjunction 
     with psychological and behavioral therapy;
       (2) training criminal justice agency personnel and 
     treatment providers on medication assisted treatment;
       (3) cross-training personnel providing behavioral health 
     and health services, administration of medicines, and other 
     administrative expenses, including required reports; and
       (4) the provision of recovery coaches who are responsible 
     for providing mentorship and transition plans to individuals 
     reentering society following incarceration or alternatives to 
     incarceration.
       (e) Priority Consideration With Respect to States.--In 
     awarding grants to States under this section, the Secretary 
     shall give priority to a State that--
       (1) provides civil liability protection for first 
     responders, health professionals, and family members who have 
     received appropriate training in the administration of 
     naloxone in administering naloxone to counteract opioid 
     overdoses; and
       (2) submits to the Secretary a certification by the 
     attorney general of the State that the attorney general has--
       (A) reviewed any applicable civil liability protection law 
     to determine the applicability of the law with respect to 
     first responders, health care professionals, family members, 
     and other individuals who--
       (i) have received appropriate training in the 
     administration of naloxone; and
       (ii) may administer naloxone to individuals reasonably 
     believed to be suffering from opioid overdose; and
       (B) concluded that the law described in subparagraph (A) 
     provides adequate civil liability protection applicable to 
     such persons.
       (f) Technical Assistance.--The Secretary, in coordination 
     with the Director of the National Institute on Drug Abuse and 
     the Attorney General, shall provide technical assistance and 
     training for an eligible entity receiving a grant under this 
     section.
       (g) Reports.--
       (1) In general.--An eligible entity receiving a grant under 
     this section shall submit a report to the Secretary on the 
     outcomes of each grant received under this section for 
     individuals receiving medication assisted treatment, based 
     on--
       (A) the recidivism of the individuals;
       (B) the treatment outcomes of the individuals, including 
     maintaining abstinence from illegal, unauthorized, and 
     unprescribed or undispensed opioids and heroin;
       (C) a comparison of the cost of providing medication 
     assisted treatment to the cost of incarceration or other 
     participation in the criminal justice system;
       (D) the housing status of the individuals; and
       (E) the employment status of the individuals.
       (2) Contents and timing.--Each report described in 
     paragraph (1) shall be submitted annually in such form, 
     containing such information, and on such dates as the 
     Secretary shall specify.
       (h) Funding.--During the 5-year period beginning on the 
     date of enactment of this Act, the Secretary shall carry out 
     this section using funds made available to the Substance 
     Abuse and Mental Health Services Administration for Criminal 
     Justice Activities.

     SEC. 303. NATIONAL YOUTH RECOVERY INITIATIVE.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 301, is amended by adding at the end the following:

     ``SEC. 2999B. NATIONAL YOUTH RECOVERY INITIATIVE.

       ``(a) Definitions.--In this section:
       ``(1) Eligible entity.--The term `eligible entity' means--
       ``(A) a high school that has been accredited as a recovery 
     high school by the Association of Recovery Schools;

[[Page S1176]]

       ``(B) an accredited high school that is seeking to 
     establish or expand recovery support services;
       ``(C) an institution of higher education;
       ``(D) a recovery program at a nonprofit collegiate 
     institution; or
       ``(E) a nonprofit organization.
       ``(2) Institution of higher education.--The term 
     `institution of higher education' has the meaning given the 
     term in section 101 of the Higher Education Act of 1965 (20 
     U.S.C. 1001).
       ``(3) Recovery program.--The term `recovery program'--
       ``(A) means a program to help individuals who are 
     recovering from substance use disorders to initiate, 
     stabilize, and maintain healthy and productive lives in the 
     community; and
       ``(B) includes peer-to-peer support and communal activities 
     to build recovery skills and supportive social networks.
       ``(b) Grants Authorized.--The Secretary of Health and Human 
     Services, in coordination with the Secretary of Education, 
     may award grants to eligible entities to enable the entities 
     to--
       ``(1) provide substance use recovery support services to 
     young people in high school and enrolled in institutions of 
     higher education;
       ``(2) help build communities of support for young people in 
     recovery through a spectrum of activities such as counseling 
     and health- and wellness-oriented social activities; and
       ``(3) encourage initiatives designed to help young people 
     achieve and sustain recovery from substance use disorders.
       ``(c) Use of Funds.--Grants awarded under subsection (b) 
     may be used for activities to develop, support, and maintain 
     youth recovery support services, including--
       ``(1) the development and maintenance of a dedicated 
     physical space for recovery programs;
       ``(2) dedicated staff for the provision of recovery 
     programs;
       ``(3) health- and wellness-oriented social activities and 
     community engagement;
       ``(4) establishment of recovery high schools;
       ``(5) coordination of recovery programs with--
       ``(A) substance use disorder treatment programs and 
     systems;
       ``(B) providers of mental health services;
       ``(C) primary care providers and physicians;
       ``(D) the criminal justice system, including the juvenile 
     justice system;
       ``(E) employers;
       ``(F) housing services;
       ``(G) child welfare services;
       ``(H) high schools and institutions of higher education; 
     and
       ``(I) other programs or services related to the welfare of 
     an individual in recovery from a substance use disorder;
       ``(6) the development of peer-to-peer support programs or 
     services; and
       ``(7) additional activities that help youths and young 
     adults to achieve recovery from substance use disorders.''.

     SEC. 304. BUILDING COMMUNITIES OF RECOVERY.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 303, is amended by adding at the end the following:

     ``SEC. 2999C. BUILDING COMMUNITIES OF RECOVERY.

       ``(a) Definition.--In this section, the term `recovery 
     community organization' means an independent nonprofit 
     organization that--
       ``(1) mobilizes resources within and outside of the 
     recovery community to increase the prevalence and quality of 
     long-term recovery from substance use disorders; and
       ``(2) is wholly or principally governed by people in 
     recovery for substance use disorders who reflect the 
     community served.
       ``(b) Grants Authorized.--The Secretary of Health and Human 
     Services may award grants to recovery community organizations 
     to enable such organizations to develop, expand, and enhance 
     recovery services.
       ``(c) Federal Share.--The Federal share of the costs of a 
     program funded by a grant under this section may not exceed 
     50 percent.
       ``(d) Use of Funds.--Grants awarded under subsection (b)--
       ``(1) shall be used to develop, expand, and enhance 
     community and statewide recovery support services; and
       ``(2) may be used to--
       ``(A) advocate for individuals in recovery from substance 
     use disorders;
       ``(B) build connections between recovery networks, between 
     recovery community organizations, and with other recovery 
     support services, including--
       ``(i) substance use disorder treatment programs and 
     systems;
       ``(ii) providers of mental health services;
       ``(iii) primary care providers and physicians;
       ``(iv) the criminal justice system;
       ``(v) employers;
       ``(vi) housing services;
       ``(vii) child welfare agencies; and
       ``(viii) other recovery support services that facilitate 
     recovery from substance use disorders;
       ``(C) reduce the stigma associated with substance use 
     disorders;
       ``(D) conduct public education and outreach on issues 
     relating to substance use disorders and recovery, including--
       ``(i) how to identify the signs of addiction;
       ``(ii) the resources that are available to individuals 
     struggling with addiction and families who have a family 
     member struggling with or being treated for addiction, 
     including programs that mentor and provide support services 
     to children;
       ``(iii) the resources that are available to help support 
     individuals in recovery; and
       ``(iv) information on the medical consequences of substance 
     use disorders, including neonatal abstinence syndrome and 
     potential infection with human immunodeficiency virus and 
     viral hepatitis; and
       ``(E) carry out other activities that strengthen the 
     network of community support for individuals in recovery.''.

              TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES

     SEC. 401. CORRECTIONAL EDUCATION DEMONSTRATION GRANT PROGRAM.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 304, is amended by adding at the end the following:

     ``SEC. 2999D. CORRECTIONAL EDUCATION DEMONSTRATION GRANT 
                   PROGRAM.

       ``(a) Definition.--In this section, the term `eligible 
     entity' means a State, unit of local government, nonprofit 
     organization, or Indian tribe.
       ``(b) Grant Program Authorized.--The Attorney General may 
     make grants to eligible entities to design, implement, and 
     expand educational programs for offenders in prisons, jails, 
     and juvenile facilities, including to pay for--
       ``(1) basic education, secondary level academic education, 
     high school equivalency examination preparation, career 
     technical education, and English as a second language 
     instruction at the basic, secondary, or post-secondary 
     levels, for adult and juvenile populations;
       ``(2) screening and assessment of inmates to assess 
     education level, needs, occupational interest or aptitude, 
     risk level, and other needs, and case management services;
       ``(3) hiring and training of instructors and aides, 
     reimbursement of non-corrections staff and experts, 
     reimbursement of stipends paid to inmate tutors or aides, and 
     the costs of training inmate tutors and aides;
       ``(4) instructional supplies and equipment, including 
     occupational program supplies and equipment to the extent 
     that the supplies and equipment are used for instructional 
     purposes;
       ``(5) partnerships and agreements with community colleges, 
     universities, and career technology education program 
     providers;
       ``(6) certification programs providing recognized high 
     school equivalency certificates and industry recognized 
     credentials; and
       ``(7) technology solutions to--
       ``(A) meet the instructional, assessment, and information 
     needs of correctional populations; and
       ``(B) facilitate the continued participation of 
     incarcerated students in community-based education programs 
     after the students are released from incarceration.
       ``(c) Application.--An eligible entity seeking a grant 
     under this section shall submit to the Attorney General an 
     application in such form and manner, at such time, and 
     accompanied by such information as the Attorney General 
     specifies.
       ``(d) Priority Considerations.--In awarding grants under 
     this section, the Attorney General shall give priority to 
     applicants that--
       ``(1) assess the level of risk and need of inmates, 
     including by--
       ``(A) assessing the need for English as a second language 
     instruction;
       ``(B) conducting educational assessments; and
       ``(C) assessing occupational interests and aptitudes;
       ``(2) target educational services to assessed needs, 
     including academic and occupational at the basic, secondary, 
     or post-secondary level;
       ``(3) target career technology education programs to--
       ``(A) areas of identified occupational demand; and
       ``(B) employment opportunities in the communities in which 
     students are reasonably expected to reside post-release;
       ``(4) include a range of appropriate educational 
     opportunities at the basic, secondary, and post-secondary 
     levels;
       ``(5) include opportunities for students to attain industry 
     recognized credentials;
       ``(6) include partnership or articulation agreements 
     linking institutional education programs with community sited 
     programs provided by adult education program providers and 
     accredited institutions of higher education, community 
     colleges, and vocational training institutions; and
       ``(7) explicitly include career pathways models offering 
     opportunities for incarcerated students to develop academic 
     skills, in-demand occupational skills and credentials, 
     occupational experience in institutional work programs or 
     work release programs, and linkages with employers in the 
     community, so that incarcerated students have opportunities 
     to embark on careers with strong prospects for both post-
     release employment and advancement in a career ladder over 
     time.
       ``(e) Requirements.--An eligible entity desiring a grant 
     under this section shall--
       ``(1) describe the evidence-based methodology and outcome 
     measurements that will be used to evaluate each program 
     funded with a grant under this section, and specifically 
     explain how such measurements will provide valid measures of 
     the impact of the program; and
       ``(2) describe how the program described in paragraph (1) 
     could be broadly replicated if demonstrated to be effective.
       ``(f) Control of Internet Access.--An entity that receives 
     a grant under this section may restrict access to the 
     Internet by prisoners, as appropriate and in accordance with 
     Federal and State law, to ensure public safety.''.

     SEC. 402. NATIONAL TASK FORCE ON RECOVERY AND COLLATERAL 
                   CONSEQUENCES.

       (a) Definition.--In this section, the term ``collateral 
     consequence'' means a penalty, disability, or disadvantage 
     imposed on an individual who is in recovery for a substance 
     use disorder (including by an administrative agency, 
     official, or civil court ) as a result of a Federal or State 
     conviction for a drug-related offense but not as part of the 
     judgment of the court that imposes the conviction.
       (b) Establishment.--

[[Page S1177]]

       (1) In general.--Not later than 30 days after the date of 
     enactment of this Act, the Attorney General shall establish a 
     bipartisan task force to be known as the Task Force on 
     Recovery and Collateral Consequences (in this section 
     referred to as the ``Task Force'').
       (2) Membership.--
       (A) Total number of members.--The Task Force shall include 
     10 members, who shall be appointed by the Attorney General in 
     accordance with subparagraphs (B) and (C).
       (B) Members of the task force.--The Task Force shall 
     include--
       (i) members who have national recognition and significant 
     expertise in areas such as health care, housing, employment, 
     substance use disorders, mental health, law enforcement, and 
     law;
       (ii) not fewer than 2 members--

       (I) who have personally experienced substance abuse or 
     addiction and are in recovery; and
       (II) not fewer than 1 one of whom has benefitted from 
     medication assisted treatment; and

       (iii) to the extent practicable, members who formerly 
     served as elected officials at the State and Federal levels.
       (C) Timing.--The Attorney General shall appoint the members 
     of the Task Force not later than 60 days after the date on 
     which the Task Force is established under paragraph (1).
       (3) Chairperson.--The Task Force shall select a chairperson 
     or co-chairpersons from among the members of the Task Force.
       (c) Duties of the Task Force.--
       (1) In general.--The Task Force shall--
       (A) identify collateral consequences for individuals with 
     Federal or State convictions for drug-related offenses who 
     are in recovery for substance use disorder; and
       (B) examine any policy basis for the imposition of 
     collateral consequences identified under subparagraph (A) and 
     the effect of the collateral consequences on individuals in 
     recovery from resuming their personal and professional 
     activities.
       (2) Recommendations.--Not later than 180 days after the 
     date of the first meeting of the Task Force, the Task Force 
     shall develop recommendations, as it considers appropriate, 
     for proposed legislative and regulatory changes related to 
     the collateral consequences identified under paragraph (1).
       (3) Collection of information.--The Task Force shall hold 
     hearings, require the testimony and attendance of witnesses, 
     and secure information from any department or agency of the 
     United States in performing the duties under paragraphs (1) 
     and (2).
       (4) Report.--
       (A) Submission to executive branch.--Not later than 1 year 
     after the date of the first meeting of the Task Force, the 
     Task Force shall submit a report detailing the findings and 
     recommendations of the Task Force to--
       (i) the head of each relevant department or agency of the 
     United States;
       (ii) the President; and
       (iii) the Vice President.
       (B) Submission to congress.--The individuals who receive 
     the report under subparagraph (A) shall submit to Congress 
     such legislative recommendations, if any, as those 
     individuals consider appropriate based on the report.

  TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND 
                                VETERANS

     SEC. 501. IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM 
                   WOMEN.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 401, is amended by adding at the end the following:

     ``SEC. 2999E. IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM 
                   WOMEN.

       ``(a) In General.--The Secretary of Health and Human 
     Services (referred to in this section as the `Secretary'), 
     acting through the Director of the Center for Substance Abuse 
     Treatment, may carry out a pilot program under which the 
     Secretary makes competitive grants to State substance abuse 
     agencies to--
       ``(1) enhance flexibility in the use of funds designed to 
     support family-based services for pregnant and postpartum 
     women with a primary diagnosis of a substance use disorder, 
     including opioid use disorders;
       ``(2) help State substance abuse agencies address 
     identified gaps in services furnished to such women along the 
     continuum of care, including services provided to women in 
     non-residential based settings; and
       ``(3) promote a coordinated, effective, and efficient State 
     system managed by State substance abuse agencies by 
     encouraging new approaches and models of service delivery 
     that are evidence-based, including effective family-based 
     programs for women involved with the criminal justice system.
       ``(b) Requirements.--In carrying out the pilot program 
     under this section, the Secretary--
       ``(1) shall require State substance abuse agencies to 
     submit to the Secretary applications, in such form and manner 
     and containing such information as specified by the 
     Secretary, to be eligible to receive a grant under the 
     program;
       ``(2) shall identify, based on such submitted applications, 
     State substance abuse agencies that are eligible for such 
     grants;
       ``(3) shall require services proposed to be furnished 
     through such a grant to support family-based treatment and 
     other services for pregnant and postpartum women with a 
     primary diagnosis of a substance use disorder, including 
     opioid use disorders;
       ``(4) shall not require that services furnished through 
     such a grant be provided solely to women that reside in 
     facilities; and
       ``(5) shall not require that grant recipients under the 
     program make available all services described in section 
     508(d) of the Public Health Service Act (42 U.S.C. 290bb-
     1(d)).
       ``(c) Required Services.--
       ``(1) In general.--The Secretary shall specify minimum 
     services required to be made available to eligible women 
     through a grant awarded under the pilot program under this 
     section. Such minimum services--
       ``(A) shall include the requirements described in section 
     508(c) of the Public Health Service Act (42 U.S.C. 290bb-
     1(c));
       ``(B) may include any of the services described in section 
     508(d) of the Public Health Service Act (42 U.S.C. 290bb-
     1(d));
       ``(C) may include other services, as appropriate; and
       ``(D) shall be based on the recommendations submitted under 
     paragraph (2).
       ``(2) Stakeholder input.--The Secretary shall convene and 
     solicit recommendations from stakeholders, including State 
     substance abuse agencies, health care providers, persons in 
     recovery from a substance use disorder, and other appropriate 
     individuals, for the minimum services described in paragraph 
     (1).
       ``(d) Duration.--The pilot program under this section shall 
     not exceed 5 years.
       ``(e) Evaluation and Report to Congress.--
       ``(1) In general.--Out of amounts made available to the 
     Center for Behavioral Health Statistics and Quality, the 
     Director of the Center for Behavioral Health Statistics and 
     Quality, in cooperation with the recipients of grants under 
     this section, shall conduct an evaluation of the pilot 
     program, beginning 1 year after the date on which a grant is 
     first awarded under this section. The Director of the Center 
     for Behavioral Health Statistics and Quality, in coordination 
     with the Director of the Center for Substance Abuse 
     Treatment, not later than 120 days after completion of such 
     evaluation, shall submit to the relevant Committees of the 
     Senate and the House of Representatives a report on such 
     evaluation.
       ``(2) Contents.--The report to Congress under paragraph (1) 
     shall include, at a minimum, outcomes information from the 
     pilot program, including any resulting reductions in the use 
     of alcohol and other drugs, engagement in treatment services, 
     retention in the appropriate level and duration of services, 
     increased access to the use of drugs approved by the Food and 
     Drug Administration for the treatment of substance use 
     disorders in combination with counseling, and other 
     appropriate measures.
       ``(f) State Substance Abuse Agency Defined.--For purposes 
     of this section, the term `State substance abuse agency' 
     means, with respect to a State, the agency in such State that 
     manages the substance abuse prevention and treatment block 
     grant program under part B of title XIX of the Public Health 
     Service Act.''.

     SEC. 502. REPORT ON GRANTS FOR FAMILY-BASED SUBSTANCE ABUSE 
                   TREATMENT.

       Section 2925 of the Omnibus Crime Control and Safe Streets 
     Act of 1968 (42 U.S.C. 3797s-4) is amended--
       (1) by striking ``An entity'' and inserting ``(a) Entity 
     Reports.--An entity''; and
       (2) by adding at the end the following:
       ``(b) Attorney General Report on Family-Based Substance 
     Abuse Treatment.--The Attorney General shall submit to 
     Congress an annual report that describes the number of grants 
     awarded under section 2921(1) and how such grants are used by 
     the recipients for family-based substance abuse treatment 
     programs that serve as alternatives to incarceration for 
     custodial parents to receive treatment and services as a 
     family.''.

     SEC. 503. VETERANS' TREATMENT COURTS.

       Section 2991(j)(1)(B)(ii) of title I of the Omnibus Crime 
     Control and Safe Streets Act of 1968 (42 U.S.C. 
     3797aa(j)(1)(B)(ii)) is amended--
       (1) by inserting ``(I)'' after ``(ii)'';
       (2) in subclause (I), as so designated, by striking the 
     period and inserting ``; or''; and
       (3) by adding at the end the following:
       ``(II) was discharged or released from such service under 
     dishonorable conditions, if the reason for that discharge or 
     release, if known, is attributable to drug use.''.

  TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS 
                        OPIOID AND HEROIN ABUSE

     SEC. 601. STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE OPIOID 
                   ABUSE RESPONSE.

       (a) Definitions.--In this section--
       (1) the term ``dispenser'' has the meaning given the term 
     in section 102 of the Controlled Substances Act (21 U.S.C. 
     802);
       (2) the term ``prescriber of a schedule II, III, or IV 
     controlled substance'' does not include a prescriber of a 
     schedule II, III, or IV controlled substance that dispenses 
     the substance--
       (A) for use on the premises on which the substance is 
     dispensed;
       (B) in a hospital emergency room, when the substance is in 
     short supply;
       (C) for a certified opioid treatment program; or
       (D) in other situations as the Attorney General may 
     reasonably determine;
       (3) the term ``prescriber'' means a dispenser who 
     prescribes a controlled substance, or the agent of such a 
     dispenser; and
       (4) the term ``schedule II, III, or IV controlled 
     substance'' means a controlled substance that is listed on 
     schedule II, schedule III, or schedule IV of section 202(c) 
     of the Controlled Substances Act (21 U.S.C. 812(c)).
       (b) Planning and Implementation Grants.--
       (1) In general.--The Attorney General, in coordination with 
     the Secretary of Health and Human Services and in 
     consultation with the Director of the Office of National Drug 
     Control Policy, may award grants to States, and combinations 
     thereof, to prepare a comprehensive plan for and implement an 
     integrated opioid abuse response initiative.
       (2) Purposes.--A State receiving a grant under this section 
     shall establish a comprehensive response to opioid abuse, 
     which shall include--

[[Page S1178]]

       (A) prevention and education efforts around heroin and 
     opioid use, treatment, and recovery, including education of 
     residents, medical students, and physicians and other 
     prescribers of schedule II, III, or IV controlled substances 
     on relevant prescribing guidelines and the prescription drug 
     monitoring program of the State ;
       (B) a comprehensive prescription drug monitoring program to 
     track dispensing of schedule II, III, or IV controlled 
     substances, which shall--
       (i) provide for data sharing with other States by statute, 
     regulation, or interstate agreement; and
       (ii) allow for access to all individuals authorized by the 
     State to write prescriptions for schedule II, III, or IV 
     controlled substances on the prescription drug monitoring 
     program of the State.
       (C) developing, implementing, or expanding prescription 
     drug and opioid addiction treatment programs by--
       (i) expanding programs for medication assisted treatment of 
     prescription drug and opioid addiction, including training 
     for treatment and recovery support providers;
       (ii) developing, implementing, or expanding programs for 
     behavioral health therapy for individuals who are in 
     treatment for prescription drug and opioid addiction;
       (iii) developing, implementing, or expanding programs to 
     screen individuals who are in treatment for prescription drug 
     and opioid addiction for hepatitis C and HIV, and provide 
     treatment for those individuals if clinically appropriate; or
       (iv) developing, implementing, or expanding programs that 
     provide screening, early intervention, and referral to 
     treatment (commonly known as ``SBIRT'') to teenagers and 
     young adults in primary care, middle schools, high schools, 
     universities, school-based health centers, and other 
     community-based health care settings frequently accessed by 
     teenagers or young adults; and
       (D) developing, implementing, and expanding programs to 
     prevent overdose death from prescription medications and 
     opioids.
       (3) Planning grant applications.--
       (A) Application.--
       (i) In general.--A State seeking a planning grant under 
     this section to prepare a comprehensive plan for an 
     integrated opioid abuse response initiative shall submit to 
     the Attorney General an application in such form, and 
     containing such information, as the Attorney General may 
     require.
       (ii) Requirements.--An application for a planning grant 
     under this section shall, at a minimum, include--

       (I) a budget and a budget justification for the activities 
     to be carried out using the grant;
       (II) a description of the activities proposed to be carried 
     out using the grant, including a schedule for completion of 
     such activities;
       (III) outcome measures that will be used to measure the 
     effectiveness of the programs and initiatives to address 
     opioids; and
       (IV) a description of the personnel necessary to complete 
     such activities.

       (B) Period; nonrenewability.--A planning grant under this 
     section shall be for a period of 1 year. A State may not 
     receive more than 1 planning grant under this section.
       (C) Amount.--A planning grant under this section may not 
     exceed $100,000.
       (D) Strategic plan and program implementation plan.--A 
     State receiving a planning grant under this section shall 
     develop a strategic plan and a program implementation plan.
       (4) Implementation grants.--
       (A) Application.--A State seeking an implementation grant 
     under this section to implement a comprehensive strategy for 
     addressing opioid abuse shall submit to the Attorney General 
     an application in such form, and containing such information, 
     as the Attorney General may require.
       (B) Use of funds.--A State that receives an implementation 
     grant under this section shall use the grant for the cost of 
     carrying out an integrated opioid abuse response program in 
     accordance with this section, including for technical 
     assistance, training, and administrative expenses.
       (C) Requirements.--An integrated opioid abuse response 
     program carried out using an implementation grant under this 
     section shall--
       (i) require that each prescriber of a schedule II, III, or 
     IV controlled substance in the State--

       (I) registers with the prescription drug monitoring program 
     of the State; and
       (II) consults the prescription drug monitoring program 
     database of the State before prescribing a schedule II, III, 
     or IV controlled substance;

       (ii) require that each dispenser of a schedule II, III, or 
     IV controlled substance in the State--

       (I) registers with the prescription drug monitoring program 
     of the State;
       (II) consults the prescription drug monitoring program 
     database of the State before dispensing a schedule II, III, 
     or IV controlled substance; and
       (III) reports to the prescription drug monitoring program 
     of the State, at a minimum, each instance in which a schedule 
     II, III, or IV controlled substance is dispensed, with 
     limited exceptions, as defined by the State, which shall 
     indicate the prescriber by name and National Provider 
     Identifier;

       (iii) require that, not fewer than 4 times each year, the 
     State agency or agencies that administer the prescription 
     drug monitoring program of the State prepare and provide to 
     each prescriber of a schedule II, III, or IV controlled 
     substance an informational report that shows how the 
     prescribing patterns of the prescriber compare to prescribing 
     practices of the peers of the prescriber and expected norms;
       (iv) if informational reports provided to a prescriber 
     under clause (iii) indicate that the prescriber is repeatedly 
     falling outside of expected norms or standard practices for 
     the prescriber's field, direct the prescriber to educational 
     resources on appropriate prescribing of controlled 
     substances;
       (v) ensure that the prescriber licensing board of the State 
     receives a report describing any prescribers that repeatedly 
     fall outside of expected norms or standard practices for the 
     prescriber's field, as described in clause (iii);
       (vi) require consultation with the Single State Authority 
     for Substance Abuse; and
       (vii) establish requirements for how data will be collected 
     and analyzed to determine the effectiveness of the program.
       (D) Period.--An implementation grant under this section 
     shall be for a period of 2 years.
       (E) Amount.--The amount of an implementation grant under 
     this section may not exceed $5,000,000.
       (5) Priority considerations.--In awarding planning and 
     implementation grants under this section, the Attorney 
     General shall give priority to a State that--
       (A)(i) provides civil liability protection for first 
     responders, health professionals, and family members who have 
     received appropriate training in the administration of 
     naloxone in administering naloxone to counteract opioid 
     overdoses; and
       (ii) submits to the Attorney General a certification by the 
     attorney general of the State that the attorney general has--
       (I) reviewed any applicable civil liability protection law 
     to determine the applicability of the law with respect to 
     first responders, health care professionals, family members, 
     and other individuals who--

       (aa) have received appropriate training in the 
     administration of naloxone; and
       (bb) may administer naloxone to individuals reasonably 
     believed to be suffering from opioid overdose; and

       (II) concluded that the law described in subclause (I) 
     provides adequate civil liability protection applicable to 
     such persons;
       (B) has in effect legislation or implements a policy under 
     which the State shall not terminate, but may suspend, 
     enrollment under the State plan for medical assistance under 
     title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) 
     for an individual who is incarcerated for a period of fewer 
     than 2 years;
       (C) has a process for enrollment in services and benefits 
     necessary by criminal justice agencies to initiate or 
     continue treatment in the community, under which an 
     individual who is incarcerated may, while incarcerated, 
     enroll in services and benefits that are necessary for the 
     individual to continue treatment upon release from 
     incarceration;
       (D) ensures the capability of data sharing with other 
     States, such as by making data available to a prescription 
     monitoring hub;
       (E) ensures that data recorded in the prescription drug 
     monitoring program database of the State is available within 
     24 hours, to the extent possible; and
       (F) ensures that the prescription drug monitoring program 
     of the State notifies prescribers and dispensers of schedule 
     II, III, or IV controlled substances when overuse or misuse 
     of such controlled substances by patients is suspected.
       (c) Authorization of Funding.--For each of fiscal years 
     2016 through 2020, the Attorney General may use, from any 
     unobligated balances made available under the heading 
     ``GENERAL ADMINISTRATION'' to the Department of Justice in an 
     appropriations Act, such amounts as are necessary to carry 
     out this section, not to exceed $5,000,000 per fiscal year.

                        TITLE VII--MISCELLANEOUS

     SEC. 701. GAO REPORT ON IMD EXCLUSION.

       (a) Definition.--In this section, the term ``Medicaid 
     Institutions for Mental Disease exclusion'' means the 
     prohibition on Federal matching payments under Medicaid for 
     patients who have attained age 22, but have not attained age 
     65, in an institution for mental diseases under subparagraph 
     (B) of the matter following subsection (a) of section 1905 of 
     the Social Security Act and subsection (i) of such section 
     (42 U.S.C. 1396d).
       (b) Report Required.--Not later than 1 year after the date 
     of enactment of this Act, the Comptroller General of the 
     United States shall submit to Congress a report on the impact 
     that the Medicaid Institutions for Mental Disease exclusion 
     has on access to treatment for individuals with a substance 
     use disorder.
       (c) Elements.--The report required under subsection (b) 
     shall include a review of what is known regarding--
       (1) Medicaid beneficiary access to substance use disorder 
     treatments in institutions for mental disease; and
       (2) the quality of care provided to Medicaid beneficiaries 
     treated in and outside of institutions for mental disease for 
     substance use disorders.

     SEC. 702. FUNDING.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 501, is amended by adding at the end the following:

     ``SEC. 2999F. FUNDING.

       ``There are authorized to be appropriated to the Attorney 
     General and the Secretary of Health and Human Services to 
     carry out this part $77,900,000 for each of fiscal years 2016 
     through 2020.''.

     SEC. 703. CONFORMING AMENDMENTS.

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.) is amended--
       (1) in the part heading, by striking ``CONFRONTING USE OF 
     METHAMPHETAMINE'' and inserting ``COMPREHENSIVE ADDICTION AND 
     RECOVERY''; and
       (2) in section 2996(a)(1), by striking ``this part'' and 
     inserting ``this section''.

     SEC. 704. GRANT ACCOUNTABILITY.

       (a) Grants Under Part II of Title I of the Omnibus Crime 
     Control and Safe Streets Act of 1968.--

[[Page S1179]]

       Part II of title I of the Omnibus Crime Control and Safe 
     Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by 
     section 702, is amended by adding at the end the following:

     ``SEC. 2999G. GRANT ACCOUNTABILITY.

       ``(a) Definitions.--In this section--
       ``(1) the term `applicable committees'--
       ``(A) with respect to the Attorney General and any other 
     official of the Department of Justice, means--
       ``(i) the Committee on the Judiciary of the Senate; and
       ``(ii) the Committee on the Judiciary of the House of 
     Representatives; and
       ``(B) with respect to the Secretary of Health and Human 
     Services and any other official of the Department of Health 
     and Human Services, means--
       ``(i) the Committee on Health, Education, Labor, and 
     Pensions of the Senate; and
       ``(ii) the Committee on Energy and Commerce of the House of 
     Representatives;
       ``(2) the term `covered agency' means--
       ``(A) the Department of Justice; and
       ``(B) the Department of Health and Human Services; and
       ``(3) the term `covered official' means--
       ``(A) the Attorney General; and
       ``(B) the Secretary of Health and Human Services.
       ``(b) Accountability.--All grants awarded by a covered 
     official under this part shall be subject to the following 
     accountability provisions:
       ``(1) Audit requirement.--
       ``(A) Definition.--In this paragraph, the term `unresolved 
     audit finding' means a finding in the final audit report of 
     the Inspector General of a covered agency that the audited 
     grantee has utilized grant funds for an unauthorized 
     expenditure or otherwise unallowable cost that is not closed 
     or resolved within 12 months after the date on which the 
     final audit report is issued.
       ``(B) Audit.--Beginning in the first fiscal year beginning 
     after the date of enactment of this section, and in each 
     fiscal year thereafter, the Inspector General of a covered 
     agency shall conduct audits of recipients of grants awarded 
     by the applicable covered official under this part to prevent 
     waste, fraud, and abuse of funds by grantees. The Inspector 
     General shall determine the appropriate number of grantees to 
     be audited each year.
       ``(C) Mandatory exclusion.--A recipient of grant funds 
     under this part that is found to have an unresolved audit 
     finding shall not be eligible to receive grant funds under 
     this part during the first 2 fiscal years beginning after the 
     end of the 12-month period described in subparagraph (A).
       ``(D) Priority.--In awarding grants under this part, a 
     covered official shall give priority to eligible applicants 
     that did not have an unresolved audit finding during the 3 
     fiscal years before submitting an application for a grant 
     under this part.
       ``(E) Reimbursement.--If an entity is awarded grant funds 
     under this part during the 2-fiscal-year period during which 
     the entity is barred from receiving grants under subparagraph 
     (C), the covered official that awarded the grant funds 
     shall--
       ``(i) deposit an amount equal to the amount of the grant 
     funds that were improperly awarded to the grantee into the 
     General Fund of the Treasury; and
       ``(ii) seek to recoup the costs of the repayment to the 
     fund from the grant recipient that was erroneously awarded 
     grant funds.
       ``(2) Nonprofit organization requirements.--
       ``(A) Definition.--For purposes of this paragraph and the 
     grant programs under this part, the term `nonprofit 
     organization' means an organization that is described in 
     section 501(c)(3) of the Internal Revenue Code of 1986 and is 
     exempt from taxation under section 501(a) of such Code.
       ``(B) Prohibition.--A covered official may not award a 
     grant under this part to a nonprofit organization that holds 
     money in offshore accounts for the purpose of avoiding paying 
     the tax described in section 511(a) of the Internal Revenue 
     Code of 1986.
       ``(C) Disclosure.--Each nonprofit organization that is 
     awarded a grant under this part and uses the procedures 
     prescribed in regulations to create a rebuttable presumption 
     of reasonableness for the compensation of its officers, 
     directors, trustees, and key employees, shall disclose to the 
     applicable covered official, in the application for the 
     grant, the process for determining such compensation, 
     including the independent persons involved in reviewing and 
     approving such compensation, the comparability data used, and 
     contemporaneous substantiation of the deliberation and 
     decision. Upon request, a covered official shall make the 
     information disclosed under this subparagraph available for 
     public inspection.
       ``(3) Conference expenditures.--
       ``(A) Limitation.--No amounts made available to a covered 
     official under this part may be used by the covered official, 
     or by any individual or entity awarded discretionary funds 
     through a cooperative agreement under this part, to host or 
     support any expenditure for conferences that uses more than 
     $20,000 in funds made available by the covered official, 
     unless the covered official provides prior written 
     authorization that the funds may be expended to host the 
     conference.
       ``(B) Written authorization.--Written authorization under 
     subparagraph (A) shall include a written estimate of all 
     costs associated with the conference, including the cost of 
     all food, beverages, audio-visual equipment, honoraria for 
     speakers, and entertainment.
       ``(C) Report.--
       ``(i) Department of justice.--The Deputy Attorney General 
     shall submit to the applicable committees an annual report on 
     all conference expenditures approved by the Attorney General 
     under this paragraph.
       ``(ii) Department of health and human services.--The Deputy 
     Secretary of Health and Human Services shall submit to the 
     applicable committees an annual report on all conference 
     expenditures approved by the Secretary of Health and Human 
     Services under this paragraph.
       ``(4) Annual certification.--Beginning in the first fiscal 
     year beginning after the date of enactment of this section, 
     each covered official shall submit to the applicable 
     committees an annual certification--
       ``(A) indicating whether--
       ``(i) all audits issued by the Office of the Inspector 
     General of the applicable agency under paragraph (1) have 
     been completed and reviewed by the appropriate Assistant 
     Attorney General or Director, or the appropriate official of 
     the Department of Health and Human Services, as applicable;
       ``(ii) all mandatory exclusions required under paragraph 
     (1)(C) have been issued; and
       ``(iii) all reimbursements required under paragraph (1)(E) 
     have been made; and
       ``(B) that includes a list of any grant recipients excluded 
     under paragraph (1) from the previous year.
       ``(c) Preventing Duplicative Grants.--
       ``(1) In general.--Before a covered official awards a grant 
     to an applicant under this part, the covered official shall 
     compare potential grant awards with other grants awarded 
     under this part by the covered official to determine if 
     duplicate grant awards are awarded for the same purpose.
       ``(2) Report.--If a covered official awards duplicate 
     grants to the same applicant for the same purpose, the 
     covered official shall submit to the applicable committees a 
     report that includes--
       ``(A) a list of all duplicate grants awarded, including the 
     total dollar amount of any duplicate grants awarded; and
       ``(B) the reason the covered official awarded the duplicate 
     grants.''.
       (b) Other Grants.--
       (1) Definitions.--In this subsection--
       (A) the term ``applicable committees''--
       (i) with respect to the Attorney General and any other 
     official of the Department of Justice, means--

       (I) the Committee on the Judiciary of the Senate; and
       (II) the Committee on the Judiciary of the House of 
     Representatives; and

       (ii) with respect to the Secretary of Health and Human 
     Services and any other official of the Department of Health 
     and Human Services, means--

       (I) the Committee on Health, Education, Labor, and Pensions 
     of the Senate; and
       (II) the Committee on Energy and Commerce of the House of 
     Representatives;

       (B) the term ``covered agency'' means--
       (i) the Department of Justice; and
       (ii) the Department of Health and Human Services; and
       (C) the term ``covered official'' means--
       (i) the Attorney General; and
       (ii) the Secretary of Health and Human Services.
       (2) Accountability.--All grants awarded by a covered 
     official under section 201, 302, or 601 shall be subject to 
     the following accountability provisions:
       (A) Audit requirement.--
       (i) Definition.--In this subparagraph, the term 
     ``unresolved audit finding'' means a finding in the final 
     audit report of the Inspector General of a covered agency 
     that the audited grantee has utilized grant funds for an 
     unauthorized expenditure or otherwise unallowable cost that 
     is not closed or resolved within 12 months after the date on 
     which the final audit report is issued.
       (ii) Audit.--Beginning in the first fiscal year beginning 
     after the date of enactment of this Act, and in each fiscal 
     year thereafter, the Inspector General of a covered agency 
     shall conduct audits of recipients of grants awarded by the 
     applicable covered official under section 201, 302, or 601 to 
     prevent waste, fraud, and abuse of funds by grantees. The 
     Inspector General shall determine the appropriate number of 
     grantees to be audited each year.
       (iii) Mandatory exclusion.--A recipient of grant funds 
     under section 201, 302, or 601 that is found to have an 
     unresolved audit finding shall not be eligible to receive 
     grant funds under those sections during the first 2 fiscal 
     years beginning after the end of the 12-month period 
     described in clause (i).
       (iv) Priority.--In awarding grants under section 201, 302, 
     or 601, a covered official shall give priority to eligible 
     applicants that did not have an unresolved audit finding 
     during the 3 fiscal years before submitting an application 
     for a grant under such section.
       (v) Reimbursement.--If an entity is awarded grant funds 
     under section 201, 302, or 601 during the 2-fiscal-year 
     period during which the entity is barred from receiving 
     grants under clause (iii), the covered official that awarded 
     the funds shall--

       (I) deposit an amount equal to the amount of the grant 
     funds that were improperly awarded to the grantee into the 
     General Fund of the Treasury; and
       (II) seek to recoup the costs of the repayment to the fund 
     from the grant recipient that was erroneously awarded grant 
     funds.

       (B) Nonprofit organization requirements.--
       (i) Definition.--For purposes of this subparagraph and the 
     grant programs under sections 201, 302, and 601, the term 
     ``nonprofit organization'' means an organization that is 
     described in section 501(c)(3) of the Internal Revenue Code 
     of 1986 and is exempt from taxation under section 501(a) of 
     such Code.
       (ii) Prohibition.--A covered official may not award a grant 
     under this section 201, 302, or 601

[[Page S1180]]

     to a nonprofit organization that holds money in offshore 
     accounts for the purpose of avoiding paying the tax described 
     in section 511(a) of the Internal Revenue Code of 1986.
       (iii) Disclosure.--Each nonprofit organization that is 
     awarded a grant under section 201, 302, or 601 and uses the 
     procedures prescribed in regulations to create a rebuttable 
     presumption of reasonableness for the compensation of its 
     officers, directors, trustees, and key employees, shall 
     disclose to the applicable covered official, in the 
     application for the grant, the process for determining such 
     compensation, including the independent persons involved in 
     reviewing and approving such compensation, the comparability 
     data used, and contemporaneous substantiation of the 
     deliberation and decision. Upon request, a covered official 
     shall make the information disclosed under this clause 
     available for public inspection.
       (C) Conference expenditures.--
       (i) Limitation.--No amounts made available to a covered 
     official under section 201, 302, or 601 may be used by the 
     covered official, or by any individual or entity awarded 
     discretionary funds through a cooperative agreement under 
     those sections, to host or support any expenditure for 
     conferences that uses more than $20,000 in funds made 
     available by the covered official, unless the covered 
     official provides prior written authorization that the funds 
     may be expended to host the conference.
       (ii) Written authorization.--Written authorization under 
     clause (i) shall include a written estimate of all costs 
     associated with the conference, including the cost of all 
     food, beverages, audio-visual equipment, honoraria for 
     speakers, and entertainment.
       (iii) Report.--

       (I) Department of justice.--The Deputy Attorney General 
     shall submit to the applicable committees an annual report on 
     all conference expenditures approved by the Attorney General 
     under this subparagraph.
       (II) Department of health and human services.--The Deputy 
     Secretary of Health and Human Services shall submit to the 
     applicable committees an annual report on all conference 
     expenditures approved by the Secretary of Health and Human 
     Services under this subparagraph.

       (D) Annual certification.--Beginning in the first fiscal 
     year beginning after the date of enactment of this Act, each 
     covered official shall submit to the applicable committees an 
     annual certification--
       (i) indicating whether--

       (I) all audits issued by the Office of the Inspector 
     General of the applicable agency under subparagraph (A) have 
     been completed and reviewed by the appropriate Assistant 
     Attorney General or Director, or the appropriate official of 
     the Department of Health and Human Services, as applicable;
       (II) all mandatory exclusions required under subparagraph 
     (A)(iii) have been issued; and
       (III) all reimbursements required under subparagraph (A)(v) 
     have been made; and

       (ii) that includes a list of any grant recipients excluded 
     under subparagraph (A) from the previous year.
       (3) Preventing duplicative grants.--
       (A) In general.--Before a covered official awards a grant 
     to an applicant under section 201, 302, or 601, the covered 
     official shall compare potential grant awards with other 
     grants awarded under those sections by the covered official 
     to determine if duplicate grant awards are awarded for the 
     same purpose.
       (B) Report.--If a covered official awards duplicate grants 
     to the same applicant for the same purpose, the covered 
     official shall submit to the to the applicable committees a 
     report that includes--
       (i) a list of all duplicate grants awarded, including the 
     total dollar amount of any duplicate grants awarded; and
       (ii) the reason the covered official awarded the duplicate 
     grants.

           Committee-Reported Substitute Amendment Withdrawn

  The PRESIDING OFFICER. Under the previous order, the committee-
reported substitute is withdrawn.
  The Senator from Iowa.


                           Amendment No. 3378

       (Purpose: In the nature of a substitute.)

  Mr. GRASSLEY. Mr. President, I call up the substitute amendment No. 
3378.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Iowa [Mr. Grassley] proposes an amendment 
     numbered 3378.

  Mr. GRASSLEY. Mr. President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The amendment is printed in the Record of March 1, 2016, under 
``Text of Amendments.'')


                Amendment No. 3362 to Amendment No. 3378

  Mr. GRASSLEY. Mr. President, I call up the Feinstein-Grassley 
amendment No. 3362.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Iowa [Mr. Grassley], for Mrs. Feinstein, 
     proposes an amendment numbered 3362 to amendment No. 3378.

  The amendment is as follows:

(Purpose: To provide the Department of Justice with additional tools to 
   target extraterritorial drug trafficking activity, and for other 
                               purposes)

       At the end, add the following:

              TITLE __--TRANSNATIONAL DRUG TRAFFICKING ACT

     SEC. _01. SHORT TITLE.

       This title may be cited as the ``Transnational Drug 
     Trafficking Act of 2015''.

     SEC. _02. POSSESSION, MANUFACTURE OR DISTRIBUTION FOR 
                   PURPOSES OF UNLAWFUL IMPORTATIONS.

       Section 1009 of the Controlled Substances Import and Export 
     Act (21 U.S.C. 959) is amended--
       (1) by redesignating subsections (b) and (c) as subsections 
     (c) and (d), respectively; and
       (2) in subsection (a), by striking ``It shall'' and all 
     that follows and inserting the following: ``It shall be 
     unlawful for any person to manufacture or distribute a 
     controlled substance in schedule I or II or flunitrazepam or 
     a listed chemical intending, knowing, or having reasonable 
     cause to believe that such substance or chemical will be 
     unlawfully imported into the United States or into waters 
     within a distance of 12 miles of the coast of the United 
     States.
       ``(b) It shall be unlawful for any person to manufacture or 
     distribute a listed chemical--
       ``(1) intending or knowing that the listed chemical will be 
     used to manufacture a controlled substance; and
       ``(2) intending, knowing, or having reasonable cause to 
     believe that the controlled substance will be unlawfully 
     imported into the United States.''.

     SEC. _03. TRAFFICKING IN COUNTERFEIT GOODS OR SERVICES.

       Chapter 113 of title 18, United States Code, is amended--
       (1) in section 2318(b)(2), by striking ``section 2320(e)'' 
     and inserting ``section 2320(f)''; and
       (2) in section 2320--
       (A) in subsection (a), by striking paragraph (4) and 
     inserting the following:
       ``(4) traffics in a drug and knowingly uses a counterfeit 
     mark on or in connection with such drug,'';
       (B) in subsection (b)(3), in the matter preceding 
     subparagraph (A), by striking ``counterfeit drug'' and 
     inserting ``drug that uses a counterfeit mark on or in 
     connection with the drug''; and
       (C) in subsection (f), by striking paragraph (6) and 
     inserting the following:
       ``(6) the term `drug' means a drug, as defined in section 
     201 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
     321).''.

  Mr. GRASSLEY. Mr. President, I am pleased we are considering the bill 
before us entitled the ``Comprehensive Addiction and Recovery Act''--
acronym CARA--and that we are on the floor discussing this very 
important issue.
  Since I spoke about the bill earlier this week, I will not have any 
more opening remarks at this point. I look forward to a bipartisan 
process where we are able to consider many amendments and move this 
bill forward.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. BARRASSO. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Cotton). Without objection, it is so 
ordered.
  Mr. BARRASSO. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                               ObamaCare

  Mr. BARRASSO. Mr. President, I come to the floor today to discuss 
more of the troubling news that has come out on how the health care law 
has affected the people of this country. A new poll just came out from 
National Public Radio as well as the Robert Wood Johnson Foundation. 
This is what they found: According to the poll, 26 percent of Americans 
are telling us that the health care law--ObamaCare--has directly hurt 
them. Twenty-six percent of Americans say that ObamaCare, the health 
care law, has directly hurt them. Only 14 percent of the people in the 
poll said that their personal health care has gotten better under 
ObamaCare. So it is just one in seven who say it is better; over one-
quarter say they have personally been hurt. So almost twice as many 
people have been directly hurt by the law compared to the people who 
have been helped.
  American taxpayers are also being hurt by ObamaCare because of the 
waste and the fraud in the health care system. There is a new report 
just out from the Government Accountability Office. It came out last 
week. It found that the Obama administration is still failing to stop 
the fraud in health care subsidies.

[[Page S1181]]

  Here is how the law was designed to work: People must have 
government-approved insurance because of the law. It is a mandate. 
There are a lot of people who have been forced to buy very expensive 
insurance to comply with the law, and in many cases it is far more 
coverage than they want, that they need, or that they can afford. So 
the health care law, which the Democrats voted for and the Republicans 
voted against, said that the government will give subsidies to people 
to help them pay for this Washington-mandated, expensive insurance.
  To get the subsidy, people are supposed to be able to prove they are 
eligible for the subsidy. There are various criteria to make sure 
people are eligible. That means things like proving they make a certain 
income or how many people are in their family or that they are citizens 
of the United States or that they are here legally.
  Washington then pays the subsidy directly to the insurance company. 
Then later, the government comes around and tries to figure out if the 
person even qualified for the money, so there is a huge potential for 
fraud and for wasting taxpayer dollars.
  This new report from the Government Accountability Office found that, 
despite the billions of dollars at stake, the Obama administration has 
taken what they describe as a ``passive approach'' to identifying and 
preventing the fraud. The Obama administration has taken a ``passive 
approach.'' It says the Obama administration has struggled--struggled 
to confirm the eligibility of millions of people who applied for 
subsidies. This is a report from the Government Accountability Office. 
We want accountability in government.
  The report found that there are 431,000 people who still had 
unresolved issues with the subsidy paperwork more than a year after 
they first applied. The cases amount to over $1.7 billion in taxpayer 
subsidies. Now, the insurance coverage that these people had for that 
year has already ended. The Obama administration still did not know if 
they should have gotten the money that was sent out to the insurance 
companies on their behalf.
  There are another 22,000 cases where it still is not clear if the 
person who got the subsidy was serving time in prison. How can 
Washington not even know if someone is in prison? This should be one of 
the easiest things to find out. But there are millions of cases where 
the administration is taking this passive approach to figuring out if 
there is fraud occurring with these subsidies.
  People all around the country are asking: Where is the accountability 
from the Obama administration? They are spending billions of taxpayer 
dollars. Where is the accountability to make sure that it is being 
spent properly and not wasted? There is no accountability because the 
Obama administration does not seem to care about protecting taxpayer 
money. It cares more about getting a large number of people enrolled in 
insurance. That is what they want, no matter what the law says, no 
matter how much money they waste to do it.
  This report from the Government Accountability Office came out last 
Wednesday. The very next day, there was more bad news for taxpayers 
because of the health care law. There was an article in the Wall Street 
Journal on Thursday, February 25, under the headline ``Insurance Fight 
Escalates.'' It goes on to say: ``Health co-op leaders say the effort 
to recoup Federal loans will come up short.''
  This is taxpayer money. Remember, the health care law gave out 
billions of dollars--billions of dollars in loans to set up these 
health insurance co-ops across the country. They set up 23. Already, 
more than half of them have collapsed and have gone out of business, 12 
out of 23 have gone bust, and 700,000 Americans lost their insurance 
because these co-ops failed.
  Now it looks as if hard-working taxpayers are going to lose the money 
that the government loaned to these failed insurance businesses. 
According to this Wall Street Journal article, leaders of the co-ops 
say that taxpayers are going to lose more than $1 billion in the failed 
co-ops. They say it is because most of the money has already been 
spent.
  The article quotes the head of the co-op in New Mexico as saying: 
``Will there be any money left?''
  ``Yeah, maybe.'' That is what he said. That is his answer: ``Yeah, 
maybe.'' Maybe there will be a little money left out of more than $1 
billion in taxpayer loans. It is outrageous. It was not supposed to be 
a bailout of the insurance company. These were supposed to be loans.
  Is that how the administration thinks loans are supposed to work? 
Does the Obama administration think that if they lend out money and 
people borrow it from the taxpayers and spend it, then they don't have 
to pay it? Where is the accountability from these co-ops for the 
American people? Where is the accountability for the Obama 
administration to make sure that they loan this money responsibly and 
don't waste it? Reports like this paint a very bad picture of health 
care and the health care law in this country.
  We talked about these 23 co-ops and half of them have failed. This 
was headlined yesterday: ``Losses deepen for remaining ObamaCare co-
ops.''

       Losses snowballed in the fourth quarter at four co-op 
     health plans [that have now reported their numbers for 2015].

  The article says:

       The nonprofit startups based in Illinois, Wisconsin, Ohio 
     and Maine lost about $270 million last year. . . . That's 
     more than five times the level of losses those plans recorded 
     in 2014.

  That was the first year they operated. They are still waiting for the 
updated financial reports on the other seven remaining co-ops that have 
not yet posted their returns.
  Here we are. Six years ago, there was a debate in Congress about the 
Americans' health care system. Everyone in this body agreed we had a 
problem. Everybody agreed we needed to do something to help Americans. 
Republicans presented our ideas on the floor of the Senate. We went to 
meetings at the White House. We offered President Obama solutions. 
Democrats and the President rejected our ideas, and they came up with 
their own massive plan.
  Washington took on too much power over the health care decisions of 
American families. More Washington control, less Washington 
accountability--they are never the right answers for our country. If 
Washington can't protect taxpayer dollars, it shouldn't be collecting 
so many of these dollars in the first place.
  Republicans warned that ObamaCare would be bad for patients, bad for 
providers, and terrible for the taxpayers. The news keeps coming out, 
showing that we were exactly right. Republicans are going to continue 
to talk about our health care ideas and will continue to talk about 
ideas that will actually hold Washington accountable as Washington 
spends taxpayers' dollars. We will continue to talk about ideas such as 
giving families more control over their health care and their health 
care decisions and giving Washington less control. That is what 
Americans want.
  This new report out from the National Public Radio poll showed 26 
percent of Americans say that the health care law, ObamaCare, has 
directly hurt them. They didn't want this kind of health care reform 
that directly hurts them, instead of helping them; they wanted to be 
helped. They don't want an approach like we have; they want an approach 
that gives them control and, certainly, not a passive approach to 
preventing fraud. The American people do not want ObamaCare.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.


                Amendment No. 3345 to Amendment No. 3378

  Mrs. SHAHEEN. Mr. President, I wish to call up amendment No. 3345, 
which is my supplemental amendment to address the heroin and opioid 
epidemic.
  The PRESIDING OFFICER. The clerk will report.
  The senior assistant legislative clerk read as follows:

       The Senator from New Hampshire [Mrs. Shaheen] proposes an 
     amendment numbered 3345 to amendment No. 3378.

  Mrs. SHAHEEN. I ask unanimous consent that the reading of the 
amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

(Purpose: To make appropriations to address the heroin and opioid drug 
     abuse epidemic for the fiscal year ending September 30, 2016)

       At the end, add the following:

[[Page S1182]]

  


       TITLE VIII--ADDITIONAL APPROPRIATIONS FOR FISCAL YEAR 2016

     SEC. 801. DEPARTMENT OF JUSTICE.

       (a) State and Local Law Enforcement Assistance.--
       (1) In general.--In addition to any amounts otherwise made 
     available, there is appropriated, out of any money in the 
     Treasury not otherwise appropriated, for fiscal year 2016, 
     $230,000,000, to remain available until expended, to the 
     Department of Justice for State law enforcement initiatives 
     (which shall include a 30 percent pass-through to localities) 
     under the Edward Byrne Memorial Justice Assistance Grant 
     program, as authorized by subpart 1 of part E of title I of 
     the Omnibus Crime Control and Safe Streets Act of 1968 (42 
     U.S.C. 3750 et seq.) (except that section 1001(c) of such Act 
     (42 U.S.C. 3793(c)) shall not apply for purposes of this 
     Act), to be used, notwithstanding such subpart 1, for a 
     comprehensive program to combat the heroin and opioid crisis, 
     and for associated criminal justice activities, including 
     approved treatment alternatives to incarceration.
       (2) Emergency requirement.--The amount appropriated under 
     paragraph (1) shall be designated by the Congress as an 
     emergency requirement pursuant to section 251(b)(2)(A)(i) of 
     the Balanced Budget and Emergency Deficit Control Act of 1985 
     (2 U.S.C. 901(b)(2)(A)(i)).
       (b) Heroin and Methamphetamine Task Forces.--
       (1) In general.--In addition to any amounts otherwise made 
     available, there is appropriated, out of any money in the 
     Treasury not otherwise appropriated, for fiscal year 2016, 
     $10,000,000, to remain available until expended, to the 
     Department of Justice to carry out section 2999 of title I of 
     the Omnibus Crime Control and Safe Streets Act of 1968, as 
     added by section 204 of this Act, to be used to assist State 
     and local law enforcement agencies in areas with high per 
     capita levels of opioid and heroin use, targeting resources 
     to support law enforcement operations on the ground.
       (2) Emergency requirement.--The amount appropriated under 
     paragraph (1) shall be designated by the Congress as an 
     emergency requirement pursuant to section 251(b)(2)(A)(i) of 
     the Balanced Budget and Emergency Deficit Control Act of 1985 
     (2 U.S.C. 901(b)(2)(A)(i)).

     SEC. 802. DEPARTMENT OF HEALTH AND HUMAN SERVICES.

       (a) Substance Abuse and Mental Health Services 
     Administration.--
       (1) In general.--In addition to any amounts otherwise made 
     available, there is appropriated, out of any money in the 
     Treasury not otherwise appropriated, for fiscal year 2016--
       (A) $300,000,000, to remain available until expended, to 
     the Substance Abuse and Mental Health Services Administration 
     of the Department of Health and Human Services, for 
     ``Substance Abuse Treatment'', to address the heroin and 
     opioid crisis and its associated health effects, of which not 
     less than $15,000,000 shall be to improve treatment for 
     pregnant or postpartum women under the pilot program 
     authorized under section 508(r) of the Public Health Service 
     Act (42 U.S.C. 290bb-1), as amended by section 501 of this 
     Act; and
       (B) $10,000,000, to remain available until expended, to the 
     Substance Abuse and Mental Health Services Administration of 
     the Department of Health and Human Services, for grants for 
     medication assisted treatment for prescription drug and 
     opioid addiction under section 2999A of title I of the 
     Omnibus Crime Control and Safe Streets Act of 1968, as added 
     by section 301 of this Act.
       (2) Emergency requirement.--The amount appropriated under 
     paragraph (1) shall be designated by the Congress as an 
     emergency requirement pursuant to section 251(b)(2)(A)(i) of 
     the Balanced Budget and Emergency Deficit Control Act of 1985 
     (2 U.S.C. 901(b)(2)(A)(i)).
       (b) Centers for Disease Control and Prevention.--
       (1) In general.--In addition to any amounts otherwise made 
     available, there is appropriated, out of any money in the 
     Treasury not otherwise appropriated, for fiscal year 2016, 
     $50,000,000, to remain available until expended, to the 
     Centers for Disease Control and Prevention of the Department 
     of Health and Human Services, for prescription drug 
     monitoring programs, community health system interventions, 
     and rapid response projects.
       (2) Emergency requirement.--The amount appropriated under 
     paragraph (1) shall be designated by the Congress as an 
     emergency requirement pursuant to section 251(b)(2)(A)(i) of 
     the Balanced Budget and Emergency Deficit Control Act of 1985 
     (2 U.S.C. 901(b)(2)(A)(i)).

  Mrs. SHAHEEN. Mr. President, I am not going to speak to this 
amendment right now because I hope to do it later. I spent a fair 
amount of time yesterday talking about the need to provide the 
resources to address the heroin and opioid epidemic, but I am very 
pleased to see my colleague from Maine on the floor to speak to it. He 
has been a cosponsor of the legislation and a huge advocate for 
addressing the challenge that Maine--like New Hampshire and so many 
other States--is facing from the heroin and opioid epidemic. I look 
forward to his remarks and to the opportunity for us to vote on this 
amendment later today.
  The PRESIDING OFFICER. The Senator from Maine.
  Mr. KING. Mr. President, this week, this body is talking about one of 
the most serious problems facing our country. The word ``epidemic'' 
really isn't strong enough to represent what we are seeing in terms of 
drug addiction--opioids and heroin, in particular. The bipartisan 
support for the bill that is on the floor this week is an indication of 
the belief of Members of both parties, of all parties of all parts of 
the country, that this is a critically important question.
  We have heard the appalling figures in committees and caucuses and on 
the floor. In the State of Maine, there are 200 deaths a year from 
overdoses. This is an eightfold increase in the last 3 years. The 
figure that got my attention most dramatically was that a year ago in 
Maine, we had 12,000 babies born, and of that number over 950 were 
addicted to a substance. That is almost 1 in 12 babies born in my 
State.
  Nationally, the figures are just as shocking and as bad. In my 
neighboring State of New Hampshire, the number of overdose deaths is 
now over 380 a year. It is more than one a day. Nationally, there are 
47,000 overdose deaths--more deaths than are caused by automobiles.
  If this were Ebola or ISIS or any other kind of national crisis, we 
would be in 24-hour session to find a solution. We would be doing 
everything the equivalent of the Manhattan Project to deal with 
something that is killing so many of our citizens, particularly our 
young people.
  Like any other problem that gets to this body, this is complicated. 
There isn't any single solution. It involves law enforcement. It 
involves national security--stopping drugs at the border. It involves 
treatment of mental illness. It involves treatment of drug addiction 
and figuring out what works. It involves figuring out prevention. It 
involves dealing with the overwhelming number of opioid prescription 
drugs that we now know lead to heroin and other addictions.
  It is a very complex problem. There is no single answer, but there 
are some things we do know about this problem:
  The first thing we know is that law enforcement alone isn't enough. 
Essentially, we have tried that for 25 years. Law enforcement alone 
isn't enough. It is important. It is a critical part of our defense 
against the scourge, but it is not the entire answer.
  The second thing we know is that this epidemic is directly related to 
the dramatic rise of prescription painkillers based upon opioids. The 
data is that four out of five new heroin users started with 
prescription drugs. This is something we need to discuss. We need to 
discuss it with the medical community. We need to discuss it with the 
educational community, and we need to understand that when these drugs 
are prescribed, there are risks--serious, undeniable, dangerous risks 
that are taking an enormous toll on our society.
  Four out of five new heroin users started with prescription drugs. I 
met a young man in Maine who was in treatment, who was trying to 
recover, who had become an addict. He got there starting with a high 
school sports injury, and he was prescribed opioid treatment--opioid 
pills--and he ended up in the drug culture that was destroying his 
life.
  That is the second thing we know. We know that law enforcement isn't 
enough. We know that a big part of our focus has to be on opioids and 
prescription drugs.
  The third thing we know is, there are some treatments that appear to 
work. We don't know for sure. One of the things that I think we need to 
do in this body is to provide for the research and the data sharing and 
the data collection from around the country so we can find out what 
works. It appears that medication and counseling together are something 
that works, but we need more research and more data.
  The fourth thing we know is that treatment resources are grossly 
inadequate. This epidemic has exploded in the last few years, but the 
resources in terms of treatment have, in some cases, actually 
diminished. There are fewer beds today than there were 3 years ago 
because of budget cuts, because of policy changes, and we end up

[[Page S1183]]

with young people and people generally that have this terrible problem 
eating up their lives with no place to go.
  The greatest tragedy is when we have someone who is suffering from 
addiction and wants treatment and is ready to take the step and say ``I 
need it,'' and there is no place to go. The estimates are that among 
teenagers who are caught in this trap, only 20 percent have treatment 
available to them.
  All these numbers and statistics and policy prescriptions aren't 
really my subject today. I don't want to talk about politics or even 
policy. I want to talk about people. In particular, I want to talk 
about this little boy. This picture is of a young man from Maine named 
Garrett Brown. There was an extraordinary story about Garrett in the 
Bangor Daily News late last week. A reporter, Erin Rhoda, an editor at 
the Bangor Daily News--one of our great newspapers--got to know this 
young man named Garrett Brown and spent a lot of time interacting with 
him over the last 3 years and recounted it in this extraordinary piece 
of journalism. It is the story of this young man's attempts to survive 
and what happened in his life.
  This isn't politics. It isn't policy. It is people. In reading this 
story as I sat in my darkened office late last week--as my staff went 
home, they thought there was something wrong with me. The lights were 
dimmed, the sun was setting, and I read this story. It was like reading 
the story of the Titanic or of the Lincoln assassination. You knew how 
it was going to come out, but you hoped it wouldn't happen. You kept 
seeing moments when it could have been avoided; the tragic end could 
have been avoided, but it didn't happen. That was what was so gripping 
to me about this story. It was so real, and it was so close to home.
  I have four boys of my own. I venture to say that every family in 
America that has a son has a picture like it or just like it somewhere 
in their family scrapbooks or stored on their telephone or in their 
computer. This is a wonderful Maine kid--a smiling 8-year-old, happy, 
and ready to go to school with his backpack. Then, about 15 years 
later, he is with his mom, and he is on his way out. He had a mom who 
loved him, but he had a system that failed him.
  He took responsibility, by the way. He said: It's not that my mom or 
my stepdad didn't care. They tried. My grandparents tried everything 
they could. They were devout Christians. There was nothing they would 
have done to change it.
  He took responsibility. But when he took responsibility, we didn't 
provide the means for him to effectuate that and save his own life. He 
had to want to beat it, but he also had to have the means, the 
resources to take that step.
  The Bangor Daily News quite accurately laid out the issue: ``Opioid 
addiction like Garrett's requires treatment.'' We have this idea in our 
society that it is just a choice. You make the choice; you don't have 
to take that pill. Well, the way these drugs work on your brain, they 
hijack the very parts of your brain that enable you to make that 
decision. They actually go to the parts of the brain that deal with 
executive function, decisionmaking, and fear, and derail those parts of 
the brain. It requires treatment. I am sure that occasionally there are 
people who can do this by themselves, but that is very rare. Most 
people require treatment, and odds are that those with an addiction to 
drugs or alcohol won't get any treatment at all. As I mentioned, only 
one out of five teenagers who needs treatment has it available to them. 
If they do go through treatment, they are likely to get the wrong 
treatment. There is a world of different theories on treatments 
options, and that is why I say we need to have the research so we can 
understand what works and put our resources into the things that will 
actually bring results. Often it means they die, and that is what 
happened to young Garrett.

  Between 2010 and 2014, the number of overdose deaths in Maine 
involving heroin overdose increased eightfold. This is Maine. This 
could have been any State in the country. It seems to be striking rural 
States now as strongly or even worse than urban areas of the country.
  I didn't know Garrett Brown, but he was a brave kid. I could tell by 
his conversations with Erin Rhoda and by his conversations with us. He 
knew he was talking to us. He knew this was going to be public. He knew 
he was communicating with us, and here is what he said:

       If this changes one kid's life, saves one kid from being in 
     jail, saves his family the pain of seeing him go through it--

  This is a guy with an addiction saying this. It is extraordinary.
  He continued:

       If this . . . saves one kid from overdosing and dying, then 
     all that I've done hasn't been in vain. I guess that's why I 
     keep doing this with you?

  This is a tragedy. It is not a tragedy of numbers. It is a tragedy of 
real people. It is a tragedy of young lives lost, of treasures 
squandered, and of hearts broken. I have never in my adult life seen a 
problem like this that is facing my State and every State in this 
country. We can't solve it all at once. There is no magic wand. But if 
we find young people like Garrett who are ready to take a step toward a 
cure--if not a cure, at least have an ongoing recovery--we need to meet 
them halfway. We need to meet them halfway through the support of 
treatment, the support of creating options that are available, by 
understanding the relationship between addiction and the criminal 
justice system, and ultimately by loving our neighbors as ourselves.
  People sometimes ask me: What is so special about Maine? I tell them 
Maine is a small town with very long streets. We know each other, care 
about each other, think about each other, and we try to help each 
other. I think this country can also be a community--should be a 
community where we think about and care about each other.
  Young lives lost, treasures squandered, and hearts broken. I hope we 
can start to change that tragic trajectory that is breaking so many 
hearts in this country this week so we can make a difference, not for 
Garrett but for the young people to whom he was desperately sending 
this message. We can, we should, and we shall.
  I thank the Presiding Officer and yield the floor.
  Mr. GRASSLEY. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                   Commemorating Texas Independence Day

  Mr. CORNYN. Mr. President, I rise to speak about a very important day 
in the history of my State of Texas, a day that inspires pride and 
gratitude in the hearts of all Texans. I rise to commemorate Texas 
Independence Day.
  In a moment, I wish to read a letter that was written 180 years ago 
from behind the walls of an old Spanish mission called the Alamo--a 
letter written by a 26-year-old lieutenant colonel in the Texas Army, 
William Barret Travis--and in doing so, I carry on a tradition that was 
started by the late Senator John Tower, who represented Texas and this 
body for more than two decades. This tradition was upheld by his 
successor, Senator Phil Gramm, and then by Senator Kay Bailey Hutchison 
after him. So it is an honor today to carry on this great tradition.
  On February 24, 1836, with his position under siege and outnumbered 
nearly 10-to-1 by the forces of the Mexican dictator Antonio Lopez de 
Santa Ana, Travis penned the following letter:

       To the people of Texas and all Americans in the world:
       Fellow citizens and compatriots, I am besieged by a 
     thousand or more of the Mexicans under Santa Ana. I have 
     sustained a continual bombardment and cannonade for 24 hours 
     and have not lost a man.
       The enemy has demanded a surrender at discretion. 
     Otherwise, the garrison are to be put to the sword if the 
     fort is taken.
       I have answered the demand with a cannon shot, and our flag 
     still waves proudly from the walls. I shall never surrender 
     or retreat. Then, I call on you in the name of Liberty, of 
     patriotism and everything dear to the American character, to 
     come to our aid, with all dispatch.
       The enemy is receiving reinforcements daily and will no 
     doubt increase to 3,000 or 4,000 in 4 or 5 days. If this call 
     is neglected, I am determined to sustain myself as long as 
     possible and die like a soldier who never forgets what is due 
     to his own honor and that of his country. Victory or death.


[[Page S1184]]


  Signed:

       William Barret Travis.

  Of course, we know in the battle that ensued, all 189 defenders of 
the Alamo lost their lives, but they did not die in vain. The Battle of 
the Alamo bought precious time for the Texas revolutionaries allowing 
General Sam Houston to maneuver his army into position for a decisive 
victory at the Battle of San Jacinto.
  With this victory, Texas became a sovereign nation, and so today we 
celebrate the adoption of the Texas Declaration of Independence on 
March 2, 1836. For 9 years, the Republic of Texas thrived as a separate 
nation. In 1845, it was annexed to the United States as the 28th State. 
Many Texan patriots who fought in the revolution went on to serve in 
the U.S. Congress, and I am honored to hold the seat of one of them, 
Sam Houston. More broadly, I am honored to have the opportunity to 
serve 27 million Texans, thanks to the sacrifices made by these brave 
men 180 years ago.


Return from Space of Commander Scott Kelly and Manifest For Human Space 
                               Flight Act

  Mr. President, on a separate matter, one thing William Barret Travis 
and the other early settlers of Texas had in common was a thirst for 
adventure and a hunger for the great next frontier. It is an attitude 
of optimistic perseverance that has become a trademark of Texans for 
generations. So I think it is fitting today that we also celebrate a 
man who has devoted his life to expanding our footprint in space.
  Last night Scott Kelly returned to Earth after almost a year in 
space--one of the longest lasting space flights of all time. By 
tomorrow Scott should be back in Houston, home to the Johnson Space 
Center.
  In June I was able to tour the Johnson Space Center and meet some of 
the men and women who made Scott Kelly's mission possible. They make 
their work look easy. They literally have a hand in sending someone to 
space, ensuring their safety, and executing multiple projects all at 
the same time. Yet for them it is all in a day's work. They are doing 
an outstanding job, not only for Houston but for Texas and the United 
States. As you might expect, Texans view the space center with a 
particular pride. The world has turned to it as a leader in space 
exploration and research for more than 50 years. As one of NASA's 
largest research centers, it continues to keep the United States in the 
forefront of innovation and research related to science, technology, 
engineering, and medicine as well.
  Importantly, the Johnson Space Center also leads our commercial space 
partnerships--a growing sector in my State--and helps design and test 
the next generation of exploration capabilities and systems. The space 
center also trains members of our brave astronaut corps, people such as 
Scott Kelly, to ensure they are prepared for the incredible challenge 
they face.
  A real highlight of my most recent visit to the Johnson Space Center 
was my ability to actually speak to Scott Kelly while he was in space 
in the International Space Station. As you can tell from his social 
media presence--and I follow him on Twitter; he publishes pictures of 
his incredible view from space on his Twitter feed--he is an optimistic 
guy, and it is easy to see that he loves his job, but I am sure he is 
looking forward to being back home.
  Scott's mission aboard the International Space Station was about 
something much bigger than just he, which I am sure he would say if he 
were here. It was about an investment in the next generation and a 
commitment to new discoveries and exploring new frontiers. The research 
he was a part of, included studies to evaluate the effects of living in 
space on the human body. Scott is actually a twin. His twin brother was 
here on Earth while he was in space for a year, and I am sure there 
will be a lot of extensive studies, given the fact that they are twins, 
on what changes Scott experienced in his own metabolism, body, and the 
like. They also grew plants in zero gravity in space and much more, 
which will lay the groundwork for preparing future Americans to go 
farther, explore more places, and push the outer limits of human space 
exploration safely without endangering their health and well-being.
  The work Scott Kelly accomplished, along with all of the men and 
women at the Johnson Space Center and with NASA, is so important 
because it secures America's position as the global leader in space 
exploration. As important, this research and development impacts more 
than our space program. It helps applications in the medical field, for 
our military, and other scientific endeavors. I remember growing up, 
when we landed the first astronaut on the Moon and what an inspiration 
it was to me as a young person. I think space exploration has a way of 
opening the eyes and the imaginations of young people even today about 
the future--a future perhaps in space exploration or other fields of 
science, lured as they are to work in the forefront of discovery or 
help engineer the next great innovation.
  Developments like this don't occur automatically and they don't occur 
overnight. We have to task our space program with taking on new 
challenges to reap the full benefits, technological breakthroughs, and 
scientific advancements, and that is why we needed a long-term strategy 
for the U.S.-manned space mission.
  Today I am introducing legislation called the Manifest for Human 
Space Flight Act that would require NASA to provide Congress with a 
clear goal and thoughtful strategy. This would include outlining our 
exploration goals and selecting destinations for future manned space 
missions that fully utilize our existing assets, provide opportunities 
to work with commercial and international partners, and position our 
overall space program on a more focused and stable trajectory. This 
legislation would also, for the first time, designate a human presence 
on Mars as a long-term goal of NASA.
  Lieutenant Watley was perhaps an American on Mars in a great movie 
``The Martian,'' but I believe actually establishing a human presence 
on Mars would be a worthy goal that would then necessitate the strategy 
to accomplish that goal. With this bill, I hope we can rightly 
prioritize space exploration and confirm our commitment to discovering 
the next great frontier.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. LEAHY. Mr. President, while the distinguished senior Senator from 
Texas is still on the floor, he mentioned the astronaut and his year in 
space. As one who has a hobby of photography, I was envious as I looked 
at all those. I am sure the distinguished Senator from Texas has the 
same feeling I had seeing these photographs and seeing what an amazing 
country we are in all times of days and nights and seasons. So I thank 
him for raising that issue.
  Mr. President, this week we are considering the Comprehensive 
Addiction Recovery Act or as they call it CARA. There are few problems 
in this country that have had more of a devastating impact on American 
families than opioid abuse. Communities across the country are 
struggling and they are seeking help. Vermont is no exception, and I 
found this as I held hearings around the State.
  Finally, after years of a misguided approach, Congress now sees 
addiction for what it is, a public health crisis. We have before us a 
bipartisan bill we are considering that demonstrates strong bipartisan 
support by Senators for addressing addiction.
  CARA authorizes a critical public health program that I helped create 
to expand access to medication-assisted treatment programs. Some 
Vermonters who have been struggling with addiction have had to wait 
nearly a year to receive treatment. In fact, several died waiting. 
Unfortunately, the story is not unique.
  The bill also includes my provision to support rural communities with 
the overdose reversal drug naloxone. Rural locations have the highest 
death rates in the country from opioid poisoning, talking about my 
small State of Vermont, but every State, no matter how large or how 
small, has rural areas. I want people to know that rural locations have 
the highest death rate. Now, if we can get naloxone into more hands, we 
can save lives.

  Last week, the police in Burlington, VT, were equipped with naloxone, 
and they were able to save a man's life with this impactful treatment. 
In fact, the man was unconscious. They saved his life, and Police Chief 
Brandon del Pozo

[[Page S1185]]

called it ``a textbook case of how police save lives using naloxone.''
  Now, CARA recognizes that law enforcement will always play a vital 
role. That is why I worked to include an authorization for funding to 
expand State-led anti-heroin task forces.
  These are important efforts, but I can't emphasize enough that one 
authorization bill alone is not going to pull our communities out of 
addiction--not the communities in my State, in the distinguished 
Presiding Officer's State or in anybody else's State. We can't pretend 
that solving a problem as large as opioid addiction does not require 
more resources.
  That is why the amendment proposed by Senator Shaheen is so 
essential. It puts real dollars behind the rhetoric. It is going to 
ensure that the important programs authorized in CARA can actually 
succeed.
  We can all feel good about going on record saying we are against the 
problem and that we want to solve the problem of opioid addiction. But 
if we say we are not going to give you any money to do it, it sounds 
more like empty rhetoric.
  In fact, Congress has approved much larger emergency supplemental 
bills addressing Ebola and swine flu. Even though we didn't have a 
single Ebola case in this country, we had supplemental funds addressing 
it, while we have thousands of opioid addiction cases across the 
country. These efforts were appropriate--but for Ebola and swine flu. 
Now we have a public health crisis that is here in our own country, and 
we must respond. Of course, we have responded to epidemics in other 
countries, but this is an epidemic here at home.
  I think everybody agrees that opioid addiction is an epidemic. We 
should start treating it like one. The Shaheen amendment provides that 
commitment. I urge every Member who supports CARA--and that is a strong 
bipartisan group in this body--every Member who is concerned about 
addiction in their community--and I have to assume that includes every 
Senator--to put real resources behind CARA.
  I think of the different hearings I have held around our State. In 
one city, where some had suggested maybe we shouldn't have a hearing 
yet because we shouldn't talk about what is going on, the mayor of that 
city took just the opposite view. He said: We have a problem; so we 
should talk about it to see what we can do about it. He was happy I 
came there. Although he is a Republican and I am a Democrat, we both 
said there is no politics and partisanship in this and we ought to face 
it.
  But here is what happened. We scheduled that hearing, and we thought 
we could use a hall of such-and-such a size. As the days toward the 
hearing kept coming, we found we needed a bigger and bigger hall 
because more and more people wanted to come there. We found we had the 
faith community, law enforcement, the medical profession, mothers and 
fathers, addicts, and educators. All of these people came together and 
said: We have a problem, and we need the resources to work together. 
Law enforcement can't do it alone. The medical profession can't do it 
alone. The faith community can't do it alone. Educators can't do it 
alone. But together, with the resources, we might be able to do 
something.
  For another hearing I held--again, the very same thing in a small 
town--we had to keep enlarging the place where we were going to meet. I 
recall several people testifying, but one was a now-retired but highly 
respected, decorated pediatrician. He told us about talking to a 
couple. He didn't identify them for obvious reasons. But he said: You 
know, we have this opioid problem here in our city. We have young 
teenagers who come from very good families--families that are well 
educated, prosperous, have good income, nice homes. But these teenagers 
are addicts, and they are getting some of this right from their home 
medicine cabinet. In this hall with hundreds of people, you could hear 
a pin drop. He stopped and paused for a moment, and he said: The 
parents thanked me and said: This is something we should watch out for. 
He said: No, I am talking about your daughter. Your 14-year-old 
daughter is an addict. I am talking about her. There are a lot of 
others in this community, but I am talking about her. I am talking 
about her.
  To this day, I can hear the collective gasp in that room.
  I later had the opportunity to meet the parents and the doctor and 
see the things they were doing. They had the ability, and to the extent 
that there were things available, they could pay for them, but most 
people couldn't.
  Yes, we should pass CARA, but we should also acknowledge that we have 
this problem in every single State in the Union, across every 
demographic, every income level, every area of education. Let's pass 
some appropriations so that we are not just giving empty words and we 
are not addressing a terrible problem with just empty words. But the 
Senate is saying: We will stand up for a problem in our own country, as 
we have in other countries when we have helped other countries, and we 
will stand up for a serious problem right here at home, and we have the 
courage to spend the money to do it.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Sasse). The Senator from New Jersey.


                   Filling the Supreme Court Vacancy

  Mr. MENENDEZ. Mr. President, I appreciate the distinguished ranking 
member of the Judiciary Committee for yielding at this time. I agree 
with him on the issue of the legislation before us, but I felt 
compelled to come to the floor to speak about the vacancy in the U.S. 
Supreme Court.
  I rise to support this President's obligation--any 
President's obligation--to name a Supreme Court nominee to fill a 
vacancy, no matter when that vacancy occurs--election year or not. We 
should rightfully expect any President to fulfill his or her 
constitutional duty and send an eminently qualified nominee to the 
Senate. All logic, all reason, and the Constitution itself dictates 
that every President has the duty to do so, under any interpretation of 
constitutional law. Likewise, we should rightfully expect the Senate to 
do its job and send that name to the Judiciary Committee, hold a 
hearing, debate the nomination on the floor, and take a vote.

  We are not talking about a vague clause that invites interpretation. 
We are talking about a very clear and concise clause--article II, 
section 2, clause 2--that states: ``The President. . . . shall 
nominate, and by and with the Advice and Consent of the Senate, shall 
appoint . . . Judges of the Supreme Court. . . . ''
  It does not say: except in an election year. It does not say: except 
when it does not suit the political agenda of the majority party in the 
Senate. It does not say: No appointments can be made in the final year 
of a President's term. And it does not say: The Senate can arbitrarily 
and preemptively choose to obstruct the President's responsibility to 
make appointments.
  The point is, the Constitution is clear. In fact, in the last 100 
years, the Senate has taken action on every Supreme Court nominee, 
regardless of whether the nomination was made in a Presidential 
election year.
  But this goes far beyond the filling of a Supreme Court vacancy. This 
goes to the very heart of the constant and continuous attacks this 
President has had to endure. For more than 7 years, some Republicans 
have, time and again, questioned the legitimacy of this President. From 
his election, beginning with the legitimacy of his birth certificate to 
accusing the President of lawlessness, having a Republican Member of 
Congress shout ``liar'' during the State of the Union to questioning 
his legitimate authority in his final year in office to fill the 
vacancy left by the death of Justice Scalia. It begs the question of 
why this President is being denied the opportunity to fulfill his 
constitutional obligation.
  Why are constitutional standards, backed by history and precedent, 
being questioned for this President's Supreme Court nominee? If we were 
to rely on pure logic and simple consistency, the question to ask is, 
Would our friends on the other side deny a President of their own party 
the right to make that appointment? I think not.
  The only conclusion we can draw is that this is yet another 
validation of their strategic decision 7 years ago at a Republican 
retreat to make Barack Obama a one-term President and obstruct this 
President at every turn, and then claim political victory for their own 
misguided inaction and refusal to govern.
  What is most astonishing is that they claim, like Justice Scalia, 
that the

[[Page S1186]]

Constitution is carved in stone, that it is undeniable and impervious 
to interpretation. Yet, somehow, they can completely ignore what it 
clearly states in yet another effort to obstruct this President's 
ability to govern.
  So I say to my friends on the other side: This President was elected 
twice to serve two full terms. It has only been 7 years. It is time to 
accept it and move away from obstructionism and on to governing.
  The President and I may have differences on certain policies, but we 
are in complete agreement that he should not be denied the ability to 
fill this vacancy on the Court. Democrats did not deny President Reagan 
the ability to confirm Justice Kennedy in an election year, and the 
Republicans should not deny this President the same ability under the 
same circumstances. We should have the decency and respect for the 
Constitution to let the unambiguous wisdom of article II, section 2, 
clause 2 to determine our actions today, as we did then.
  So let's stop the political posturing. Let the President fulfill his 
constitutional responsibility and the Senate fulfill its advice and 
consent role. Let's fulfill one of the most basic and solemn duties we 
have. Let's have a hearing and take a vote. The American people deserve 
a fully functioning Supreme Court.
  There is a bipartisan tradition of giving full and fair consideration 
to Supreme Court nominees. Even when a majority of the Senate Judiciary 
Committee has not supported the nominee, the committee has still sent 
the nominee to the full Senate for a floor vote. And it should be noted 
that at no time since World War II has the Court operated with fewer 
than nine Justices because of the Senate simply refusing to consider a 
nominee.
  Now, every day when I come to work, I pass the Supreme Court, and the 
words over the portal of the Supreme Court say: ``Equal Justice Under 
Law.'' Equal justice under law demands that the judicial branch be 
fully functional.
  When we have a Supreme Court deadlocked in a decision, the decision 
in the lower court stands and the highest court in the land has no 
precedential value. Let's be clear. When there is a difference between 
different Federal courts in our country in different jurisdictions, it 
is the Supreme Court that determines what is the law of the land so 
that Federal law is not different in New Jersey than it is in Texas. 
But if the Court is deadlocked in two similar cases and the decision 
reverts to the finding of the lower court, there could be differences 
in how a person in New Jersey is treated than a person is in Texas 
under the same Federal statute. It is not equal justice under the law.

  To have equal justice under the law, the Nation needs the Supreme 
Court to be fully functioning. Justice Scalia himself spoke of the 
problems with an eight-Justice Court. In 2004, in explaining why he 
would not recuse himself in a case involving former Vice President Dick 
Cheney, he said:

       With eight Justices, [it raises] the possibility that, by 
     reason of a tie vote, the Court will find itself unable to 
     resolve the significant legal issue presented by the case. 
     Even one unnecessary recusal impairs the functioning of the 
     Court.

  So I believe that in life, Justice Scalia, as a textualist, would say 
the President has an obligation to nominate a Supreme Court Justice. In 
1987, before the Democratic Senate confirmed Justice Kennedy, it was 
President Reagan who said: ``Every day that passes with the Supreme 
Court below full strength impairs the people's business in that 
crucially important body.''
  I ask my Republican colleagues: How long are you willing to impair 
the people's business? How long are you willing to stick to a strategy 
of obstructionism over good governance? How long are you willing to 
deny this President his constitutional authority and obligation to 
appoint a nominee to satisfy your political agenda? How long are you 
willing to deny equal justice under the law?
  It was John Adams who reminded us that this is ``a government of 
laws, not of men.''
  It was Justice Felix Frankfurter who said: ``If one man can be 
allowed to determine for himself what is law, every man can. That means 
first chaos then tyranny. Legal process is the essential part of the 
democratic process.''
  Let's not in this Chamber be the ``one man.'' Let's respect the 
Constitution and do our jobs. In this case, the Constitution is settled 
law. Let's not unsettle it through a misguided determination to score 
political points to undermine the legitimacy of this President.
  The American people understand that our obligation in this process is 
to advise and consent, not neglect and obstruct. The American people 
will see the harm to our country and our courts if the majority 
continues these political tactics. Let's do the right thing. Let's do 
our jobs and respect this institution and the Constitution by holding 
hearings and voting on a Supreme Court nominee.
  Let's provide for equal justice under the law.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. GRASSLEY. Mr. President, we just heard some very legitimate 
questions from the previous speaker that ought to be answered, and I am 
going to go back to the familiar to answer that--to the so-called Biden 
rules.
  By now everyone is pretty familiar with the Biden rules, so I am not 
going to take time to go over all of them again, but they boil down to 
a couple basic points.
  First, the President should exercise restraint and ``not name a 
nominee until after the November election is completed,'' or, stated 
differently, the President should let the people decide. But if the 
President chooses not to follow this model, but instead, as Chairman 
Biden said, ``goes the way of Fillmore and Johnson and presses an 
election-year nomination,'' then the Senate shouldn't consider the 
nomination and shouldn't hold hearings.
  It doesn't matter, he said, ``how good a person is nominated by the 
President.'' So the historical record is pretty clear. But we haven't 
talked as much about one of the main reasons Chairman Biden was so 
adamant that the Senate shouldn't consider a Supreme Court nominee 
during a heated Presidential election. It is because of the tremendous 
damage such a hyperpolitical environment would cause the Court, the 
nominee, and the Nation. In short, if the Senate considered a Supreme 
Court nominee during a heated Presidential election campaign, the Court 
would become even more political than it already is.
  That is a big part of what was driving Chairman Biden in 1992 when he 
spoke these strong words. Here is how Chairman Biden described the 
problem in an interview--not the speech on the floor that I have quoted 
in the past--about a week before his famous speech of 1992:

       Can you imagine dropping a nominee . . . into that fight, 
     into that cauldron in the middle of a Presidential year?

  He continued:

       I believe there would be no bounds of propriety that would 
     be honored by either side. . . . The environment within which 
     such a hearing would be held would be so supercharged and so 
     prone to be able to be distorted.

  As a result, Chairman Biden concluded:

       Whomever the nominee was, good, bad or indifferent . . . 
     would become a victim.

  My friend the Vice President--but a friend when he was in the 
Senate--then considered the tremendous damage that thrusting a Supreme 
Court nominee into a frenzied political environment would cause and 
weighed it against the potential impact of an eight-member Court for a 
short time. He concluded that the ``minor'' cost of the ``three or four 
cases'' that would be reargued were nothing compared to the damage a 
hyperpoliticized fight would have on ``the nominee, the President, the 
Senate, and the Nation, no matter how good a person is nominated by the 
President.''
  The former chairman concluded that because of how badly such a 
situation would politicize the process, and based on the historical 
record, the only reasonable and fair approach--or as he said, the 
``pragmatic'' approach--is to not consider a nominee during a 
Presidential election.
  He said.

       Once the political season is underway . . . action on a 
     Supreme Court nomination must be put off until after the 
     election campaign is over. That is what is fair to the 
     nominee and is central to the process. Otherwise, it seems to 
     me, Mr. President, we will be in deep trouble as an 
     institution.

  He concluded:


[[Page S1187]]


  

       Senate consideration of a nominee under these circumstances 
     is not fair to the President, to the nominee, or to the 
     Senate itself.

  This, in part, is why Chairman Biden went to such lengths to explain 
the history of the bitter fights that occurred in Presidential years. 
He said: ``Some of our Nation's most bitter and heated confirmation 
fights have come in Presidential election years.''
  I will state this about the discussion we are having today and will 
probably have every day for the next several months: Everyone knows 
that this nominee isn't going to get confirmed. Republicans know it, 
Democrats know it, the President knows it, and, can you believe it, 
even the press knows it. That is why the Washington Post called the 
President's future nominee a ``judicial kamikaze pilot,'' and the New 
York Times noted that the nominee would need an ``almost suicidal 
willingness to become the central player in a political fight that 
seems likely to end in failure.''
  So the only question is, Why would the other side come to the floor 
to express outrage about not having a hearing? It is because they want 
to make this as political as possible.
  The press has already picked up on it. For instance, CNN reported 
that the other side hopes to use the fight over a Supreme Court nominee 
to ``energize the Democratic base.'' They are already using the Supreme 
Court and the eventual nominee as a political weapon. They want nothing 
more than to make the process as political as possible. That is why the 
President wants to push forward with a nominee who won't get confirmed. 
That is why the other side is clamoring for a hearing on a nominee 
everyone knows won't get confirmed. Making the Court even more 
political is absolutely the last thing the Supreme Court needs.
  The Court has been politicized enough already. A recent Gallup poll 
documents the frustration I hear expressed even at the grassroots of my 
State of Iowa. In the 6 years since President Obama has appointed two 
Justices, the American people's disapproval of the Supreme Court jumped 
from 28 percent disapproval in 2009 to 50 percent disapproval in 2015. 
That is what happens when Justices legislate from the bench. This 
Senator might say there is even a Republican nominee sitting on that 
bench that has legislated from the bench as well.
  That is what happens when Justices make decisions based on their 
personal political preferences or what is in their heart rather than 
what is in the Constitution and the law. The last thing we need is to 
further politicize that process and the Court.
  I just want to make sure that everyone understands what all of this 
outrage is really about. It is about making this process as political 
as possible.
  We aren't going to let that happen to the Court, the nominee or the 
Nation, to follow the suggestion of then-Senator Biden. We are going to 
have a debate--a national debate--between the Democratic nominee and 
the Republican nominee about what kind of Justice the American people 
want on the Supreme Court. That is what the American people deserve, 
and that is why we are going to let the people decide.
  But beyond one Justice, there is an even more basic debate occurring. 
At my town meetings, often somebody will come in very outraged about 
why I won't impeach Supreme Court justices. They say: ``They're making 
law, instead of interpreting law. How come you put up with that?''
  So we can have a debate between the Republican nominee and the 
Democrat nominee on what the constitutional role of the Court is. And 
we can have a debate about whether we want a Justice who expresses 
empathy and understanding of people's problems--the President's 
standard. As we all know, that is not the purpose of the judicial 
branch of government. That branch of government isn't supposed to let 
their personal feelings be involved whatsoever. And the President 
should not encourage the Justices he appoints to let their feelings 
decide cases. Their job is to look at what the law says, what the 
Constitution says, what the facts of the case are, and to make an 
impartial judgment.
  Consider a Justice appointed to the Supreme Court by a Republican 
president, who wrote that the Affordable Care Act didn't fit into what 
Congress could do in regards to regulating interstate commerce--because 
that reasoning could not be upheld under the Constitution. Instead, 
that Justice decided the Court could uphold the Act under the 
Congressional taxing power and found a way to sustain this President's 
legacy. It was also a Republican Justice who said: Find all kinds of 
ways to do what you want to do as opposed to what the Constitution 
requires or what Congress intends in legislation.

  It would be nice to have a debate between a Democratic nominee and a 
Republican nominee, whether we have two, three, or four national 
debates or whether they have hundreds of appearances around the 
country, to have these basic constitutional issues discussed. And then 
we should let the people decide not only who appoints the next Justice 
but who will decide the direction of the Supreme Court for generations 
to come.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. LEAHY. Mr. President, I found this interesting. When my children 
were little, I would read fairy tales to them, and they especially 
loved ``Through the Looking-Glass'' and ``Alice in Wonderland.'' And 
listening to this speech, I thought of ``Through the Looking-Glass'' 
and ``Alice in Wonderland.''
  It is interesting how President Obama gets blamed for everything. 
``Oh, the approval rating of the Supreme Court has gone down.'' The 
majority of the Supreme Court Justices have been appointed or nominated 
by Republican Presidents. And we are going to blame President Obama 
because the Republican Justices, nominated by Republican Presidents, 
are bringing down the approval rating of the U.S. Supreme Court? 
According to my dear friend from Iowa--he is saying President Obama 
should be blamed for what those Republican Justices on the Supreme 
Court did. This is ``Alice in Wonderland.''
  I don't care what happens; President Obama has to get blamed for it. 
Even if we have a hurricane or something, it must be President Obama's 
fault. But this is about as far a stretch as I've ever heard. If the 
approval rating of the court goes down because of the five Republicans 
who constitute the majority of it, it is about as farfetched as ``Alice 
in Wonderland'' to blame President Obama for it.
  Let's talk about facts. I like to talk about facts. It's the way 
Democrats have handled Republicans' nominees. What my distinguished 
friend doesn't point out, even though it has been pointed out to him by 
the Vice President and by the President personally, certainly in my 
presence, Vice President Biden's speech--you should read the whole 
speech--he is talking about what happens after the election. Vice 
President Biden as Chairman Biden put through, in an election year, a 
Republican nominee to the Supreme Court and got a unanimous vote of 
Democrats and Republicans in this body. Those are the facts. The fact 
is that we now use a different standard, it appears. In President 
Bush's final 2 years, Democrats controlled the Senate. I was chairman. 
We confirmed 68 of his nominees. In President Obama's final years in 
office, Republicans have allowed only 16. These are facts. This isn't 
rhetoric, these are facts. We allowed 68 for a Republican President and 
Republicans allowed only 16 for a Democratic President, and then they 
are going to blame the state of the judiciary on President Obama?
  Then he talked about Vice President Biden when he was chairman and 
what he might have said during President H.W. Bush's last year in 
office. Do you know what Vice President Biden did? They tried to imply 
that he blocked judges. He put through 11 Republican nominees for the 
circuit court and 53 Republican nominees for the district court--11 for 
the circuit court, 53 for the district court. Do you know what 
Republicans have allowed? Five lower court nominees this year. So if 
you say we want to follow the Biden rule, I wish we would. We put 
through 53 district court nominees and 11 circuit court nominees, and 
during a Democrat President's last year in office the Republican-
controlled Senate has allowed only five. Come on, let's be fair.
  The fact is, in a Presidential election year, we have never blocked a 
Supreme

[[Page S1188]]

Court nominee because it was a Presidential election year. In fact, 
since the Judiciary Committee began holding confirmation hearings for 
Supreme Court nominees in 1916, it has never denied a nominee a 
hearing.
  I tell you this because the Constitution requires the President to 
make a nomination--it is very clear--and then it says that we shall 
advise and consent. Well, they are saying: ``No, we won't advise; we 
won't consent; we won't even have a hearing.''
  Mr. President, I have taken the oath of office here seven times. It 
is a moving, thrilling moment. I am sure the distinguished Presiding 
Officer, when he was sworn in, knew it was a solemn moment. You promise 
to uphold the Constitution, so help me God. The Constitution says the 
President shall nominate. It says we shall advise and consent.
  I took my oath very, very seriously. That is why--just as Vice 
President Biden did when he was chairman--I moved a significant number 
of Republican judges through, even in the last year that President Bush 
was in office. And that is so different from what we see now.
  Just think about it. They criticize Vice President Biden. The last 
year President George H.W. Bush was in office, Vice President Biden was 
chairman of the Judiciary Committee. He put through 11 circuit court 
judges and 53 district court judges. If you want to talk about the 
Biden rule, the Republicans have allowed only five lower court judges. 
Come on, let's get this out of partisanship. By any standard 
whatsoever, when there has been a Republican President and a 
Democratically-controlled Senate, we have treated that Republican 
President far better than they have treated Democratic Presidents.
  But then to hear that because the five Republican-appointed majority 
members of the Supreme Court are bringing down the approval rating of 
the Supreme Court for the American people, telling the American people 
it must be President Obama's fault--even if those five members were 
nominated and approved before President Obama's Presidency--that goes 
too far. That is ``Through the Looking-Glass.'' That is ``Alice in 
Wonderland.''
  I see the distinguished senior Senator from Rhode Island on the 
floor.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. WHITEHOUSE. I thank the distinguished ranking member of the 
Judiciary Committee very much. While he is on the floor, let me thank 
him for his leadership, support, and passion for the Comprehensive 
Addiction and Recovery Act, which was shepherded through the Judiciary 
Committee under his guidance and with his wise and benevolent support. 
I am very grateful.
  I am on the floor to talk about the Comprehensive Addiction and 
Recovery Act today because it has been said by several of my colleagues 
that there is funding to implement this bill and that that funding is 
already in the government's accounts, that if we pass the CARA bill, we 
will be able to fund it and put it to work right away. Let me say with 
regret that I disagree with that assertion.
  I am sorry to have a disagreement with my colleagues over this 
funding question after all the very excellent bipartisan work we have 
done to get this bill to this point. This really has been a legislative 
model. For years we worked on the statute. We had five different full-
on national seminars in Washington, bringing people in from all around 
the country to advise us on all the different aspects of the opioid 
problem. We had an advisory committee that supported us which was 
broadly represented from all the different interests that are affected 
by the opioid crisis. We came up with a bipartisan bill which came 
through committee in regular order, without objection from anyone, and 
which is now on the Senate floor awaiting passage. That is the way it 
is supposed to work. But on this question of whether it is funded, I 
must disagree, and I wish to explain why.
  For openers, let me explain that in Congress, there are committees 
that authorize funding. In the case of this bill, the relevant 
committees are the HELP Committee and the Judiciary Committee. But it 
is the Appropriations Committee that actually determines what funding 
will go into which accounts. The Appropriations Committee, in turn, is 
broken up into subcommittees, which determine the funding of different 
accounts in different areas of government. So one subcommittee has 
jurisdiction in one set of accounts and another subcommittee has the 
appropriations authority over other accounts.
  The funding my colleagues have referred to as the funding for this 
CARA bill was appropriated by what we call in the Senate the Labor-HHS 
Appropriations Subcommittee. The Labor-HHS Appropriations Subcommittee 
appropriates two accounts that generally correspond to the authorizing 
power of the HELP Committee. So there are three committees involved: 
Judiciary, HELP, and Appropriations. The subcommittee on Appropriations 
that appropriated this money generally correlates to the authorizing 
power and jurisdiction of the HELP Committee. There are other 
Appropriations subcommittees. For instance, there is one that we refer 
to as CJS. CJS appropriates to, among others, the accounts within the 
authorizing power of the Judiciary Committee. So that is the 
background.
  Now let's go through the problems. One problem with my friend's 
argument that the bill is funded is that the funding measure to which 
they refer originally passed out of its Appropriations subcommittee 
last June. We didn't even take up the CARA bill in the Judiciary 
Committee until this February. So there is a timing problem. How could 
the appropriators last June have predicted this state of affairs on the 
floor right now? The appropriators would have had to have had an 
astonishing, wizard-like ability to read the future in order to fund 
back then an unpassed bill--indeed, a bill that then didn't even have a 
committee hearing scheduled, let alone markup, passage, and the choice 
to bring it to the floor. Clearly, in June the Labor-HHS appropriators 
were funding existing programs, and when the omnibus passed in 
December, these same programs were funded at an even higher level. In 
fact, Democrats demanded they be funded at nearly the identical level 
proposed in the President's budget. The President's budget goes even 
further back in time. The President's budget certainly could not have 
foreseen CARA, the Comprehensive Addiction and Recovery Act. So there 
is a timing problem.

  Second, this CARA bill, back when these appropriations were passed in 
June, was funded through different accounts than the accounts it is 
funded through now as we see it on the floor. When the appropriations 
were passed, it was funded through accounts that would be funded by CJS 
appropriators. So there is a committee mismatch as well as a timing 
problem to any claim that these funds were intended for the CARA bill.
  The bulk of the CARA bill back then--in fact, 10 out of its 13 
programs--authorized funding through Judiciary Committee programs, 
which is why the bill was sent by the Parliamentarians here to the 
Judiciary Committee. So if back then the intention was to fund CARA, it 
would have been CJS that would have funded 10 of those 13 programs. The 
appropriators for the funds my colleagues speak of were not the CJS 
appropriators but the Labor-HHS appropriators. Again, there is a 
committee mismatch.
  Here is what happened that explains the shift. After the fiscal year 
2016 omnibus had passed, we were informed--the sponsors and authors of 
the legislation--that in order to get our bill out of the Judiciary 
Committee, the CARA bill had to be rewritten so that it operated only 
through existing Federal programs. There are Republicans, as the 
Presiding Officer well knows, who live by the principle of no new 
Federal programs, even for new crises, and we were asked in the 
Judiciary Committee to accommodate them. So we accommodated them. We 
rewrote the bill in January to accommodate those concerns.
  So this February, when CARA came before the Judiciary Committee, it 
had been revised to move the bulk of its new programs out of the 
Judiciary Committee accounts and into accounts under the jurisdiction 
of the Committee on Health, Education, Labor, and Pensions. Now, of the 
10 programs remaining in the bill, 8 are located at

[[Page S1189]]

the Department of Health and Human Services, in the jurisdiction of the 
HELP Committee. But that move was long after these appropriations were 
made. You cannot connect them.
  I should interject that this change created an intrusion by our 
Judiciary bill into the jurisdiction of the HELP Committee. All here 
today who support the CARA bill owe a great debt of gratitude and 
appreciation to Chairman Alexander and to Ranking Member Murray for 
allowing this bill to proceed, even though it now involves a 
considerable number of accounts under their committee's jurisdiction. 
They have done so very graciously, without demanding further hearings 
or otherwise asserting their HELP Committee's turf. So to both of them 
I offer, and we should all offer, our sincere and heartfelt thanks.
  It does seem a stretch to think that the appropriators in the 
Appropriations subcommittee that funds these HELP accounts could have 
foreseen last June not only that CARA would pass out of the Judiciary 
Committee in February and not only that it would come to the floor now, 
but also could have foreseen that so many of its programs would have 
been transferred from Judiciary Committee to HELP Committee accounts. 
That would have been an astonishing--indeed, truly magical--feat of 
prediction.
  The simple fact is that the Labor-HHS appropriations that my friends 
rely on as the funding for this CARA bill passed out of the relevant 
subcommittee with little or no regard for CARA.
  Mr. President, I ask unanimous consent to have printed in the Record 
a letter dated April 2, 2015, regarding this matter.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                  U.S. Senate,

                                    Washington, DC, April 2, 2015.
     Hon. Richard Shelby,
     Chairman, Subcommittee on Commerce, Justice, Science and 
         Related Agencies, Committee on Appropriations, 
         Washington, DC.
     Hon. Roy Blunt,
     Chairman, Subcommittee on Labor, Health and Human Services, 
         Education, and Related Agencies, Committee on 
         Appropriations, Washington, DC.
     Hon. Barbara Mikulski,
     Ranking Member, Subcommittee on Commerce, Justice, Science 
         and Related Agencies, Committee on Appropriations, 
         Washington, DC.
     Hon. Patty Murray,
     Ranking Member, Subcommittee on Labor, Health and Human 
         Services, Education, and Related Agencies, Committee on 
         Appropriations, Washington, DC.
       Dear Chairman Shelby, Chairman Blunt, Ranking Member 
     Mikulski, and Ranking Member Murray: As you may know, heroin 
     use and prescription opioid abuse are having devastating 
     effects on public health and safety across the United States. 
     According to the Centers for Disease Control and Prevention 
     (CDC), drug overdoses now surpass automobile accidents as the 
     leading cause of injury-related death for Americans ages 25 
     to 64. Every day, more than 120 Americans die as a result of 
     drug overdose. Over half of these drug overdoses are related 
     to prescription drugs. While addiction is a treatable 
     disease, only about ten percent of those who need treatment 
     receive it.
       We write to express our strong support for fiscal year (FY) 
     2016 funding for programs that would support the integrated 
     strategies for addressing opioid abuse included in the 
     Comprehensive Addiction and Recovery Act of 2015 (CARA, S. 
     524). This bipartisan legislation was developed over the past 
     year and a half through a cooperative process involving key 
     national stakeholders in the public health, law enforcement, 
     criminal justice, and drug policy fields, and is designed to 
     fight prescription opioid abuse and heroin use holistically--
     from expanding prevention to supporting recovery.
       Among other objectives, CARA would:
       Expand prevention and educational efforts--particularly 
     aimed at teens, parents and other caretakers, and aging 
     populations--to prevent prescription opioid abuse and the use 
     of heroin.
       Expand the availability of the overdose reversal drug 
     naloxone to law enforcement agencies and other first 
     responders.
       Expand resources to promptly identify and treat individuals 
     suffering from substance use disorders in the criminal 
     justice system.
       Expand disposal sites for unwanted prescription medications 
     to keep them out of the hands of children and adolescents.
       Launch an evidence-based prescription opioid and heroin 
     treatment and intervention program to expand best practices 
     throughout the country.
       Launch a medication-assisted treatment and intervention 
     demonstration program.
       Strengthen prescription drug monitoring programs to help 
     states monitor and track prescription drug diversion and to 
     help at-risk individuals access services.
       As you begin consideration of the FY 2016 appropriations 
     bills, we urge you to provide sufficient funding for the 
     provisions included in CARA, which would provide the 
     resources and incentives necessary for states and local 
     governments to expand treatment, prevention, and recovery 
     efforts for the millions of Americans who are affected by 
     substance use disorders. Among other things, we ask that you 
     ensure adequate funding for CDC's prescription drug 
     surveillance and monitoring activities and the Substance 
     Abuse and Mental Health Services Administration's Medication-
     Assisted Treatment for Prescription Drug and Opioid Addiction 
     program. Because we know that medication-assisted treatment 
     should be an important component in treating those suffering 
     from opioid abuse in the criminal justice system, we urge you 
     to continue your support for the Medication-Assisted 
     Treatment Pilot Program at the Bureau of Prisons.
       Only through a comprehensive approach that leverages 
     evidence-based law enforcement initiatives, treatment, and 
     support for recovery can we reverse the current skyrocketing 
     numbers of heroin and prescription opioid overdoses and 
     deaths. Thank you for your consideration.
           Sincerely,
     Kelly A. Ayotte,
     Susan Collins,
     Christopher A. Coons,
     Sheldon Whitehouse,
     Amy Klobuchar,
       United States Senators.

  Mr. WHITEHOUSE. Mr. President, the letter I have submitted was 
written to bring CARA to the attention of both the CJS and the Labor-
HHS subcommittees. But those subcommittees, when they got this letter, 
had no idea the bulk of this would move from the Judiciary Committee to 
the HELP Committee. Back then, CARA was mostly funded through another 
subcommittee--CJS. Back then, CARA had not even been scheduled for its 
hearing in Judiciary.
  So why was the funding for the opioid crisis put in and, indeed, 
increased by the appropriators of the HELP accounts? Obviously, because 
47,000 people died last year--in 2014, the last year we have on 
record--of opioid overdose deaths. This is a national crisis. They were 
paying attention to it. They were putting resources in, but not 
resources to implement the bill that we are about to vote on in the 
next few days.
  Indeed, as we speak, SAMSHA, the relevant agency, is gearing up its 
grant applications to go forward and solicit bids for all the money the 
appropriators approved and that was dialed up in the omnibus. And 
SAMSHA is proceeding under the pre-CARA laws. SAMSHA intends to spend 
every dollar of the appropriated funds, CARA or no CARA. That means if 
this CARA bill passes, every dollar that goes this year to fund a CARA 
program will take away funds from that pre-CARA grant array that SAMSHA 
is preparing right now. In that case, we will necessarily be robbing 
Peter to pay Paul. You cannot count the same funding twice, and there 
is no new money for CARA.
  One can make the argument, and, indeed, I would accept the argument 
that though we are robbing Peter to pay Paul, CARA's Paul is better 
than pre-CARA's Peter. CARA is, after all, a very good bill, but the 
funding math is still undeniable. We are, in fact, robbing pre-CARA 
Peter to pay for a new CARA-improved Paul. So one can argue that funded 
programs may improve because of CARA, at least to the extent the 
funding goes to new CARA-authorized purposes. But that is an argument 
that the same money will be better spent. It is not a fair argument 
that there is new money for CARA programs. There is no new money.
  In sum, the timing does not support the argument that there is new 
funding for CARA. That money was appropriated long ago. Indeed, this 
bill will not even be law if we get it through the Senate. There is 
still the House, the Conference, and the President. What kind of 
wizards do we think our appropriators must have been 8 months ago at 
seeing a future for this bill which we even now cannot see?
  On top of that, the jurisdictional problem between Judiciary and HELP 
shows that the HELP appropriations had to be intended back in June for 
other programs, specifically for the HELP grants now underway at 
SAMSHA, which we would be robbing to fund CARA programs.
  Unless they were time-traveling wizards, if the appropriators had 
intended to add extra money for CARA for this fiscal year, they would 
have added the money to the Judiciary accounts that were what CARA 
authorized back then

[[Page S1190]]

when it was introduced and when the appropriators passed the 
appropriations in the subcommittee.
  Finally, it is a fact that all of this appropriated money my friends 
speak of is already on its way to being spent. It will be spent even 
without CARA. It will be spent even if, for some reason, CARA fails. It 
may even be spent before CARA becomes law, and it will be spent in 
programs to support addiction recovery.
  That is the logic of my conclusion that there is no funding for CARA. 
That is the logic of my conclusion that to fund CARA without robbing 
other addiction recovery programs, we would need new funding, not just 
last year's appropriations. And that, my friends, is why Senator 
Shaheen's emergency funding bill is so important.
  With that, I see my distinguished chairman on the floor, and I yield 
the floor.
  Mr. GRASSLEY. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. MARKEY. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. MARKEY. Mr. President, I would like to start my remarks on the 
Comprehensive Addiction and Recovery Act today by complimenting all of 
the Members--Senator Whitehouse, Senator Grassley, Senator Portman, 
Senator Ayotte, Senator Shaheen, and all the Members who have been 
working so hard on this legislation to produce something which is very 
much needed by our country.
  I will start my remarks by telling a little story of a constituent 
who wants to remain anonymous. This is her story:

       On July 20, 2009, I was the passenger in a vehicle with my 
     close friend at the time behind the wheel. The light turned 
     green and as expected he hit the gas. While he was hitting 
     the gas, the oncoming car never hit their brakes to stop at 
     the red light they were approaching.
       I was painfully pinned in the passenger's seat. All I could 
     hear was my friend asking me if I was OK. Upon arriving in 
     the ER I was quickly poked, prodded, and injected with high-
     level painkillers. This is where it all began.
       Walking out of the hospital, I wasn't only walking out with 
     crutches, but a prescription that changed the next 5 years of 
     my life. I was prescribed OxyContin to help manage the pain I 
     was experiencing. With continuing follow-up appointments and 
     check-ins, also came more prescriptions for ``pain management 
     prescriptions.''
       Two months after getting into a car accident, I was a 
     heroin addict. How quickly all things I knew changed. In 
     September of 2009 I not only began shooting heroin but I also 
     began my first semester of college. I was a freshman at UMass 
     Boston, worked full time, but, secretly, I was also a heroin 
     addict. I kept my addiction a secret from everyone I knew 
     including my close friends and family.
       On August 31, 2014 I woke up and said to myself ``enough is 
     enough.'' It took three overdoses in order to open my eyes. 
     Since leaving treatment in November of 2014, my recovery has 
     not stopped; I continue to learn and to grow daily. I have 
     also learned of the medical issues and complications that my 
     heroin use has led to. I now suffer from seizures because the 
     excessive drug use over 5 years has led to minor brain 
     damage. Along with the seizures, I have tested positive for 
     Hepatitis C and HIV, which is common with injection drug 
     users.
       At the end of the day, all I want to do is to help others 
     who are struggling because I know what they are going 
     through.

  Mr. President, she is one of the fortunate ones. She found the help 
she needed and had the strength and support to get clean. But I am 
hearing enormous frustration from people who don't feel that sufficient 
resources are being brought to bear on this enormous epidemic of 
prescription drug and heroin addiction.
  All week we have heard the statistics here in this Chamber. Our 
Nation is experiencing more deaths from drug overdoses than from gun 
violence or auto accidents. Eighty percent of the people suffering from 
heroin addiction started with opioid pain medications approved by the 
FDA and prescribed by doctors, with 27,000 people dying from an opioid 
overdose in 2014 and 1,300 of those coming from the State of 
Massachusetts.
  This issue is one that doesn't just affect the Bay State. America is 
drowning in a tsunami of heroin and prescription drug addiction that we 
must stop before it drowns any more families and communities.
  Let us compare what we are did as a nation when confronted with other 
deadly epidemics. A bipartisan majority in Congress funded more than $5 
billion to respond to Ebola. We dispatched the medical community and 
public health experts. Today the Obama administration is asking 
Congress for $1.8 billion in emergency funding to fight the Zika virus.
  Imagine if we applied the same commitment, the same urgency, and the 
same level of resources to the prescription drug and heroin epidemic. 
We need an immediate and comprehensive strategy that requires 
commitment from all levels of government--State, local, and Federal. 
That means Congress must step up to respond with leadership and with 
resources. We need to stop the overprescription of opioid pain 
medication, we must prevent addiction before it takes hold, and we must 
provide the funding necessary to ensure that we stem this tide of 
deadly addiction.
  The Food and Drug Administration must change its decision not to seek 
expert advice about the risks of addiction before it approves abuse-
deterring opioids. Abuse-deterring opioids is a contradiction in terms. 
Whether an opioid is used as a deterrent or not, it has not prevented 
tens of thousands of people who have had their wisdom teeth removed or 
experienced lower back pain from getting addicted to these painkillers. 
By refusing to convene the advisory committee to inform all of its 
opioid approval decisions, the FDA continues to ignore outside experts 
who could help stem the tide of tragic deaths and overdoses plaguing 
this country.
  That is why I have filed an amendment to require the FDA to convene 
advisory committees of outside experts for all opioid approval 
decisions--period. Now is the time to implement effective and 
commonsense solutions, but we need funding to do that; funding for 
families, funding for treatment providers, funding for our sheriffs and 
firefighters who carry overdose prevention drugs that save lives. We 
need to provide the real resources necessary to address a crisis that 
is only growing in numbers and severity, and that comes in the form of 
emergency funding. We are hemorrhaging lives by the day, and 
supplemental funding is the first step needed to staunch the flow of 
suffering and death.
  Ladies and gentlemen, we are at a watershed moment in this national 
debate to address the public health crisis of addiction. So let us be 
clear. Stopping the overprescription of pain medication that is fueling 
opioid addiction and overdoses starts with the prescribers. We need to 
require anyone who prescribes opioid pain medication and other 
controlled substances to undergo mandatory training on safe prescribing 
practices and the identification of possible substance abuse disorders. 
That is why I have filed an amendment that requires prescribers to get 
the education needed to help staunch this wall of suffering and death.
  The doctors will say they don't want education to be mandated; that 
it should be voluntary. Well, the FDA has had voluntary education for 
opioid prescribers in place since 2013 and has been actively 
encouraging doctors to take these voluntary education modules, but in 
more than 2 years, less than 12 percent of prescribers have actually 
completed the FDA's voluntary education program. A survey of 1,000 
physicians nationwide found that nearly one-half of doctors erroneously 
reported that abuse-deterrent formulations were less addictive than 
their counterparts. It is unconscionable that our doctors know so 
little about these potentially deadly painkillers.
  I intend to call up amendment No. 3382 later so we can make 
consideration of the bill. The amendment would ensure that as a 
condition of receiving a license to prescribe opioids, the recipient of 
the license is educated in the best practices for using opioids and the 
connection with addiction and with diversion. I intend to call up that 
amendment later, asking for consideration.
  From my perspective, if we are going to have a real strategy, then we 
have to make sure there is a requirement that there is continuing 
education. We also need to remove the barriers to effective treatment, 
including outdated Federal restrictions on medication-assisted 
therapies like SUBOXONE.

[[Page S1191]]

  Medication-assisted therapy for opioid addition is cost-effective, it 
decreases overdose deaths, and it reduces transmission of HIV and 
hepatitis C. That is why I have filed an amendment that would lift the 
caps that are limiting the number of patients doctors can treat with 
medication-assisted therapy. If we are going to reduce the supply of 
heroin and illicit prescription drugs, we have to reduce the demand 
through effective treatment. I have been working with Senator Paul from 
Kentucky on that amendment.
  Also, fear of a lawsuit should not deter anyone from trying to save 
the life of someone suffering from an overdose. That is why I have 
filed an amendment that creates a Federal Good Samaritan provision that 
shields from civil liability family members, friends, and other 
bystanders who administer opioid prevention treatments like Narcan.
  The debate we are having on this legislation this week is just the 
beginning. We must let prescribers know that unless they get basic 
education in opioids, they will have to turn off the spigot of 
painkillers that are flooding this country and leading to deadly 
overdoses. We must let law enforcement and the judicial system know we 
cannot incarcerate our way out of this problem. We must let Big Pharma 
know we are going to work to ensure that we have a lifting of awareness 
of this issue every single day. Enough is enough in this country. 
Enough is enough. We have just seen an explosion in terms of this 
problem.
  We must now let all of those struggling with addiction know that help 
is on the way and that no matter how dark life seems right now, there 
is hope and the Sun will rise for them once again.
  I thank the Presiding Officer for giving me the opportunity to speak 
for some time, and I yield the floor.
  The PRESIDING OFFICER (Mrs. Ernst). The Senator from Oregon.
  (The remarks of Mr. Merkley pertaining to the introduction of S. 2621 
are printed in today's Record under ``Statements on Introduced Bills 
and Joint Resolutions.'')
  The PRESIDING OFFICER. The Senator from Virginia.


                   Filling the Supreme Court Vacancy

  Mr. KAINE. Madam President, I rise to offer some thoughts about the 
current discussion over a vacancy on the Supreme Court.
  I had high hopes yesterday for the meeting in the White House between 
the majority leader, the chairman of the Judiciary Committee, President 
Obama, and Vice President Biden. I had high hopes that meeting might 
lead to an opening and a willingness to entertain the important 
business of filling a vacancy on the Supreme Court, but the 
announcements made directly after that meeting suggested--a phrase we 
sometimes use back home--that the schoolhouse door is going to stay 
closed. There will not be a debate. There will not be a vote. There 
will not be a committee hearing. In fact, there was even a suggestion, 
a commitment, that the majority would refuse even to entertain courtesy 
office visits with the nominee that President Obama is expected to send 
up soon.
  I was disappointed in that, and I wanted to take the floor to offer a 
simple message. It is very important that the Senate do its 
constitutional duty and do its job with respect to the Supreme Court 
vacancy. The job is pretty plain. We have a job description, as most 
people do who have jobs. The job description is contained mostly in 
article I of the Constitution, but there are also descriptions of what 
we must do in the Senate in article II. Article II, section 2, clause 2 
of the Constitution says the President ``shall nominate, and . . . with 
the Advice and Consent of the Senate, shall appoint'' a variety of 
officials, including Supreme Court Justices.
  This is part of our job description, to entertain Presidential 
nominations for Supreme Court Justices. We volunteer for the job. We 
take an oath to do the job. We cash a paycheck written by the American 
people to pay for us to do the job. Frankly, we don't have the option 
of refusing to do the job.
  Is there anything unusual about this situation, a vacancy on the 
Supreme Court occurring during the last year of a President's term? The 
answer to that is no.
  On 17 occasions, this body has entertained and had a confirmation 
vote on a Supreme Court Justice in the final year of a President's 
term--17 times. When this happened, people thought it seemed rare, but 
when you go back and look at the historical record, it is not rare at 
all. On each of those occasions in a Presidential election year, the 
Senate has done its job under article II, section 2, clause 2, and 
entertained a nominee. There is no reason why this Senate should not do 
exactly the same thing, follow that historical precedent.
  As I have traveled around Virginia in the weeks since the vacancy 
became open, I have talked to a lot of citizens about this. Sometimes 
it is helpful for us in this body to think about the way others--
especially our citizens--look at what we are doing or not doing here. 
Citizens ask me: What possibly could be the reason why the Senate would 
not follow its clear historical precedent and do a job description that 
is contained in the Constitution and would refuse a vote, refuse 
debate, refuse committee hearings, refuse even to meet with a nominee? 
Why would Congress not do its job? Why would the Senate not do its job?
  I have been thinking about that, and I can only conceive of two 
reasons why this Senate would not do its job, and both of the reasons 
are highly illegitimate, in my opinion.
  The first reason--and this is a reason that occurs to many citizens, 
and they are very concerned about this--is that the Senate is 
announcing that it will not do its job because of the identity of this 
particular President. The Senate has been willing to do the job for 
other Presidents, but is there something about this particular 
President that is making the Senate decide to break its historical 
traditions and violate article II, section 2, clause 2, and not do the 
job?
  This question has given some added oomph because of another recent 
event. In early February, President Obama sent his budget to the 
Congress. Pursuant to the Budget Act of 1974--and this has been 
followed uniformly by the Senate and the House--when the President 
sends up a budget, the Budget Committees have a hearing about the 
President's budget--even if they do not like it, and they often don't 
like it, but that is what you do. You have a hearing about the 
President's budget. If you don't like it, you criticize the budget and 
then you write a different budget. That is what has happened for every 
President since the Budget Control Act of 1974 passed.
  In the last year of the Bush administration, when there were 
Democratic majorities in both Houses when President Bush sent up his 
budget, hearings were held on the budget. But in this instance, just 
within the last month, when the budget was sent up from President 
Obama, both committees said: For this President--breaking the statute, 
breaking all tradition--we will not even have a hearing on this 
President's budget.
  So if we are going to break a constitutional command and break a 
history in which 17 Justices have been confirmed in a Presidential 
year, and if we are going to break it for this President, and if we are 
going to break the Budget Control Act and break a uniform history since 
1974 by not according even a hearing for the budget submitted by this 
President, then a question that is being asked by the citizens of this 
country--certainly the citizens of this Commonwealth--is whether the 
actions taken here on this Supreme Court nomination to not allow a 
vote, not allow a debate, not allow a committee hearing, and not even 
allow courtesy office visits, is actually not about the Supreme Court 
at all, not even about the nominee, whosoever it shall be, but it is a 
particular mark of disrespect for this President that is unprecedented 
in the history of this body. That is an explanation which many of my 
citizens are deeply worried about and which many of my citizens are 
talking about and asking about, and frankly I don't have a good answer 
to that concern.
  There is a second reason that suggests itself to me with respect to 
breaking all of the historical precedent on this particular Supreme 
Court vacancy. It connects to another concern that I have taken to the 
floor many times to talk about as a member of the Foreign Relations and 
Armed Services Committees. There is another clause of the Constitution 
that I care deeply

[[Page S1192]]

about, and that is article 1, section 8, clause 11. We should not be at 
war without a vote of Congress.
  We are now in the 20th month of a war, and Congress hasn't even 
voted--this war against ISIL. I go to hearings all the time where 
Members of the Senate criticize the President for what he is doing or 
not doing in the war, but I see a complete unwillingness in this House 
and the House of Representatives to actually do what the Constitution 
commands and have a vote on the war.
  This circumstance reminds me of that: a clear constitutional command 
in article 2, section 2, clause 2; a clear historical precedent of the 
Senate engaging; but now, for this President, on this vacancy, a 
decision: Hold on a second. Maybe we can just avoid voting yes or no. 
If we vote yes for a nominee the President might send up, we will make 
some people mad. If we vote no on a nominee the President sends up, we 
will make some other people mad. Maybe we can just avoid the commands 
of article II, section 2, clause 2, avoid the uniform history of this 
body, and not vote at all. If we can avoid voting at all, maybe we can 
evade accountability; maybe we can evade the criticism that might come 
to us from our constituents.
  That is also highly troubling.
  I can't think of any other reasons why this body would violate the 
clear commands of article II, section 2, clause 2, and violate a 
uniform history of approving 17 Supreme Court Justices during a 
Presidential year other than, A, it is fundamentally a sign of 
disrespect for this particular President or, B, it is a desire by a 
Senate that certainly has the votes to confirm or deny, consistent with 
the constitutional provision, to avoid taking a vote and thereby think 
we can avoid the accountability to our citizens for casting a vote on 
something that might be controversial. Needless to say, both of those 
reasons are highly illegitimate and, in my view, are really beneath 
what we should be doing in this Chamber.
  The last thing I will say is this: The job description of a Senator 
is laid out in the Constitution, but there are other parts of the job 
that may not be laid out so plainly but that we all understand to be 
our job. For example, I don't think it is laid out that we should 
passionately represent our citizens and do constituent service for 
them, but we all understand that is part of the job.
  Well, another part of the job of a U.S. Senator that may not be 
spelled out as directly as the power to advise and consent on 
nominations or the power to declare war is that we are elected 
guardians of this institution, and more than just the institution of 
the Senate, we are elected to be guardians of the Democratic traditions 
that are set out in the Constitution, in this marvelous Constitution 
that establishes three branches of government that have checks and 
balances against each other.
  We should always act, regardless of our disagreements, regardless of 
our debates or arguments, and the differences of opinion are 
legitimate. We should always act to promote respect for our 
institutions, not only the institution of the Senate but the 
institution of the court system, which has a vacancy right now on the 
Supreme Court, the institution of the Presidency, toward whom we are 
sending a signal of disrespect by the actions that are being undertaken 
in this body. It is part of the job we need to do to build up the 
respect for the institutions of our government. If Senators don't 
respect the institutions of our government, why would anyone else 
respect them? If we act in a way that subverts or tears them down, why 
would we expect anyone else to respect the institution?
  I came here to this body because I do respect the institution. I 
respect its history. We are all humans; we can make mistakes. Votes 
have been cast that in the light of day you could look at and expect to 
be different. But compared to other systems in the world--and I lived 
in a country that was a military dictatorship when I was a young man, 
and I can certainly see the great blessing it is to live here in this 
country and serve here in this body. I deeply fear that the actions we 
are embarking on in connection with the Supreme Court nomination are 
expressing a profound disrespect for the article III branch, the 
courts; a profound disrespect for the article II branch of the 
Presidency; and, frankly, a profound disrespect for our own history, 
traditions, and job description in this article I branch of the 
legislature.
  It is not too late for us to turn this around. It is not too late for 
us to take a pause and, when the President sends over a nomination for 
the Supreme Court, to do what justice demands. If justice demands 
anything, it should be that we would analyze an individual on that 
person's own merits instead of just saying that the blanket rule is 
that no matter who you are, no matter what your qualifications, because 
you were sent by this President, we will create a unique rule for you 
and refuse to entertain you.
  We still have time to turn this around. I have no idea when the 
President will send a nominee over, and I have no idea who that nominee 
will be, but when that nominee is delivered and recommended to the 
Senate, it is my prayer that this body will do what article II, section 
2, clause 2, demands; that we will do what we have done in every other 
instance when a President has sent a nominee over in a Presidential 
election year; that we will not bar the schoolhouse door but we will 
open the doors to our office to accord a nominee the courtesy of a 
discussion; that we will have hearings in the Judiciary Committee; and 
that we will have a robust debate and a vote on this floor. If that 
vote is a yes, that will be great. If that vote is a no, that will 
still be fully in accord with the constitutional job description of 
this Congress. But to not entertain a nominee at all, in my view, would 
violate our oath, would violate the Constitution, and would express a 
significant disrespect for all three branches of government.
  Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.


                Amendment No. 3367 to Amendment No. 3378

       (Purpose: To establish a life-saving program to prevent 
     drug and opioid abuse in Medicare.)

  Mr. GRASSLEY. Madam President, I call up the Toomey amendment No. 
3367.
  The PRESIDING OFFICER. Without objection, the pending amendment is 
set aside.
  The clerk will report.
  The senior assistant legislative clerk read as follows:

       The Senator from Iowa [Mr. Grassley], for Mr. Toomey, 
     proposes an amendment numbered 3367 to Amendment No. 3378.

  Mr. GRASSLEY. I ask unanimous consent that the reading of the 
amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The amendment is printed in the Record of March 1, 2016, under 
``Text of Amendments.'')
  Mr. GRASSLEY. I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.


                Amendment No. 3395 to Amendment No. 3378

  Mr. WYDEN. Madam President, I call up amendment No. 3395.
  The PRESIDING OFFICER. Without objection, the pending amendment is 
set aside.
  The clerk will report.
  The senior assistant legislative clerk read as follows:

       The Senator from Oregon [Mr. Wyden] proposes an amendment 
     numbered 3395 to amendment No. 3378.

  Mr. WYDEN. Madam President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

 (Purpose: To provide for comprehensive provisions for the prevention 
   and enforcement of opioid abuse and treatment of opioid addiction)

       At the appropriate place, insert the following:

     SEC. __. INCREASED ANTI-KICKBACKS PENALTIES.

       Paragraphs (1) and (2) of section 1128B(b) of the Social 
     Security Act (42 U.S.C. 1320a-7b(b)) are each amended by 
     inserting ``(or, beginning January 1, 2017, $50,000)'' after 
     ``$25,000''.

     SEC. __. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING 
                   OF OPIOID ABUSE TREATMENT PROGRAM MODEL FOR 
                   PART D PRESCRIPTION DRUG PLAN ENROLLEES.

       Section 1115A of the Social Security Act (42 U.S.C. 1315a) 
     is amended--
       (1) in subsection (b)(2)(A), by adding at the end the 
     following new sentence: ``The models

[[Page S1193]]

     selected under this subparagraph shall include the model 
     described in subsection (h).''; and
       (2) by adding at the end the following new subsection:
       ``(h) Opioid Abuse Treatment Program Model.--
       ``(1) In general.--The Secretary shall test a model 
     requiring prescription drug plans under part D of title XVIII 
     to have in place, directly or through appropriate 
     arrangements, an opioid abuse treatment program for 
     applicable enrollees in lieu of the medication therapy 
     management program under section 1860D-4(c)(2) with respect 
     to such applicable enrollees.
       ``(2) Start date.--The model under this subsection shall 
     start in plan year 2018.
       ``(3) Selection.--The Secretary shall select a limited 
     number of Medicare part D regions in which to the model, 
     giving priority to regions based on the number of total 
     opioid prescriptions in the region.
       ``(4) Requirements for program.--Under an opioid abuse 
     treatment program, the PDP sponsor offering the plan shall--
       ``(A) establish a care team that includes at least--
       ``(i) a pharmacist;
       ``(ii) a physician; and
       ``(iii) an individual licenced in a State with expertise in 
     behavioral health (as determined by the Secretary), which may 
     be the physician described in clause (ii); and
       ``(B) develop, in consultation with the applicable enrollee 
     and with input from the prescriber to the extent necessary 
     and practicable, a care plan for the applicable enrollee that 
     is intended to treat the applicable enrollee's pain and limit 
     any unnecessary opioid prescriptions when possible.
       ``(5) Payment.--
       ``(A) In general.--Under the model under this subsection, 
     the Secretary shall make a monthly payment to the PDP sponsor 
     offering the prescription drug plan for each applicable 
     enrollee who receives services under the opioid abuse 
     treatment program.
       ``(B) Shared savings.--Under the model under this 
     subsection, the Secretary shall (using a methodology 
     determined appropriate by the Secretary) make payments (in 
     addition to the payments under subparagraph (A)) to the PDP 
     sponsor offering the prescription drug plan if the Secretary 
     determines that total spending under parts A, B, and D of 
     title XVIII (and including the payments under subparagraph 
     (A)) for applicable enrollees who receive services under the 
     opioid abuse treatment program is less than a historical 
     benchmark of total spending under such parts A, B, and D for 
     such enrollees or similar enrollees. Such benchmark shall be 
     adjusted at the Secretary's discretion for changes in law or 
     regulation, unforeseen circumstances, or advances in medical 
     practice.
       ``(6) Quality.--Under the model under this subsection, the 
     Secretary shall measure the quality of care furnished by 
     opioid abuse treatment programs, including elements related 
     to access to care, the unnecessary use of opioids, pain 
     management, and the delivery of behavioral health services.
       ``(7) Applicable enrollee.--In this subsection, the term 
     `applicable enrollee' means an individual who is, with 
     respect to a prescription drug plan--
       ``(A) enrolled with the plan; and
       ``(B) an at-risk beneficiary for prescription drug abuse 
     (as defined in section 1860D-4(c)(5)(C)).
       ``(8) Model not applicable to ma-pd plans.--The model under 
     this subsection shall not apply to MA-PD plans or enrollees 
     of such plans.
       ``(9) Clarification of application.--For purposes of the 
     preceding provisions of this section (including paragraphs 
     (3) and (4) of subsection (b) and subsections (d) and (f)), 
     the model under this subsection shall be deemed to be a model 
     under subsection (b).''.

  Mr. WYDEN. Madam President, along with my colleague Senator Schumer, 
I rise to offer what, in my view, are some needed changes to the 
amendment Senator Toomey has now offered to the opioid bill. My bottom 
line for the opioid legislation is that a real solution has to include 
three priorities: more prevention, better treatment, and tougher 
enforcement. To be successful, all three priorities must work in 
tandem.
  The Toomey amendment, which is often called the Part D lock-in, would 
allow Part D plans to identify people in Medicare who may be abusing 
opioids. These people would then be assigned to one prescriber and one 
pharmacy to get their pills. This is an enforcement policy, and it 
cracks down on those who game the system.
  What is important, what is critical for the Senate to understand is 
that the story does not stop there. If someone is addicted to opioids, 
they need a path--a real path--to treatment. Without treatment, they 
may get their pills on the street or they may turn to heroin. This 
amendment ensures those who are at risk for opioid abuse are connected 
to meaningful treatment choices so they can better manage their pain 
and limit excessive prescriptions. Those struggling with addiction need 
the health care system to be all hands on deck, working to ensure that 
there is adequate treatment. That means your doctor, your health care 
plan, and your pharmacy need to come together and develop a treatment 
plan in order to ensure that Americans are on the road to real 
recovery. Without access to treatment, the Toomey amendment alone would 
simply lock persons suffering from addiction into a pharmacy, and they 
would still be without a path out of addiction. Effective treatment has 
to be more than handing a pamphlet to somebody struggling with a 
condition as powerful as addiction.

  My amendment also aims to end the tide of overprescribing in the 
first place. It doubles the penalties for opioid manufacturers that 
provide kickbacks to prescribers in order to boost their profits by 
promoting the unapproved use of these drugs at the expense of a 
patient's safety. The inappropriate practices of these companies have 
been well documented in recent years, and it is high time for real 
accountability when the opioid manufacturers go too far.
  I will close by saying that at the Finance Committee hearing, which 
was held last week, I asked the three panelists--one was a witness 
chosen by the distinguished chairman, Senator Hatch, one was a witness 
I chose, and one was an individual that both of us thought would make 
an important contribution. The panel consisted of a pharmacist, a State 
assistant attorney general, and a child welfare and substance abuse 
expert. I asked all of them one simple question, and that question was: 
Does treatment and enforcement have to work in tandem to solve the 
opioid crisis? Each one of these witnesses--a witness chosen by 
Chairman Hatch, a witness chosen by me, and an independent witness--
answered yes to my question. Prevention, treatment, and enforcement 
must work in tandem, and to do that we have to adopt this amendment.
  We ought to take action to improve policies in our government that 
will actually solve the opioid crisis. I hope all of my colleagues will 
support my perfecting amendment to the Toomey amendment.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from New York.
  Mrs. GILLIBRAND. Madam President, I rise to speak in favor of 
amendment No. 3354. I filed this amendment with my colleague from West 
Virginia, Senator Capito, who has been a leader in our fight against 
opioid addiction. The opioid addiction problem in our country is 
severe. It is growing, and it is not going to end unless Congress comes 
together to pass a law that targets the root causes of this epidemic. 
The stakes are simply too high to ignore.
  Last year alone, in communities all across our country, including 
many in New York, 1.4 million more Americans started abusing opioids. 
Every day, 44 more people are killed by an overdose. We have seen 
enough data to know that our opioid addiction problem is spiraling out 
of control. Opioid addiction is destroying too many lives in our 
cities, too many families in our rural communities, and too many young 
men and women in our suburbs.
  I wish to tell the story of one of my constituents whose name is Sean 
Murdick. Sean was a really special and gifted young man. He was 
cocaptain of his high school football team and had that rare ability to 
bring people together and connect with anyone. Sean didn't care if you 
were on the football team or had a disability, he was always the first 
one there to help you when you needed it.
  After high school, Sean loved working with his hands, so he got a 
good job as a construction worker. One day Sean broke his arm. Sean's 
doctor gave him a prescription for oxycodone, a powerful opioid to mask 
his pain. By the time his prescription ran out, Sean was already 
addicted. He couldn't shake the addiction no matter how hard he tried. 
He started using heroin and tried to quit many times, but the system 
failed. The system failed him nearly every step of the way, and last 
fall Sean overdosed and died.
  I would like to tell you Sean's story from the perspective of his 
parents. My hometown paper, the Times Union, did an incredible story 
about his life. I can imagine the pain they suffer because I have two 
young sons. The Murdicks

[[Page S1194]]

had many questions but very few answers, and they have been lost in a 
fog of grief since their son's death 2 months ago.
  The Times Union wrote:

       They want to speak out in Sean's memory, to reclaim what 
     heroin stole from them in the hope that it might help other 
     parents struggling with a child's addiction.
       ``Sean did not die in vain,'' his father said, choking back 
     tears.
       ``We tried our best to save him. It wasn't enough,'' his 
     older brother said, his voice cracking. . . . His mother 
     walked over, embraced her son and spoke soothing words into 
     his ear. The father buried his head in his hands. It was a 
     tableau of sorrow.

  We have seen this happen far too often. When their son spiraled down 
into addiction--

       His parents could see something was wrong with Sean. He 
     lost a lot of weight and seemed distant and fidgety. He 
     nodded off at the dinner table.
       His father found a syringe in the bathroom and confronted 
     Sean.
       ``Dad, I'm sick. I need help,'' he said. ``This is not me. 
     I don't want to be like this.''

  The parents told their story to our paper. The paper says:

       It was a revolving door of failure: detox, intensive 
     outpatient care, relapse. He did not qualify for the most 
     intensive and costliest level of care, inpatient residential 
     treatment. They denied him because he was not homicidal or 
     suicidal and had a stable home environment. ``It was a never-
     ending battle with the insurance companies,'' his mother 
     said. ``They treated him like the scum of the Earth.''

  Now imagine being a parent and going through this with your son--
going from treatment center to treatment center.
  When Sean finally died, he had the best care. He was in a treatment 
center. When he called his mother, he said:

       ``Mom, I've gotta go. My steak's ready,'' he said. ``Love 
     you, mom.''

  He went into the bathroom, and he overdosed.

       Sean left his parents a final solace. Not long before he 
     died, he thanked them for their unconditional love and how 
     they supported him through a long road of misery.
       ``You did everything right,'' he told them.

  I don't know how a parent can hear those words and think they did 
everything right, but I can tell you as a Senator that the U.S. 
Congress is not doing everything right.
  Too many parents are telling these stories about their children who 
have died and too many patients are being prescribed opioids, such as 
Percocet, Vicodin, and OxyContin for acute pain. This medication is 
prescribed to patients for a broken wrist or when they have a wisdom 
tooth pulled--medication that they may need for only 2 or 3 days. Why 
in Heaven's name are they sent home with a dose of 30 oxycodone pills? 
What happens to those pills? Are they given to kids at a party? Are 
they sold to addicts?
  We know there is a huge issue with how prescriptions are being made, 
how much medicine is being given to patients for this acute care, and 
right now there are no guidelines--no guidelines--given to doctors.
  I have a bill to create that guideline. We need a guideline for the 
CDC. Our amendment is very simple. It would require the CDC to issue 
clear guidelines to our medical community for when it is appropriate to 
prescribe opioids instead of something nonaddictive, such as Extra 
Strength Tylenol.
  Our amendment simply requires the CDC to issue these clear guidelines 
for how much opioid medication our medical professionals can prescribe 
without putting a patient at high risk for addiction. These guidelines 
are already being done for chronic pain, so they should also do them 
for acute pain.
  We need to do something. As Members of Congress, we need to respond 
to the suffering of so many of our constituents. It is truly an 
epidemic, and it needs a response.
  I thank the Presiding Officer, and I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. McCONNELL. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. McCONNELL. Madam President, I ask unanimous consent that at 2:30 
p.m. today, the Senate vote in relation to the following amendments in 
the order listed: 3362, Feinstein; 3395, Wyden; 3367, Toomey; 3345, 
Shaheen; that there be no second-degree amendments in order to the 
amendments and that, where applicable, Senator Enzi or his designee be 
recognized to offer a budget point of order against the respective 
amendment and that the sponsor or their designee be recognized to make 
a motion to waive; further, that all the amendments be subject to a 60-
affirmative-vote threshold for adoption and that there be 2 minutes 
equally divided in the usual form prior to each vote.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The PRESIDING OFFICER. The Senator from Nebraska.


                               Kari's Law

  Mrs. FISCHER. Madam President, I rise today to discuss a bipartisan 
bill that ensures all Americans can access 911 in emergencies.
  In December of 2013, Kari Hunt was attacked in her Texas hotel room. 
As this was unfolding, her 9-year-old daughter tried desperately to 
call 911, but the call did not go through. Like millions of American 
children, Kari's brave daughter was taught to dial 911 for emergency 
assistance, but because they were in a hotel room, the phone required 
her to dial 9 followed by 911.
  In any emergency, a few precious seconds can mean the difference 
between life and death. And although we cannot prevent tragic events 
from taking place, we do have the ability to make it easier to get 
help. That is why I have teamed up with Senators Amy Klobuchar, John 
Cornyn, Ted Cruz, and Brian Schatz to put forward a new bill that could 
save countless lives. Our legislation, named in honor of Kari Hunt, 
would require that everyone has the ability to call 911 in an 
emergency. This problem isn't isolated to one hotel room or a 
particular incident.
  As of March 2014, consumers could not directly dial 911 in 44.5 
percent of hotel franchises and 32 percent of independent hotels. Over 
the past 2 years, the hotel industry and phone manufacturers have 
undertaken voluntary efforts to improve the problem, and I do commend 
those efforts, but we need to do more. If one person cannot call 911 in 
a life-or-death situation, that is one person too many.
  The bill we have introduced, known as Kari's Law, would require 
multiline telephone systems, such as those used in hotels and schools 
and office buildings, to have a default setting that enables people to 
directly call 911 without first dialing an access code such as 9 or 1. 
The bill also requires that these phone systems be programmed to allow 
a central location--such as the hotel front desk--to be notified if a 
911 call is made. Through our legislation, first responders can more 
easily locate people during an emergency. Then they face fewer barriers 
while this is unfolding.
  Kari's Law has already received generous support from across the 
country. For example, in Nebraska, the bill is supported by the 
firefighters associations in Omaha and Lincoln, the Buffalo County 
Sheriff's Office, the city of Beatrice Fire and Rescue Department, 
Cheyenne and Scotts Bluff County 911 representatives, and the chairman 
of the Scotts Bluff County Board of Commissioners. The bill is also 
supported by the hotel industry and the American Hotel and Lodging 
Association.
  I would also like to acknowledge the efforts of FCC Commissioner Pai, 
who has devoted time and resources to bring attention to this very 
important issue. Commissioner Pai traveled to Nebraska last June, and 
he participated in a workshop on direct-dial 911 issues while at the 
University of Nebraska in Lincoln. He has continued to encourage the 
industry to work with him in an effort to find solutions to this 
important issue. The Nebraska Public Service Commission, which led the 
workshop, has also been at the forefront of the discussion.
  And finally, we would not be here discussing this bill without the 
tireless work of Kari's father, Hank Hunt. Hank has worked day in and 
day out to advocate for this legislation at both the State and the 
national level. Hank has made it his mission to ensure that no other 
family will have to suffer through a similar tragedy. I paraphrase 
Hank: It was the look on my granddaughter's face when we failed her. A 
9-year-old did what she was instructed to do by her parents, teachers, 
and adults. She was in a true, dire emergency, and she followed 
instructions, but it didn't work.

[[Page S1195]]

  I would call on all my colleagues to support this important 
legislation. We owe it to Kari Hunt, her family, and the Americans who 
rely on their ability to call 911 for emergency help.


                        Spoofing Prevention Act

  Madam President, I also want to take a moment to speak about another 
bipartisan bill that is currently before the Senate. This legislation 
also seeks to protect Americans by updating our telecommunications 
laws. It would fix loopholes in our laws that are allowing scammers to 
take advantage of innocent Americans through a practice known as caller 
ID spoofing.
  Caller ID spoofing allows predators to deliberately falsify their 
identification and telephone numbers relayed through caller ID. The 
scammers frequently ask for personal information and for money. Often, 
senior citizens and our veterans are the target of these predatory 
practices. Caller ID spoofing has become a major problem for Nebraskans 
and for law enforcement, which is why I am committed to eliminating 
this practice.
  In September 2013, USA Today highlighted the story of Marian Kerr 
from Hastings, NE. Ms. Kerr is an 83-year-old retired hospital nursing 
administrator who fell victim to a spoofing scam. She received a call 
from individuals who claimed to work for the Federal Government, and 
they asked for her bank account information. The scammers told her they 
were Federal officials and already had her name, address, and her phone 
number. They used this information to trick Marian into providing her 
bank account number. Ms. Kerr had caller ID, but it displayed a number 
in Nevada, not Washington, DC, or Hastings, NE. She attempted to call 
back repeatedly, but she either received a busy signal or was sent to 
voice mail. Ms. Kerr reported the incident to the police, but by then 
it was too late. Her money was gone, and there was nothing that law 
enforcement could do.
  Last fall, the Omaha FBI issued a warning about the danger posed by 
scammers using the Bureau's identification to target Nebraskans. The 
callers claimed to be offering a grant from the Federal Government, and 
they proceeded to solicit credit card and banking information. This 
practice is happening across the country and it needs to stop. Whether 
it is hardworking Nebraskans like Ms. Kerr or veterans who bravely 
served our country, no one is immune to this form of fraud.
  That is why I was very pleased to join with Senator Nelson last month 
to introduce the bipartisan Spoofing Prevention Act. This bill would 
amend the Truth in Caller ID Act. Currently, loopholes in this law are 
allowing scammers to manipulate caller ID information and to harass 
millions of Americans.
  While the Truth in Caller ID Act has helped to curb spoofing, the 
growth in new technologies has allowed scammers, especially those 
operating overseas, to continue this fraudulent practice. The Spoofing 
Prevention Act would crack down on spoofing by prohibiting caller ID 
spoofing on all voice calls, including those originating outside the 
United States, and all calls made using IP-enabled voice services. It 
would also prohibit caller ID spoofing done via text messaging, which 
is now becoming a really common practice. Additionally, the bill 
directs the GAO to look at what the FCC and the FTC have done to combat 
spoofing.
  We must call for new solutions as technology continues to evolve, and 
I urge all my colleagues to support this important legislation so we 
can ensure that our citizens are protected from fraud and abuse.
  Thank you.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Tillis). The Senator from Indiana.
  Mr. DONNELLY. Mr. President, I would like you to recognize the 
assistant minority leader from Illinois, Senator Durbin.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. DURBIN. I thank my colleague from Indiana.
  Mr. President, the bill before us is the Comprehensive Addiction and 
Recovery Act. It is one of the few bills on which we find so much 
bipartisanship. It really is an issue that all of us understand back 
home is a major problem, wherever home may be. In my State of Illinois, 
there is no town too small and no suburb too wealthy to avoid the 
challenge of this heroin crisis.
  Here is what is happening. Over the last 10 years, we have seen the 
pharmaceutical industry dramatically increase the number of painkiller 
pills for sale. One classification of those opioids includes OxyContin, 
hydrocodone, and other names that are pretty familiar to us. It turns 
out that there have been so many of these pills produced that they have 
now created an industry of their own--an illicit industry where people 
are buying and selling them to get high. When they reached a point 
where they can't find these pills or they are too expensive, they 
switch, in the same category of narcotics, to heroin. Of course, heroin 
can kill you if you have an overdose.
  We now have more people dying from overdoses of heroin across the 
United States than people who are dying in traffic accidents. To give 
you an idea of the volume of this challenge, I have been all across my 
State, from one end to the other, from Southern Illinois all the way up 
to Chicago and the suburbs and towns in between. There is hardly a 
single town that has been spared where some teenager wasn't found dead 
because of a heroin overdose. There are things we are doing to try to 
resolve this, but we are not doing enough and not doing it fast enough.
  So the bill that is on the floor, the Comprehensive Addiction and 
Recovery Act, is an attempt to find new ways for prevention, education, 
and treatment of substance abuse. There is an amendment offered by 
Senator Shaheen from New Hampshire. It is really a test. All of us can 
agree on the goals. Senator Shaheen says that is not enough. That is an 
empty promise unless you pay to achieve the goals. We have to put the 
money into substance abuse treatment. We have to put the money into 
efforts with law enforcement to reduce the likelihood of these drugs 
coming into the United States. That is why I support her amendment.
  I will offer another amendment too. What we are finding is that there 
are not enough treatment facilities for this huge growth in people who 
are addicted to heroin and other narcotics. There just aren't enough. 
So my bill takes a look at Medicaid. That is the health insurance plan 
for people in low-income categories. A few years ago, we changed this 
law and said you can't treat people for substance abuse if you have any 
more than 16 beds in your facility--16. Can you imagine in the city of 
Chicago what that means?
  Well, I went to Haymarket, which is a wonderful operation started by 
Monsignor Ignatius McDermott decades ago, which treats people for 
alcoholism and substance abuse. They have empty beds now that can treat 
people who are addicted to heroin and help them to break away from this 
habit. But if they are under Medicaid, they can't offer these beds to 
these individuals. So I have an amendment with Senator Angus King of 
Maine, and this increases the number of beds in each facility to 40. 
This isn't a runaway number. It is a manageable number, and it is a 
realistic number. If we are going to deal with heroin addiction, we 
have to deal with it in an honest fashion.
  Let me give an example of what I consider to be one of the more 
effective approaches. In Gloucester, MA, the chief of police decided to 
try something new. They were having too many heroin overdose deaths, so 
he made the decision and announced that if you came to his police 
department or sheriff's office and announced your addiction, they 
wouldn't arrest you. They would put you into treatment. What happened 
was a number of people came forward and went into treatment. It was a 
good outcome for them and for the community.
  I have a similar story from the town of Dixon in Illinois. They had 
too many scary instances where people were either close to a heroin 
overdose or actually passed away. They tried the same thing as 
Gloucester, MA, and offered that if you came in and confessed your need 
for help and treatment, they wouldn't arrest you. They would take you 
into treatment. It worked. Over 20 local teenagers showed up because of 
their addiction and they were put into treatment.
  Of course, the problem is there aren't enough treatment facilities. 
So this amendment I have would expand the

[[Page S1196]]

opportunities for treatment, and we have to do that.
  The good news about this, if there is a good part of this, is that we 
are finally dealing with addiction in reality. It is no longer viewed 
just as a moral failing or characterized as some omission of 
conscience. It is being viewed as a disease--a medical condition that 
should and can be treated--and that is why we are making a step in the 
right direction.
  We also--I think it bears repeating--we also changed the law in this 
Chamber not that many years ago, a law which was brought to the floor 
originally by Senator Paul Wellstone of Minnesota and Senator Pete 
Domenici of New Mexico, and that bill required that health insurance 
policies in the United States, in the future, would cover mental health 
counseling and substance abuse treatment. So, now, because that became 
the law, the health insurance plans we buy cover our families for those 
needs. Many families who never dreamed they would need substance abuse 
treatment for their kids, thank goodness, can turn to their health 
insurance plan for that kind of help. We have to protect that. Those 
who talk about repealing the Affordable Care Act would be repealing 
this very protection that families are using now for substance abuse 
treatment. That isn't the answer. The answer is to have more treatment 
facilities available so people can rid themselves of this addiction and 
get on with their lives.
  I have met so many of these people in my roundtables, including law 
enforcement and doctors, but the ones I remember the most are the young 
people addicted in high school who finally were able to break the 
habit. They have a chance now for real life, but it is because there 
was treatment there when they needed it.
  I hope my colleagues will consider this amendment. It will not come 
up today, but it will soon.
  This is a good bill. I hope they will vote for the Shaheen amendment 
because it pays for the services we are promising. I don't want to end 
up making an empty promise to America as we face this heroin crisis.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Indiana.
  Mr. DONNELLY. Mr. President, I thank the assistant minority leader 
for those inspiring words, and I recognize the Senator from Virginia.
  The PRESIDING OFFICER. The Senator from Virginia.
  Mr. WARNER. Mr. President, I ask unanimous consent to speak for up to 
6 minutes as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WARNER. Mr. President, let me also join my colleague in agreeing 
with the Senator from Illinois on his comments, and I, too, will join 
him on voting in favor of the Shaheen amendment. It is important we not 
only take on this question of opioid drug abuse but that we also make 
sure we fund the program. I thank him for his leadership.


                   Filling the Supreme Court Vacancy

  Mr. President, I wish to take a couple of moments and join with many 
of my colleagues to talk about an issue of enormous importance on the 
constitutional obligation to fulfill our duty in terms of reviewing 
whomever the President of the United States nominates for the Supreme 
Court. I wish to start, though, by saying a few words about Supreme 
Court Justice Antonin Scalia and to offer my condolences to his family. 
Whether you agreed or disagreed with Judge Scalia's decisions--and 
mechanically I disagreed with many of them--he was a remarkable jurist 
and he was a remarkable individual. Over the last 10-plus years, I got 
to know him and his wife Maureen more in a social setting. He was warm, 
witty, charming, brilliant, and he will be missed by all who agreed or 
disagreed with him. My thoughts continue to be with Maureen and his 
family.
  I rise, I think, almost in the mode of what I believe Justice Scalia 
would have said as someone who was a strict constructionist and someone 
who believed so firmly in the words of the Constitution. The words of 
the Constitution are quite clear in article II, section 2, where it 
says the President shall nominate Justices to the Supreme Court, and it 
is the responsibility of the Senate to advise and consent.
  So my request to all colleagues in this body is simply let's do our 
job. It is not if the President will nominate, it is when the President 
will nominate--and I hope he nominates soon--we should give that 
nominee their due consideration, a fair hearing, and then an up-or-down 
vote. The President has repeatedly voiced his strong commitment to 
nominating an eminently qualified replacement. That is his duty, and we 
must do ours.
  To those who suggest we should wait and let the American people 
decide, the truth is, they already did. In 2012, the American people 
voted to return President Obama to the White House for a second 4-year 
term. That 4-year term doesn't end until January 20, 2017. I believe 
there is ample time to vet a nominee and still wrap up this process 
this spring.
  Are we going to allow politics to totally overtake the work of this 
body? Are we resigned to a complete and utter failure to govern until 
next January?
  I know the Presiding Officer and I both share a common background; 
that is, a background in business. It is remarkable to me. No business 
in America--no business in the world--would operate under the 
presumption that because it is a Presidential year, that somehow we can 
default on all of our duties and simply kick over every issue until 
next year. If we operated a business that way, we would be out of 
business.
  I believe it is absolutely essential that when the President--and I 
hope expeditiously--nominates an individual to the Supreme Court, that 
this body do its job constitutionally: review that applicant, meet with 
that applicant, hold hearings on that nominee, and then give that 
nominee the up-or-down vote the Constitution requires.
  The remarkable thing is in a year where there is a lot of commentary 
about what the public wants, I can at least tell my colleagues what the 
public wants in Virginia. They want us to do our job.
  I have received an overwhelming response from Virginians from one end 
of the Commonwealth to the other. They are expressing their opinion 
clearly about how the nomination process should move forward. A lot of 
Virginians are expressing their thoughts about what kind of nominee the 
Senate should confirm or not confirm, but what they are not saying is 
that the U.S. Senate should punt on this constitutional responsibility. 
They want us to do our job.
  Over the past week, what I have found most striking is the awkward 
public position held by so many people who otherwise claim to be 
advocates of a strict reading of the words of the U.S. Constitution, 
who somehow are saying--imagining something that doesn't appear in the 
Constitution, that a President or at least this President in his last 
year--we are not going to follow the Constitution. We are going to kick 
it over until next year. I believe that is irresponsible. I believe it 
is inappropriate. I believe that does not follow the interpretation of 
the Constitution and quite honestly I don't believe it would follow 
what Justice Scalia, who was a strict constitutionalist, would want to 
see this body do.
  Yet we saw some on the other side of the aisle, literally within 
hours of Justice Scalia's passing, saying: No vote. No proceeding. We 
are not going to do our job. We saw certain members of the leadership 
meet yesterday with the President, again reaffirming their 
unwillingness to do their job.
  This failure to act, this failure to do our constitutional duty, 
could result--will result--in a vacancy on the Supreme Court stretching 
close to a year, across two distinct terms of our highest Court. Over 
that time, the Supreme Court could be deciding extremely important 
cases, and in many ways they are not going to function as the 
Constitution laid out.
  Many of my friends on the other side of the aisle often quote 
President Reagan. President Reagan himself said: ``Every day that 
passes with a Supreme Court below full strength impairs the people's 
business in that crucially important body.''
  As a matter of fact, if we don't do our job, in effect, what we will 
be doing is potentially shutting down another branch of government. 
Regardless of where we fall on the political spectrum, if there is one 
message we have

[[Page S1197]]

heard loud and clear over the last couple of years, the American people 
do not abide shutting down various branches of government. The American 
people deserve better than this.
  I would again urge my colleagues on both sides of the aisle to step 
up and do their job. Let's give the President's Supreme Court nominee 
the appropriate respect, hear them out, have those hearings, and give 
the Senate a chance to exercise its will in a straight up-or-down vote.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Indiana.
  Mr. DONNELLY. Mr. President, I rise for all Hoosiers who have been 
touched by addiction or suffered the loss of a loved one as a result of 
opioid abuse, heroin use or other drug epidemics. I am here for every 
Hoosier community that has been gripped by addiction.
  I am here from Austin, IN, a small town of 4,200, much like many 
small towns in the Presiding Officer's home State of North Carolina, 
where more than 185 people tested positive for HIV, largely caused by 
injection drug users who shared needles. I am here for Connersville, 
which was devastated by a heroin epidemic that saw 41 overdoses and 8 
deaths in a 3-month span. I am here for my hometown of Granger, which 
was shaken last year when two teenage brothers, Nick and Jack Savage, 
died in just one night from a prescription drug-related overdose. I am 
here for Fort Wayne, Lafayette, and Terre Haute, and Indianapolis, and 
every community across our State. No part of Indiana or our country is 
immune from the pain of addiction and these drug epidemics.
  By now many of us have heard the staggering statistics. One person in 
America dies every 25 minutes from an opioid overdose, and overdose 
deaths in the United States now outnumber fatal auto accidents.
  Ultimately, this is about people. People like Mike Zoss of Tippecanoe 
County. Mike was the youngest of three boys. Mike was creative, enjoyed 
reading, and had a ton of friends. In high school he began 
experimenting with prescription drugs. During his senior year, Mike's 
mom Donna got a call no parent wants to receive. Mike had overdosed at 
a friend's house from a combination of LYRICA and methadone. He landed 
in intensive care and was in a coma for nearly 3 weeks. Miraculously, 
Mike survived, but after struggling for nearly 3 more years with his 
addiction, Mike died from another overdose.
  This scourge is about families and the heartbreak they endure and all 
the people whose lives are shattered by addiction or even cut short. 
That is why I have been working on this issue for over 2 years, 
listening to Hoosiers, introducing bipartisan legislation, partnering 
with Federal, State, and local officials, and bringing stakeholders 
together.
  These families are why I support the Comprehensive Addiction and 
Recovery Act. This bill provides States and local communities with the 
tools to prevent and treat drug addiction and to support individuals in 
recovery. CARA strengthens prevention efforts, increases access to 
treatment and recovery services, develops best prescribing practices, 
and expands access to naloxone, also known as Narcan, which can reverse 
the effects of an opioid overdose. In addition, CARA expands disposal 
sites for unwanted and unused prescription drugs to keep them out of 
the hands of children and teens, and CARA strengthens prescription drug 
monitoring programs. This bill provides States and local communities 
with the tools to prevent and treat drug addiction and to support 
individuals in recovery.
  CARA strengthens prevention efforts, increases access to treatment, 
develops best prescribing practices, and expands access to naloxone, as 
I said. Naloxone can reverse the effects of an opioid overdose. These 
are incredible steps that can make a huge change in what happens in the 
future of our country.
  While this bipartisan bill includes many important provisions that 
help families in my home State of Indiana and across our entire 
country, it will take all of us working together to prevent and treat 
addiction. Prescribers and pharmacists, law enforcement and first 
responders, parents and families, and officials at the Federal, State, 
and local levels all have a role to play.
  I want to talk today about how CARA can best help in these efforts. 
First, I want to talk about prescribers. Our prescribers play a vital 
role in addressing addiction because they are our partners in the fight 
to reduce the risk of prescription drug abuse. They have the knowledge 
and authority to help our patients, friends, neighbors, and family 
members understand both the benefits of prescription opioids and the 
potentially devastating dangers associated with opioid abuse.
  Last year, we hosted a roundtable discussion in Indianapolis on 
prescribing practices with my colleague, Congresswoman Susan Brooks. By 
bringing together State officials, doctors, and pharmacists, all of 
whom play key roles in curbing overprescribing, we can better engage 
health professionals in the fight against the opioid epidemic. We want 
to make sure doctors have the training, the tools, and the resources to 
prevent overprescribing and also to help them make the best possible 
decisions about how to treat their patients.
  Right now there is not one set of currently nationally accepted best 
practices that can help prescribers make the best informed decisions 
about prescribing opioid drugs. Existing guidelines vary in the 
recommendations that are made.
  CARA would help. It includes a provision adopted from my bipartisan 
legislation that I reintroduced last year with my friend and colleague, 
Senator Kelly Ayotte from New Hampshire, which brings experts together 
to review, modify, and update, where necessary, best practices for pain 
management and prescribing pain medication.
  Second, I want to talk about our first responders and our law 
enforcement who are on the front line of this crisis. Frequently they 
are called to scenes where an individual has overdosed, and they are 
working to find ways to address these drug epidemics. In Northwest 
Indiana, the Porter County sheriff's department is reaching out to 
educate families about the heroin crisis there with a video that 
includes first-person accounts about how the epidemic has impacted the 
local community. In the northeast part of our State, over by the Ohio 
border, the Fort Wayne Fire Department began using Narcan just last 
August to try to help save people who had overdosed. In the first 4 
days, they had to use it three different times--and many times since 
then. In Central Indiana last year, Indianapolis EMS had administered 
naloxone an astounding 1,227 times. We need to make the overdose 
reversal drug naloxone more readily available to first responders and 
law enforcement.
  CARA includes a provision similar to one from my bill with Senator 
Ayotte that provides grants to train law enforcement and other first 
responders in the administration of naloxone to save lives. I have also 
offered an amendment that encourages first responder units receiving 
funding through this program to use outreach coordinators to ensure 
that every individual who receives naloxone also receives in-person 
followup. Indianapolis EMS recently began a similar outreach program 
designed to connect overdose victims who receive naloxone with the help 
they need.
  CARA assists law enforcement by expanding resources to identify and 
treat individuals facing addiction in criminal justice centers. I hear 
frequently from my friends--the police officers, sheriffs, judges, and 
court personnel throughout the Hoosier State--that more resources are 
sorely needed.
  Third, I want to talk about families. There are countless personal 
stories across our State and almost every State about moms and dads, 
brothers and sisters, wives and husbands, and grandparents who have 
been impacted by addiction. I want to share a couple of these stories.
  Our young friend Aaron--Justin Phillips remembers her son Aaron, a 
talented athlete who had dreams of playing football in college and the 
NFL. He was a starting quarterback on Lawrence North's varsity team. He 
was smart and charming, with a generous heart.
  It started for Aaron with a prescription pain medicine and then led 
to heroin. At the age of 20 years old, in October 2013, Aaron died of a 
heroin overdose. His mom said, ``We can't pretend it is not our kid 
because it very well may be our kid who is next.''

[[Page S1198]]

  There are people like Michelle Standeford of Lebanon, IN, who lost 
her son and her nephew to addiction. Her nephew Greg died 3 years ago 
from a heroin overdose at the age of 21. Her son Troy, 33, died 
following a long battle with addiction. His struggle began when he was 
prescribed opioids for the pain he was struggling with after a jet ski 
accident. This past Christmas, Michelle visited Troy, who was in South 
Florida seeking treatment. She said he was in great spirits and eager 
to reunite with his family. A few weeks after Troy came back home to 
Indiana, he passed away. Think of this. He left behind parents, a wife, 
and two sons, 2 and 4 years old. These stories are way too common.
  As Donna Zoss of Lafayette said, ``There are way too many kids dying, 
and as a community we need to do something.'' She wants to make sure 
other families learn from her experience before it is too late.
  CARA would help families by raising awareness about opioid abuse and 
heroin abuse and expanding access to treatment. It includes a provision 
from our bipartisan bill with Senator Ayotte that establishes a 
national drug awareness program. By helping families learn about the 
serious effects of opioid abuse and its connection to heroin, it can 
make a difference.
  CARA also would strengthen additional prevention efforts and increase 
access to treatment and recovery services with the goal of helping more 
people overcome addiction, including specific initiatives for women, 
youth, and vets.
  We are not doing enough, and the burden of addressing the opioid and 
heroin use epidemic has fallen heavily on our criminal justice system, 
which is clearly not equipped to treat all those struggling with 
addiction. That is why CARA is so important and why we need to pass 
this critical legislation quickly.
  We have an opportunity to work together--all of us--to pass a good 
bipartisan bill that helps confront opioid abuse, heroin abuse, and 
other drug epidemics. On the Federal level, it is our job to support 
and strengthen partnerships on the State and local levels to make sure 
every town in every State is accounted for and can heal. CARA will do 
just that. It would be a significant step forward, although I think we 
can all agree that it is just a first step.
  Mr. President, I yield back.
  The PRESIDING OFFICER. The Senator from Pennsylvania.


                           Amendment No. 3367

  Mr. TOOMEY. Mr. President, I rise on the same topic that the Senator 
from Indiana was addressing very eloquently through the absolutely 
heart-wrenching stories he told of his constituents and their families. 
These are stories we hear all across America. I hear them all across 
Pennsylvania day in and day out.
  Drug addiction is an enormous problem. It is devastating families and 
communities in our States. I share the view of the Senator from Indiana 
that this legislation is very important. It takes a number of steps 
that are very constructive. I congratulate Senator Whitehouse and 
Senator Portman for a very good piece of legislation that is going to 
help save lives. It is going to help save families and communities.
  I have an amendment that I am going to address that is going to take 
another step to help save lives, and I hope my colleagues will 
overwhelmingly support this because it is an epidemic the likes of 
which I don't know we have seen in a very long time.
  Last October, I convened a field hearing of the Senate Finance 
Subcommittee on health care to learn more about this very epidemic of 
opioid addiction and heroin addiction and the overdoses that are 
resulting. We did it in Pittsburgh, and Senator Casey joined me. We 
reserved a very large auditorium, and we invited some of the leading 
local experts, doctors who were dealing with people who were suffering 
from addiction, law enforcement folks, recovering addicts. We had a 
standing-room-only crowd in that room. Such was the intensity of the 
concern of this issue and the breadth of it because we all know people 
who are affected by this terrible scourge.
  A couple of things I learned in the hearing that are important is 
that we have to figure out how we can reduce some of the 
overprescribing of these narcotics--these prescription opioids--upon 
which people then become addicted. We also have to find ways to address 
the diversion from prescriptions that are obtained through the 
conventional process, the black market, the streets, and the places 
where it feeds the addiction.
  I think one of the overlooked elements of this problem has been the 
opioid epidemic that is affecting older folks, aging baby boomers, and 
senior citizens who have become addicted to opioids for a variety of 
reasons.
  The headlines have screamed about this. USA Today's headline said: 
``Many seniors Hooked On Prescription Drugs.'' The Wall Street Journal 
had a headline recently: ``Aging Baby Boomers Bring Drug Habits Into 
Middle Age.'' This came from a TV news channel: ``Senior citizens 
getting hooked on painkillers.''
  This is growing problem, and it doesn't know any demographic limits. 
It affects senior citizens as well as young people. In fact, to give a 
sense of one of the, perhaps, contributing elements to this, in 2013 
there were 55 million opioid prescriptions written in America for 
Americans over the age of 65. It is a stunning number. It is a 20-
percent increase in just 5 years. We have not had a comparable increase 
in the number of senior citizens. It is a huge increase in the number 
of prescriptions per person. This is probably related to the fact that 
the number of opioid-addicted seniors has itself tripled in the last 
decade.
  One of the problems has been identified by the Government 
Accountability Office. They estimate that in 1 year alone, 170,000 
Medicare enrollees engaged in doctor shopping. That is the process by 
which beneficiaries go to multiple doctors to get multiple 
prescriptions for the same or similar powerful narcotics. They go to 
multiple pharmacies to get them all filled, and they end up with these 
commercial quantities of prescription drugs--vastly beyond anything 
that any individual could need.
  The GAO discovered that one beneficiary had visited 89 different 
doctors in one year just to get prescription painkillers--89 doctors in 
one year. That is almost 2 a week. Another beneficiary received 
prescriptions for 1,289 hydrocodone pills. That is almost like a 2-year 
supply. It makes no sense. I could go on and on with cases in which 
fraud is being committed for the purpose of obtaining these 
prescriptions, which are then sold in the black market.
  There is also a subset of Medicare beneficiaries who are innocently 
getting duplicate opioid prescriptions because they are being treated 
by different doctors for different maladies. They have multiple 
illnesses. They get multiple prescriptions because in many cases there 
is nobody providing adequate oversight and coordination for their 
care. So we have both, people who are intentionally and fraudulently 
getting multiple prescriptions and then we have people who are 
innocently getting it. So there is a way we can deal with this 
inappropriate prescription and diversion into the black market, and the 
administration has asked us to do this.

  This administration--the Obama administration--has asked Congress to 
give them, in Medicare, the power to limit certain beneficiaries who 
are engaged in doctor shopping, exactly as people already can do so 
within Medicaid and with private health care providers. So the simple 
idea is to give Medicare the power when it identifies a beneficiary who 
is engaged in doctor shopping--getting multiple, duplicative 
prescriptions, either intentionally or unintentionally--to allow 
Medicare to lock that patient into one prescriber and one pharmacy. 
That way you don't have this problem. That is what the administration 
has asked us to do.
  So I have introduced a bill that does exactly that. It is called the 
Stopping Medication Abuse and Protecting Seniors Act. Senator Brown of 
Ohio is the lead Democrat on this bill. I thank Senators Portman and 
McCain also for their work. This is the amendment we are offering to 
this bill to give Medicare the very same tool that Medicaid has, the 
tool that the administration is asking for, and the tool that all 
experts say makes sense.
  As I said, Medicaid and commercial users already do this, and we are 
not inventing something new. What we are doing is simply applying a 
proven technique that limits overprescribing and

[[Page S1199]]

diversion, applying that to Medicare, where it does not exist today. No 
one who legitimately needs a prescription for opioids will be denied 
that. That would be completely unreasonable and inappropriate.
  In fact, we exempt seniors in nursing homes, where the nursing home 
can provide the monitoring, and seniors who are in hospice, and cancer 
patients who might need unusually large quantities are exempted. In 
fact, this legislation would actually lock in a small fraction of 1 
percent of Medicare enrollees, but that is the fraction that is 
engaging in this very dangerous behavior.
  First, I am grateful for the very broad bipartisan support that we 
have. As a result, if we get this passed today--which I certainly hope 
we will--we will help opioid-addicted seniors find treatment because 
they will be notified when they come up on this list--when it is 
discovered that they are going to multiple doctors and multiple 
pharmacies. It will stop the diversion of these powerful narcotics.
  It will save taxpayer money because taxpayers reimburse for all of 
these prescriptions, even those that are fraudulent. Maybe, most 
importantly, it will reduce the availability of these opioids. We have 
25 Republican and Democratic cosponsors on the bill. We have the 
support of the National Governors Association. Nearly identical 
language was already passed in the House. It was embedded in the 21st 
Century Cures Act, where it passed overwhelmingly.
  The President's budget has asked for this very mechanism repeatedly. 
The CMS Acting Administrator was before our committee, and 
Administrator Slavitt said this legislation ``makes every bit of sense 
in the world.'' The CDC Director is for it. The White House drug czar 
is for it. The Pew Charitable Trusts testified on behalf of our 
legislation, and the Physicians for Responsible Opioid Prescribing 
support it--not to mention many law enforcement groups and senior 
groups, such as the Medicare Rights Center.
  This is a tool that is overdue. We have this tool in private health 
care insurance coverage. We have this tool in Medicaid. We just need to 
have this tool in Medicare.
  I wish to single out for a special thanks my coauthor Sherrod Brown. 
Senator Brown and his staff worked very hard and did a tremendous job. 
They provided, in fact, very valuable feedback to make sure that all 
the stakeholders were going to be treated fairly and specifically, that 
beneficiary rights would be properly respected. That is a very 
important and very constructive contribution that Senator Brown made to 
this legislation. He also helped to secure many endorsements from 
outside groups.
  My fellow Pennsylvanian, Senator Casey, was very helpful and is 
passionate about this issue. He has seen firsthand the damage that is 
being done across Pennsylvania from opioid abuse. He is a cosponsor of 
the legislation.
  We had a very successful hearing in the Finance Committee. I thank 
Senator Hatch for having this very topic of how we can limit the 
diversion through Medicare of these very dangerous narcotics, and I 
thought that was a very constructive hearing.
  I also thank Senator Kaine, who, through his work on the Senate Aging 
Committee, has been very active and extremely helpful on this issue.
  Again, this is an amendment that has broad, bipartisan support. It 
has been vetted by the stakeholders. It has been vetted by and 
requested by the administration. It is endorsed by numerous health care 
and law enforcement groups. The reason it has such broad support is 
because it will save lives, it will protect seniors from opioid 
overprescriptions, it will stop fraud, and it will dramatically reduce 
pill diversion. So to vote no on this would be to allow the continued 
flooding of very dangerous prescription opioids onto the black market, 
and I can't think of any reason we would want to do that.
  I urge my colleagues to support the bipartisan Toomey-Brown-Portman-
Kaine amendment. Let's get this adopted and then let's pass this 
underlying bill, which is very, very constructive as well.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. WHITEHOUSE. Mr. President, as one of the authors of the bill 
before us on the floor now, I wish to say that I appreciate and welcome 
the Senator's amendment, and I appreciate the bipartisan way in which 
it was achieved, with Sherrod Brown and Tim Kaine, as well as with the 
other cosponsors of the bill.
  With that, I yield the floor back so that we may hear from another 
coauthor of this legislation who was with us through the long and 
arduous process of preparing this bill, running the seminars, putting 
together the advisory committee, and crafting the legislation.
  I yield for the Senator from New Hampshire.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Ms. AYOTTE. Mr. President, I very much thank the Senator from Rhode 
Island for the work that we were able to do together on this important 
legislation, for his leadership, and, really, his passion for this 
issue that is devastating my State--the heroin and opioid epidemic that 
is facing all of us. I thank him for a very thoughtful approach and 
bringing people together around this. I am so pleased we are debating 
this on the Senate floor today.


Honoring Officer Ashley Guindon and Lieutenant James ``Jimmy'' Geraghty

  Mr. President, I come to the Senate floor today with great sadness to 
discuss and to honor the lives of two of our outstanding law 
enforcement officers from New Hampshire who were taken from us far too 
soon. One is New Hampshire State Police Lieutenant Jimmy Geraghty, a 
U.S. Army veteran and outstanding public servant. Another is Prince 
William County Officer Ashley Guindon of Merrimack, NH.
  Ashley was a Merrimack, NH, native and a Marine Corps veteran who was 
killed in the line of duty in Virginia 1 day after being sworn in as a 
police officer to serve in the Prince William County Police Department.
  These individuals represent the very best of law enforcement. It is 
with such a heavy heart that I pause to remember Ashley Guindon, an 
incredible young woman whose life was tragically cut short. Ashley was 
killed in the line of duty last week, tragically, on her first day as a 
police officer with the Prince William County Police Department in 
Virginia.
  Ashley could not have known her fate when she responded to an 
emergency call, but she responded to the call with the same sense of 
duty and resolve that all of our faithful law enforcement officers do 
every single day because they don't know at that next stop, at that 
next house that they respond to help someone in need, what they are 
going to be confronted with.
  Ashley's death is a terrible, unthinkable tragedy and serves as a 
somber reminder of the tremendous sacrifices that our law enforcement 
officers make every single day by putting their lives on the line to 
keep us safe.
  My heart breaks for Officer Guindon's mother Sharon, for her family, 
for her friends, and for the public safety community, as they mourn the 
loss of this tremendous young woman whose life ended far, far too soon. 
I will keep them in my thoughts and prayers as I know everyone in this 
Chamber will.
  But Officer Guindon should not be remembered because of the 
circumstances of her death. Rather, she should be remembered for her 
tremendous life of service to her Nation, to the people whose community 
she worked to keep safe, and for the sacrifices that she has made and 
her family has made on behalf of all of us.
  Officer Guindon demonstrated an incredible commitment to her country 
in so many ways. Following her graduation from Merrimack High School in 
2005, she joined the Marine Corps. In doing so, she was honoring the 
life of her father and the service of her father, who deployed to Iraq 
as a member of the New Hampshire Air National Guard. So she comes from 
a family of service. Her father lost his life after returning home from 
serving in Iraq, and Officer Guindon felt that she could honor his 
memory by joining the armed services herself. So she joined and became 
a marine.
  In her high school yearbook she wrote:

       As I take flight it only makes me closer to u daddy. Mom, 
     thanks for everything it'll be a long road but we can manage 
     and it will only make u stronger.


[[Page S1200]]


  Underneath her picture in her high school yearbook, the caption read: 
``live for something rather than die for nothing.''
  Think about that: ``live for something rather than die for nothing.''
  Well, absolutely, Officer Guindon did live for something. She lived 
for our country in her service as a marine. She lived for members of 
her community, giving of herself and making the ultimate sacrifice to 
keep others in her community safe. She lived with such honor and 
distinction, and she answered the call to duty.
  Officer Guindon was taken from us far too soon. But by working to 
ensure that we honor her service, her heroism, her commitment, and the 
sacrifice she and all law enforcement officers make on our behalf every 
single day, we can ensure that her inspiring legacy of dedication to 
others, of service to her country and to her community will never be 
forgotten. We will never forget her service or her sacrifice. We will 
continue to honor her and her family for what they have done in service 
to our Nation every single day.
  I also wish to take a moment to honor another law enforcement 
officer, someone with whom I had the privilege of working personally 
when I served as attorney general of our State, someone whom I probably 
called a friend, and who has also been taken from us far too soon.
  I honor Lieutenant James ``Jimmy'' Geraghty, who passed away recently 
following a courageous battle with cancer. I join his family, his 
friends, and the law enforcement community in New Hampshire who mourn 
his death. I am speaking about someone who touched so many people in 
our State, who really lived a life of service, a life of heroism, a 
life of integrity. I honor his service, his integrity, and his 
dedication to excellence.
  He was a member of the New Hampshire State Police for 24 years and 
rose to the rank of commander of the New Hampshire State Police Major 
Crimes Unit. The New Hampshire State Police Major Crimes Unit is the 
unit that handles the most difficult cases in our State--murder cases, 
very difficult cases. It is a unit where you are called upon at every 
hour of the day in the most difficult of circumstances.
  Lieutenant Geraghty handled some of the most troubling cases and the 
most horrific cases you can imagine as a law enforcement officer. He 
handled them with such incredible dedication, compassion, and 
commitment, and he did his job so well.
  In the most high-profile case of his career, Lieutenant Geraghty led 
the investigation into the brutal 2009 Mount Vernon homicide--a 
horrific, horrific case. It was a complex and extremely time-consuming 
investigation that focused on multiple juvenile defendants.
  Because of the thoroughness, professionalism, and dedication brought 
to the case by Lieutenant Geraghty and the major crimes unit, the 
prosecution was able to pursue the successful conviction of all the 
defendants involved.
  For their work on the 2009 Mount Vernon case, Lieutenant Geraghty and 
the major crimes unit were presented with the New Hampshire 
Congressional Law Enforcement Award for unit citations.
  I had the privilege of being there when Lieutenant Geraghty received 
that award, when he was there with his family. Really, the incredible 
work that he did on that case made such a difference in bringing to 
justice defendants who committed horrific, horrific crimes and in 
keeping New Hampshire safe.
  Lieutenant Geraghty will also be remembered for his entire 
outstanding career of service to both New Hampshire and the Nation.
  Lieutenant Geraghty also served very honorably in the U.S. Army for 5 
years, holding posts at Fort Benning in Georgia, Fort Polk in 
Louisiana, and at Fort Richardson in Arkansas.
  He also served overseas by participating in the REFORGER exercise in 
Germany. He achieved the rank of sergeant, E-5, during his career with 
the U.S. Army and received an honorable discharge. But his service did 
not end there. After serving in the armed services, he then returned 
home and embarked on his career in law enforcement, first serving as a 
police officer in the Hudson Police Department, after which he was 
accepted as a trooper in the New Hampshire State police.
  During his time with the New Hampshire State police, Lieutenant 
Geraghty spent 8\1/2\ years with the Narcotics and Investigations Unit, 
and he did a phenomenal job there investigating a variety of cases, 
from street-level buys to multistate trafficking organizations.
  While serving in the Narcotics and Investigations Unit, Lieutenant 
Geraghty was assigned to the HIDTA--high-intensity drug trafficking 
area--for 2\1/2\ years, so he understood and worked hard on the issues 
we are trying to address on the Senate floor today regarding heroin and 
opioid addiction and so many other illegal substances as he fought to 
keep them off our streets. Lieutenant Geraghty's natural talent for 
leadership and keen ability to work with others were critical in the 
role he played in HIDTA. During his time with HIDTA, he received 
several awards and recognitions for his dedication and commitment to 
excellence.
  He was promoted to the rank of sergeant in May of 2006, and from 
there he was assigned to the Major Crime Unit as a detective sergeant 
in February of 2008. In 2010 he was promoted to the rank of lieutenant 
within his unit, assuming the commanding officer's position--a post in 
which he served until he became ill last year. And he served with such 
distinction.
  I have many friends at the attorney general's office who worked with 
the Major Crime Unit and with whom I have spoken--the chief of the 
criminal bureau unit and with other prosecutors--and they speak of Jim 
Geraghty's service with such glowing reviews, with such incredible 
compassion, and they speak of the incredible hard work he put in. He 
represented the very best of our law enforcement officers.
  I wanted to talk about his career today because it was important for 
me to mention his professional accolades, and there are many, because 
he was such a humble man and he never liked to talk about all of his 
accomplishments. He liked to focus on something I want to make sure we 
remember about Jim Geraghty: He lived by the motto ``family first,'' 
which was incredibly apparent to anyone who knew him. He was married to 
his wife Valerie for 30 years. Together they had four wonderful 
children. They are an amazing family, son Jimmy and daughters Colleen, 
Katie, and Erin.
  I want to offer my thoughts and prayers to Valerie, to Jimmy, to 
Colleen, and to Katie and Erin. You are an incredible family, and your 
husband and father will never be forgotten. What an incredible person 
he was. He impacted the lives of so many people with the service he 
gave to his State.
  It has been said that although Geraghty had an exceptional law 
enforcement career, he considered his family his greatest adventure. In 
a 2015 letter, his fellow local law enforcement officers described him 
as a ``gallant public servant who has spent most of his life serving 
others.'' Others said of him that ``he [was] truly a consummate team 
player who demonstrated the true meaning of a quiet professional.'' 
Another individual said that ``he [was] humble, dedicated, and 
resilient with any duties and/or responsibilities [he was] faced 
with.'' And, lastly, ``His remarkable and unblemished career within law 
enforcement is a true testament and shining example of what we all wish 
to aspire to.'' This is how the officers who served with him, the 
troopers who served with him, described Lieutenant Jim Geraghty. He 
will be deeply missed.
  I am honored to recognize Lieutenant Jim Geraghty and to honor his 
tremendous contributions as the commander of the State Major Crime Unit 
and to say what an amazing family man and great human being. He was 
someone who lived his life with great integrity. He was truly someone 
we would all want to emulate in living our lives.
  Again, I offer my prayers to his family. They are an incredible 
family as well, and I hope they know we will continue to stand with 
them in their most difficult days ahead.
  So today I wish to say about both Officer Ashley Guindon and 
Lieutenant Jim Geraghty that they were incredible law enforcement 
officers who gave so much to New Hampshire, to our country, and that 
they really represented the very best in what it means to be an 
American.
  Mr. President, with that, I yield the floor.

[[Page S1201]]

  The PRESIDING OFFICER (Mr. SCOTT). The Senator from Florida.


               Return from Space of Commander Scott Kelly

  Mr. NELSON. Mr. President, I rise to welcome a national hero back to 
planet Earth--CDR Scott Kelley. After spending 340 days in space on his 
most recent visit to the International Space Station, Commander Kelley 
has smashed the previous U.S. record in space flight and for most of 
the total time spent in space as well. But Commander Kelley's 
accomplishment, while notable in its own right, is serving a greater 
purpose. NASA is preparing to undertake one of the greatest 
technological challenges in human history--a voyage to the planet Mars. 
Depending on the alignment of the planets, Mars is anywhere from 35 
million miles to an astounding 250 million miles from Earth. It is all 
according to the alignment of the planets.
  If you want to put that into perspective, Mr. President, the distance 
from you and me reflecting the 238,000 miles from Earth to the Moon, 
which is as far as we have gone and is a long way--that is the farthest 
we have ever been--if that distance from the Earth to the Moon were 
represented by the distance from you to me, then the distance to Mars 
from right where this Senator is standing would be way out to the edge 
of the District of Columbia and Maryland.
  Commander Kelley's mission is a milestone on this journey to Mars. 
The International Space Station--our football-sized laboratory orbiting 
in space, as large as a football field from one goalpost to the other--
is our test bed for exploration. Indeed, Commander Kelley spent those 
340 days at the International Space Station.
  Now, as we venture out, traveling those vast distances between Earth 
and Mars, it is going to mean that humans are going to spend more time 
in space than ever before, so Commander Kelley's yearlong stay aboard 
the station is an important validation of our ability to live and work 
in space for the long periods of time someone would be in zero-g.
  But there is another very interesting aspect to his mission. Scott 
Kelley has an identical twin, his brother Mark. Retired Navy CAPT Mark 
Kelley, also an astronaut, remained on Earth while his brother was in 
space, and now he is a baseline to compare the changes in the body and 
the psychological effects to his brother Scott. This comparison is 
going to provide important insights into the effects of space flight on 
the human body and perhaps even effects on the Human Genome itself. The 
more we learn about how the human body changes in space, the better off 
we are because we can prepare for the longer and longer voyages in 
space. But we also gain insights into the fundamental working of the 
human body that we may never have learned confined to Earth's gravity. 
And who knows where these discoveries are going to lead--perhaps to new 
cures and therapies for afflictions folks suffer here on the face of 
the Earth.
  The space station where Commander Kelley stayed for almost a year is 
a powerful tool for science and for discovery and for exploration. That 
is why at the end of last year we extended the authorization of the 
space station all the way until at least through the year 2024. It is 
also why I am so excited about the crewed flights from U.S. soil to the 
space station resuming next year. Next year, Americans on American 
rockets will go to and from low-Earth orbit. Once we have the Dragon on 
the SpaceX or the Starliner on the Atlas V, those crewed capsules are 
going to make regular trips to and from the space station. But we 
should also then be able to expand the space station crew, because of 
that regular visitation, from six to seven doing their research 
projects on board the station. That means a lot more discoveries.
  Some people may not appreciate how difficult it is to spend a year in 
space, but I can tell you it is not only an amazing experience, but it 
is tough on your body. The body experiences muscle atrophy in zero-g 
and also bone loss. This is why astronauts have to be in peak physical 
condition and also try to continue that as they are out in space for 
long durations. And spending a year away from loved ones, of course, is 
no easy task. This demonstrates the strength and the courage Scott 
Kelley has shown.
  So I want the Senate to recognize CDR Scott Kelley for this 
accomplishment. It is going to take him some days to readapt to the 
Earth's gravitational pull. I commend him for the contributions to 
space exploration and thank him for the sacrifices he has made and the 
sacrifices his family has made over the last year.
  Welcome home, Commander, and thank you for offering to be a part of 
this great adventure we call space exploration.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Arkansas.
  Mr. BOOZMAN. Mr. President, prescription drug abuse is the fastest 
growing problem in the country. It is a problem the Centers for Disease 
Control and Prevention classifies as an epidemic.
  The availability of prescription painkillers is a leading factor in 
the increase of opioid abuse. Since 1999, opioid abuse overdose deaths 
have quadrupled nationwide.
  Unfortunately, my home State of Arkansas is not immune to the 
problem. CDC data shows that it is one of 12 States with more 
painkiller prescriptions than people--I repeat, one of 12 States with 
more painkiller prescriptions than people.
  Benton, AR, police chief Kirk Lane has seen the impact in his 
community. During a recent visit to my office, he said: ``A lot of 
people become addicted very innocently and can't find a way back.''
  Placing prescription drugs in the medicine cabinet for safekeeping is 
no longer the best option because 70 percent of Americans misusing 
painkillers are getting them from friends and family.
  Arkansas has implemented measures to combat this problem by 
decreasing the availability of prescription drugs and properly 
disposing expired and unneeded medication through the Arkansas Take 
Back Program. This is an important step that has resulted in the 
removal of more than 72 tons of unneeded medication from homes in the 
State.
  Congress has taken action to fight this epidemic. As a member of the 
Senate Veterans' Affairs Committee, I have pushed the Department of 
Veterans Affairs to reform its culture of prescription. Nationwide, 
pharmacies have a system in place to prevent overfilling prescriptions. 
It is time for VA to adopt a similar system.
  I pressured the DEA--the Drug Enforcement Administration--to reform 
its policy to allow clinics and pharmacies to serve as dropoff sites 
for the collection of unused or unwanted prescription drugs.
  Last year, we passed legislation to improve the prevention and 
treatment of opioid abuse by pregnant women and care for newborns 
affected by this abuse. That bill was signed into law.
  Congress approved more than $400 million in funding to address the 
opioid epidemic this fiscal year. That is an increase of more than $100 
million from the previous year. Calls for additional funds for this 
legislation are premature. We need to see the progress and results made 
with the current finding.
  We must continue our commitment to the fighting of this epidemic and 
providing our communities with the tools they need to improve response 
to addiction and promote treatment and recovery. That is why we need to 
pass the Comprehensive Addiction and Recovery Act.
  This bill can help give communities the ability to combat the growing 
opioid epidemic in Arkansas and across the country by expanding 
prevention efforts, supporting law enforcement, combating overdoses, 
and expanding access to treatment.
  I have heard from many Arkansans who support this bill. It has the 
support of a wide range of organizations that represent law enforcement 
officials, drug treatment providers, and health care professionals. 
This speaks to the comprehensive approach we are taking to fight this 
epidemic.
  It also authorizes the Attorney General to award grants to veterans 
treatment courts. These courts are critical in helping our veterans 
break the cycle of addiction and turning their lives around.
  Prescription drug abuse is a widespread problem that impacts all ages

[[Page S1202]]

and populations of Americans. I am committed to providing Arkansas 
communities the resources they need to fight this epidemic.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.


                           Amendment No. 3345

  Mrs. SHAHEEN. Mr. President, I appreciate the comments from my 
colleague from Arkansas about the challenges of the heroin and opioid 
epidemic. I think it is really a pandemic that we are facing in too 
many States across this country. Certainly it is a huge issue in New 
Hampshire, my home State, where we have the highest percentage of 
deaths from overdoses of any State in the country.
  In a few minutes, we are going to be voting on the Comprehensive 
Addiction and Recovery Act, which is an excellent piece of legislation, 
sponsored by my colleagues Sheldon Whitehouse from Rhode Island and Amy 
Klobuchar from Minnesota, as well as my colleague from New Hampshire, 
Senator Ayotte, and Senator Portman.
  We are also going to be voting on a number of amendments, including 
an amendment that I have proposed, which is emergency supplemental 
funding to make sure that the changes we are making as a result of the 
CARA legislation actually get the resources that need to be provided in 
order to make those changes work.
  In 2014, more than 47,000 Americans died from lethal drug overdoses. 
Each day, 120 Americans die from drug overdoses in New Hampshire. We 
are losing more than a person a day from drug overdoses--three times as 
many people as we lost last year in automobile accidents. These are 
numbers we have been using a lot on the floor of the Senate in the last 
couple of days, but I think they are numbers that we need to continue 
repeating and repeating because losing 47,000 Americans from drug 
overdoses is not acceptable.
  Everywhere I go in New Hampshire, I am told one thing consistently by 
drug treatment professionals and by law enforcement, and that is, they 
need more resources and they need them now. Health workers are being 
overwhelmed. Nationwide, nearly 9 out of 10 people with substance use 
disorders don't receive treatment. They are being turned away. They are 
being denied treatment because of a chronic lack of resources.
  The amendment Senator Whitehouse and I have proposed addresses this 
problem. It provides $300 million in emergency funding for the 
Substance Abuse Prevention and Treatment Block Grant Program. This is 
funding that will save lives in our States of New Hampshire, Rhode 
Island, Arkansas, and in the Presiding Officer's home State of South 
Carolina. This is funding that will save lives in each of our States.
  Not only are health workers being overwhelmed, but law enforcement 
officials are also being overwhelmed. We need an infusion of new 
funding to mobilize additional efforts to stop opioid traffickers and 
drug dealers.
  This emergency supplemental amendment would allocate $230 million to 
the Byrne JAG Program to directly combat the opioid crisis. These are 
efforts that will keep drugs off the streets.
  In total, the Shaheen-Whitehouse amendment appropriates $600 million 
in emergency funding that will be immediately available to States and 
those working on the frontlines to address this crisis. I think that is 
why the National Governors Association, the Fraternal Order of Police, 
the American Public Health Association, the American Society of 
Addiction Medicine, the American Academy of Pain Management, the 
American College of Physicians, the National Association of State 
Alcohol and Drug Abuse Directors, and so many other groups support this 
amendment. Again, the critical point here is that this amendment funds 
key provisions of the CARA bill.
  The Comprehensive Addiction and Recovery Act is a good bill. It is 
excellent work that so many people have been involved in. The sponsors 
did great work in writing the legislation. I support it. I am a 
cosponsor. But it is an authorization bill that does not provide 
funding. So if we support making the changes in law that are included 
in the CARA bill, we should also support providing emergency funding to 
those same programs.
  To all my colleagues in this body, we know that doing the same thing 
is not working. Every year more and more people are dying from drug 
use. Congress needs to rise to this challenge, just as it has in so 
many previous public health emergencies, because, make no mistake about 
it, this is a public health emergency, and we have a history of 
providing supplemental funding to address public health emergencies. In 
2009, Congress appropriated $2 billion in emergency funding to fight 
swine flu--a bill that passed the Senate 91 to 5. Many of us who voted 
for that are still in this body. Just last year, Congress approved $5.4 
billion to combat the Ebola outbreak--an outbreak that killed just one 
person in the United States. Compare that to the 47,000 people we lost 
in 2014 to drug overdoses. Surely--surely Congress can come together 
now to fight this raging epidemic that is right here at home.
  We can't avert our eyes from the 47,000 Americans who are killed by 
lethal overdoses each year. We can't accept that 9 out of 10 Americans 
with substance use disorders don't get treatment. We can't ignore the 
fact that law enforcement officers in communities across this country 
are overwhelmed by aggressive drug traffickers and a rising tide of 
opioid-related crimes. The $600 million emergency funding in the 
amendment I am proposing will help stem the tide. It will make a 
powerful difference in communities all across America.
  CARA is important legislation. I intend to vote for it. I hope this 
body will pass it. But I urge my colleagues to also support the 
amendment that makes sure we have the urgent emergency funding to ramp 
up this fight in the months immediately ahead. Passing CARA without any 
funding is like offering a life preserver to people who are drowning 
and not putting air in that life preserver. This is a nationwide 
crisis. It is way past time we mobilized a nationwide response that is 
equal to the challenge.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Georgia.
  Mr. PERDUE. Mr. President, I know we have a vote coming. I ask 
unanimous consent to complete my remarks.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                   Filling the Supreme Court Vacancy

  Mr. PERDUE. Mr. President, I rise today to discuss why I believe the 
Senate should not hold hearings or schedule a vote on any Supreme Court 
nominee offered by President Obama until the American people choose our 
next President this November.
  The American people are reacting to our global security and debt 
crises when they go to the polls, and this upcoming election will not 
only determine the direction of our country, but it also serves as a 
referendum on the Presidency, Congress, and now the Supreme Court 
balance.
  The last 7 years have shown that this President has sought to exceed 
the constitutional bounds of the Executive office by assuming powers 
that were delegated to this body. For instance, in January of 2013 the 
President attempted to recess-appoint nominees to the National Labor 
Relations Board in direct violation of the Senate's will. Of course, 
the Supreme Court later intervened and struck down those appointments. 
As well, my colleagues across the aisle have repeatedly shown a 
willingness to aid this administration in making unprecedented power 
grabs, including employing the nuclear option for judicial nominees. 
The American people were outraged at these events, as was I.
  So while I acknowledge the President's position on insisting that the 
Senate consider a nominee, it is vital that the people get their say on 
this lifetime appointment. It is the role of the Senate to rise above 
current political theater. It is about upholding principle and not 
about the individual. The Senate simply should not consider a nominee 
at this time and let the people have their say.
  I should also point out that my position and the position of many of 
my colleagues is not a novel idea. For instance, it was then-Senator 
Obama who filibustered Justice Alito's nomination in 2006. It was then-
Senator Biden who in 1992 preemptively said that President George H.W. 
Bush should avoid a Supreme Court nomination until after that year's 
election. As chairman of

[[Page S1203]]

the Senate's Judiciary Committee, then-Senator Biden also made the same 
point we are today when he came to the floor of the Senate and made 
this quote: ``It is my view that if a Supreme Court justice resigns 
tomorrow or within the next several weeks, or resigns at the end of the 
summer, President Bush should consider following the practice of a 
majority of his predecessors and not--and not--name a nominee until 
after the November election is completed.''
  The balance of the Supreme Court is in serious jeopardy. We must 
ensure that balance remains as a check against efforts by government to 
bypass the will of the people.
  As a member of the Senate Judiciary Committee, I stand with Chairman 
Grassley and other members in saying we will not consider a nominee to 
the Supreme Court before the next President is sworn into office. We 
are already in the midst of a political campaign season, so any nominee 
will be seen through the lens of partisan politics. It is disingenuous 
for the minority party to say otherwise. And this is to the point that 
then-Senator Biden was speaking in 1992.
  As we said in our letter last week, we intend to exercise the 
constitutional power granted to the Senate under article II, section 2. 
While the President shall nominate judges to the Supreme Court, the 
power to grant or withhold consent of such nominees rests solely with 
this body.
  At a time when the stakes are so high, the American people deserve 
the opportunity to engage in a full and robust debate over the type of 
jurist they wish to decide some of the most critical issues of our time 
and for the next generation. Not since 1932 has the Senate confirmed a 
Supreme Court nominee in a Presidential election year to a vacancy 
arising in that year--not since 1932.
  It is necessary to go even further back, to 1888, to find an election 
year nominee who was both nominated and confirmed under divided 
government, as we have now. Today, the American people are presented 
with an exceedingly rare opportunity to decide the direction the Court 
will take over the next generation. The people should have this 
opportunity.
  Mr. President, I yield the floor.


                           Amendment No. 3362

  The PRESIDING OFFICER. Under the previous order, there will be 2 
minutes of debate equally divided prior to a vote in relation to 
amendment No. 3362, offered by the Senator from Iowa, Mr. Grassley.
  The PRESIDING OFFICER. Who yields time?
  The Senator from California.
  Mrs. FEINSTEIN. Mr. President, I ask unanimous consent to speak for 2 
minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mrs. FEINSTEIN. Mr. President, I wish to say a few words in support 
of amendment No. 3362, which Judiciary Committee Chairman Grassley and 
I, with Senators Cantwell and Ayotte, have cosponsored.
  This bill has passed the Senate by unanimous consent three times. It 
ensures that international drug traffickers can be prosecuted when 
there is reasonable cause to believe that their illegal drugs will be 
trafficked into our country. It also better enables the prosecution of 
manufacturers and distributors of listed precursor chemicals who know 
or intend that these chemicals will be used to manufacture illicit 
drugs destined for the United States.
  Finally, it makes a technical fix to the Counterfeit Drug Penalty 
enhancement Act of 2012 at the request of the Justice Department.
  I would like to thank Senators Grassley, Ayotte, and Cantwell for 
cosponsoring this amendment. I hope my colleagues will pass it this 
time with a vote, since it has been done by unanimous consent three 
times in the past.
  I yield the floor.
  Mr. GRASSLEY. Mr. President, I wish to speak in strong support of 
amendment No. 3362, offered by Senator Feinstein and me, the 
Transnational Drug Trafficking Act. This is a bill that she and I have 
worked on for many years.
  One of the many reasons for the ongoing heroin epidemic in this 
country is the increase in heroin supply on the streets of the United 
States.
  Mexican cartels are aggressively expanding into new territory here. 
And they are flooding our communities with cheap, pure heroin. Indeed, 
heroin seizures at the border have more than doubled since 2010. The 
U.S. Government estimates that Mexican heroin production jumped an 
incredible 62 percent from 2013 to 2014 alone.
  And the reality is that it isn't just heroin coming over the border. 
Between 2009 and 2014, U.S. Customs and Border Protection reported a 
300 percent increase in methamphetamine seizures on the southwest 
border as well.
  This bill is a natural complement to CARA. We can't arrest our way 
out of this heroin epidemic. We can try to reduce the heroin supply on 
our streets by making it easier to target these cartels for 
prosecution.
  This is in part why Senator Feinstein and I introduced this 
legislation. Our bill would make it easier for the Department of 
Justice to prosecute cartels who harm our communities from abroad by 
trafficking heroin, other drugs, and precursor chemicals for ultimate 
delivery here.
  If this amendment is adopted, prosecutors would need to prove only 
that an international drug trafficker had reasonable cause to believe 
that the illegal drugs or chemicals he manufactured or distributed 
would be unlawfully imported into the United States, as opposed to 
knowing or specifically intending that result.
  This amendment passed the Senate by unanimous consent in October. It 
also passed the Senate unanimously the past two Congresses.
  But the House still hasn't taken it up. So I ask my colleagues to 
vote for this amendment so we can send it to the House again, this time 
along with CARA.
  We need to attack the problem of opioid addiction from every angle, 
and this amendment should be part of a comprehensive approach.
  Mr. WHITEHOUSE. I yield back all time.
  The PRESIDING OFFICER. Is there objection?
  Without objection, all time is yielded back.
  The question is on agreeing to the amendment.
  Mr. GRASSLEY. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The clerk will call the roll.
  The senior assistant legislative clerk called the roll.
  Mr. PAUL (when his name was called). Present.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz), the Senator from Florida (Mr. Rubio), 
and the Senator from Alabama (Mr. Shelby).
  Mr. DURBIN. I announce that the Senator from Missouri (Mrs. 
McCaskill) and the Senator from Vermont (Mr. Sanders) are necessarily 
absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 94, nays 0, as follows:

                      [Rollcall Vote No. 28 Leg.]

                                YEAS--94

     Alexander
     Ayotte
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Boxer
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Coats
     Cochran
     Collins
     Coons
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Donnelly
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Flake
     Franken
     Gardner
     Gillibrand
     Graham
     Grassley
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kaine
     King
     Kirk
     Klobuchar
     Lankford
     Leahy
     Lee
     Manchin
     Markey
     McCain
     McConnell
     Menendez
     Merkley
     Mikulski
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Perdue
     Peters
     Portman
     Reed
     Reid
     Risch
     Roberts
     Rounds
     Sasse
     Schatz
     Schumer
     Scott
     Sessions
     Shaheen
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Vitter
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden

                        ANSWERED ``PRESENT''--1

       
     Paul
       

                             NOT VOTING--5

     Cruz
     McCaskill
     Rubio
     Sanders
     Shelby
  The PRESIDING OFFICER. Under the previous order requiring 60 votes

[[Page S1204]]

for the adoption of this amendment, the amendment is agreed to.
  Mr. GRASSLEY. Mr. President, I ask unanimous consent that the votes 
following this first vote in the series be 10 minutes in length.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


                           Amendment No. 3395

  Under the previous order, there will be 2 minutes of debate equally 
divided prior to a vote in relation to amendment No. 3395, offered by 
the Senator from Oregon Mr. Wyden.
  The Senator from Oregon.
  Mr. WYDEN. Mr. President, this amendment keeps the Toomey amendment 
on enforcement completely intact and makes two critical improvements. 
It adds prevention and treatment.
  Colleagues, this is what the Republican witness in the Finance 
Committee said is needed. It is what the Democratic witness in the 
Finance Committee said is needed. We need more prevention, better 
treatment, and tougher enforcement to work in tandem. The Toomey 
amendment is about enforcement, but we also need prevention and 
treatment. If somebody is addicted to opioids, they need a real path 
out of addiction. This amendment ensures people who need help are 
connected to meaningful treatment choices to better manage their pain 
and limit excessive prescriptions.
  My amendment also aims to end the tide of overprescribing in the 
first place. It does that by doubling the penalties for manufacturers 
that provide kickbacks to prescribers in order to boost their profits.
  I offer this with my colleagues Senator Schumer and Senator Murray. I 
very much hope we can get this amendment adopted. If we can have a 
bipartisan effort in the Senate that ensures there is tougher 
enforcement but also better treatment and better prevention to do that 
we have to vote for this amendment.
  I yield back.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, the pending amendment, No. 3395, offered by 
Senators Wyden and Schumer, would establish a new demonstration program 
within Medicare Part D to coordinate the treatment of opioid addiction. 
The proposal would also increase the penalties on drugmakers.
  According to the Congressional Budget Office, the amendment would 
increase direct spending over both the 2016 through 2020 and the 2016 
through 2025 periods. If the amendment were adopted, then the Judiciary 
Committee would exceed its spending allocation over both of these time 
periods. As a consequence of the new spending proposed, the Wyden-
Schumer amendment is a violation of section 302(f) of the Congressional 
Budget Act.
  As I said before, we all agree that the heroin and opioid abuse 
epidemic is real and has to be addressed, but I believe we ought to 
address the problem living within the confines of the budget we 
previously agreed to just last December. The underlying bipartisan bill 
provides a good framework for tackling this problem. It provides a 
comprehensive, specific, and evidence-based approach to help Americans 
combat this epidemic.
  In light of that, the pending amendment No. 3395, offered by the 
Senator from Oregon, would cause the underlying legislation to exceed 
the authorizing committee's section 302(a) allocation of new budget 
authority or outlays. Therefore, I raise a point of order against the 
measure pursuant to section 302(f) of the Congressional Budget Act of 
1974.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Mr. President, pursuant to section 904 of the 
Congressional Budget Act of 1974, I move to waive the applicable 
sections of that act for purposes of the pending amendment, and I ask 
for the yeas and nays.
  The PRESIDING OFFICER (Mr. Toomey). Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz) and the Senator from Florida (Mr. Rubio).
  Mr. DURBIN. I announce that the Senator from Missouri (Mrs. 
McCaskill) and the Senator from Vermont (Mr. Sanders) are necessarily 
absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 46, nays 50, as follows:

                      [Rollcall Vote No. 29 Leg.]

                                YEAS--46

     Ayotte
     Baldwin
     Bennet
     Blumenthal
     Booker
     Boxer
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Collins
     Coons
     Donnelly
     Durbin
     Feinstein
     Franken
     Gillibrand
     Heinrich
     Heitkamp
     Hirono
     Kaine
     King
     Klobuchar
     Leahy
     Manchin
     Markey
     Menendez
     Merkley
     Mikulski
     Murphy
     Murray
     Nelson
     Peters
     Reed
     Reid
     Schatz
     Schumer
     Shaheen
     Stabenow
     Tester
     Udall
     Warner
     Warren
     Whitehouse
     Wyden

                                NAYS--50

     Alexander
     Barrasso
     Blunt
     Boozman
     Burr
     Capito
     Cassidy
     Coats
     Cochran
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Enzi
     Ernst
     Fischer
     Flake
     Gardner
     Graham
     Grassley
     Hatch
     Heller
     Hoeven
     Inhofe
     Isakson
     Johnson
     Kirk
     Lankford
     Lee
     McCain
     McConnell
     Moran
     Murkowski
     Paul
     Perdue
     Portman
     Risch
     Roberts
     Rounds
     Sasse
     Scott
     Sessions
     Shelby
     Sullivan
     Thune
     Tillis
     Toomey
     Vitter
     Wicker

                             NOT VOTING--4

     Cruz
     McCaskill
     Rubio
     Sanders
  The PRESIDING OFFICER (Mr. Barrasso). On this vote, the yeas are 46, 
the nays are 50.
  Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected.
  The point of order is sustained and the amendment falls.


                           Amendment No. 3367

  Under the previous order, there will now be 2 minutes of debate 
equally divided prior to a vote in relation to amendment No. 3367, 
offered by the Senator from Pennsylvania, Mr. Toomey.
  The Senator from Pennsylvania.
  Mr. TOOMEY. Mr. President, this is a bipartisan, commonsense policy. 
I wish to thank my coauthors, Senators Brown, Portman, and Kaine.
  Lock-in is a tool by which beneficiaries who are abusing prescription 
opioids are locked in to a single prescriber and a single pharmacy for 
access to these powerful narcotics. It would make it difficult or 
impossible for these excessive prescriptions to continue when a patient 
is so locked in.
  It is a tool that is already used by Medicaid and private insurers. 
What our amendment would do is extend this important tool to Medicare. 
It is a policy that has been requested by the administration. It is in 
the President's budget. It has broad bipartisan support. It will help 
stop fraud, help coordinate care for seniors, and save taxpayer money.
  As Senator Wyden observed, his amendment, had it proceeded, would not 
have actually extended this tool to Medicare. The only way we can do 
that on this bill is to pass this amendment.
  I would encourage everyone's support. I think we have an agreement 
for a voice vote on this, but before we go to that, I wish to yield to 
Senator Brown for his comments.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Mr. President, I thank the Senator from Pennsylvania for 
his leadership.
  Various doctors may not realize they are prescribing duplicative 
opioid painkillers. We have done the lock-in with Medicaid. In many 
States, it has worked. This is a commonsense solution to help a 
relatively small number of people but a growing number of seniors whom 
a Medicare lock-in could assist.
  I urge support for the Toomey-Brown amendment.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. TOOMEY. Mr. President, in light of the agreement for a voice 
vote, I ask unanimous consent that the 60-vote affirmative threshold 
with respect to amendment No. 3367 be vitiated.
  The PRESIDING OFFICER. Is there objection?

[[Page S1205]]

  Without objection, it is so ordered.
  The question is on agreeing to the amendment.
  The amendment (No. 3367) was agreed to.


                           Amendment No. 3345

  The PRESIDING OFFICER. Under the previous order, there will be 2 
minutes of debate prior to a vote in relation to amendment No. 3345, 
offered by the Senator from New Hampshire, Mrs. Shaheen.
  The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, we are voting on very good legislation 
with the Comprehensive Addiction and Recovery Act. This is a way to 
expand programs that work to address what is a real pandemic of heroin 
and opioid abuse in this country. But the reality is that unless we 
provide the resources to make these programs work, it is like giving a 
drowning person a life preserver that has no air in it. It doesn't make 
a difference. We are losing 47,000 people a year--120 people a day--to 
overdoses. Our law enforcement needs additional funding. The substance 
abuse treatment folks need additional support.
  What my emergency supplemental amendment would do is to support the 
programs that are in the CARA legislation. It is about equally divided 
between support for law enforcement and support for treatment. It helps 
with prescription drug monitoring, with education, and with recovery. 
It is the kind of support we need to provide if we are really going to 
make a difference in this epidemic we are all facing.
  I urge my colleagues to not just support the underlying legislation--
that is good and we should support it, but unless we provide the 
funding, we will not have done what we need to to accomplish real 
change to keep people from dying. I urge all of my colleagues to 
support this amendment.
  Mr. GRASSLEY. Mr. President, I wish to speak in opposition to the 
Shaheen amendment No. 3345.
  Of course, the opioid crisis demands resources, and significant 
resources are being directed to it. But this amendment is political 
gamesmanship by some of my Democratic colleagues for whom the Senate's 
advancement of CARA doesn't fit their preferred political narrative.
  CARA is a bipartisan bill that addresses the clear and present public 
health crisis of heroin and prescription opioid abuse. Through the hard 
work of many on both sides of the aisle, it passed the Judiciary 
Committee unanimously. And just a few weeks later, we are considering 
it on the Senate floor. This is the Senate working in a constructive, 
bipartisan way on behalf of the American people, unlike the way it 
worked under Democrat control.
  But that is not a narrative some Democrats want the American people 
to hear. So a controversy must be manufactured to create a distraction. 
And the controversy that has been manufactured today is that CARA 
doesn't appropriate any funds for this crisis.
  CARA, of course, is an authorizing bill. It does many significant 
things that I talked about here on the floor earlier in the week. But 
it was never intended to appropriate funds.
  That is what we have the Appropriations Committee for. That is why we 
have an appropriations process. We should follow that process.
  In fact, according to the Office of National Drug Control Policy, the 
fiscal year 2016 appropriations act passed in December provides more 
than $400 million in funding specifically to address the opioid 
epidemic.
  This is an increase of more than $100 million over the previous year. 
None of that money has even been spent yet--it is available today. So 
there is simply no reason to leap ahead of the fiscal year 2017 
appropriations process.
  The reality is that this public health crisis festered while the 
Senate was in Democratic control for years. For example, heroin 
overdose deaths more than tripled from 2010 to 2014.
  And all the while, no emergency supplemental spending bill was 
brought to the floor specifically to address it. In fact, no 
authorization bill like CARA was brought to the floor either during 
those years.
  So I ask my colleagues to ignore this manufactured controversy. $400 
million is available today to combat this crisis, an increase of $100 
million. We should follow the appropriations process, which is just 
around the corner, where competing priorities and tradeoffs can be 
evaluated.
  That is the best way to ensure both that adequate resources are 
directed to this epidemic while at the same time maintaining fiscal 
discipline.
  I urge my colleagues to vote against the amendment.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. ENZI. Mr. President, the pending amendment offered by the Senator 
from New Hampshire appropriates $600 million on top of the $571 million 
provided in the bill as reported by the Judiciary Committee over the 
2016-2020 period. Unlike the underlying bill, which requires 
appropriators to provide the authorized funding within the 
discretionary spending caps, the Shaheen amendment would designate new 
spending as emergency not subject to budget enforcement.
  I am also concerned that this amendment lacks specificity in how the 
funds are allocated. For example, the bill provides $300 million to the 
Substance Abuse and Mental Health Services Administration for substance 
abuse treatment to address the heroin and opioid crisis and its 
associated health effects. While we all agree that the heroin and 
opioid abuse epidemic must be addressed, I believe the underlying 
bipartisan bill provides a better framework to tackle this problem. It 
provides a comprehensive, specific, and evidence-based approach to help 
Americans combat this epidemic.
  In the meantime, the Senate Appropriations Committee shepherds 
resources to the opioid problem in the consolidated appropriations bill 
signed into law late last year. Nearly $600 million was included to 
start down the road to helping States and communities to address this 
problem.
  The appropriators, working with our authorizers inside the framework 
of this bill, can evaluate the effectiveness of this year's spending as 
they make decisions about how much to spend and how to spend most 
effectively in upcoming years.
  Finally, last year's budget resolution conference report contained a 
deficit neutral reserve fund, spearheaded by Senator Ayotte and adopted 
unanimously by the committee, to address the opioid challenge. 
Together, Republicans and Democrats agreed that, if Congress were to 
agree on policies and funds to tackle this urgent problem, we should 
work to pay for it. The Shaheen amendment does not do that.
  Also, the Obama administration did not request opioid funding in the 
supplemental request sent just last week for emergency Zika funding.
  The PRESIDING OFFICER. The time of the Senator has expired.
  Mr. ENZI. In that case, let me say that the pending amendment, No. 
3345, offered by the Senator from New Hampshire would cause the 
aggregate level of budget authority and outlays for fiscal year 2016 as 
established in the most recently agreed to concurrent resolution on the 
budget, S. Con. Res. 11, to be exceeded; therefore, I raise a point of 
order against the amendment under section 311(a)(2)(A) of the 
Congressional Budget Act of 1974.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, do I have any time left to speak under 
the previous 2 minutes?
  The PRESIDING OFFICER. There is no time remaining.
  Mrs. SHAHEEN. Then pursuant to section 904 of the Congressional 
Budget Act of 1974 and the waiver provisions of applicable budget 
resolutions, I move to waive all applicable sections of that act and 
applicable budget resolutions for purposes of the pending amendment, 
and I ask for the yeas and nays.
  The PRESIDING OFFICER (Mr. Toomey). Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on agreeing to the motion.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Texas (Mr. Cruz) and the Senator from Florida (Mr. Rubio).
  Mr. DURBIN. I announce that the Senator from Missouri (Mrs. 
McCaskill), the Senator from Nevada (Mr. Reid), and the Senator from 
Vermont (Mr. Sanders) are necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?

[[Page S1206]]

  The yeas and nays resulted--yeas 48, nays 47, as follows:

                      [Rollcall Vote No. 30 Leg.]

                                YEAS--48

     Ayotte
     Baldwin
     Bennet
     Blumenthal
     Booker
     Boxer
     Brown
     Cantwell
     Cardin
     Carper
     Casey
     Collins
     Coons
     Donnelly
     Durbin
     Feinstein
     Franken
     Gillibrand
     Graham
     Heinrich
     Heitkamp
     Hirono
     Kaine
     King
     Kirk
     Klobuchar
     Leahy
     Manchin
     Markey
     Menendez
     Merkley
     Mikulski
     Murphy
     Murray
     Nelson
     Peters
     Portman
     Reed
     Schatz
     Schumer
     Shaheen
     Stabenow
     Tester
     Udall
     Warner
     Warren
     Whitehouse
     Wyden

                                NAYS--47

     Alexander
     Barrasso
     Blunt
     Boozman
     Burr
     Capito
     Cassidy
     Coats
     Cochran
     Corker
     Cornyn
     Cotton
     Crapo
     Daines
     Enzi
     Ernst
     Fischer
     Flake
     Gardner
     Grassley
     Hatch
     Heller
     Hoeven
     Inhofe
     Isakson
     Johnson
     Lankford
     Lee
     McCain
     McConnell
     Moran
     Murkowski
     Paul
     Perdue
     Risch
     Roberts
     Rounds
     Sasse
     Scott
     Sessions
     Shelby
     Sullivan
     Thune
     Tillis
     Toomey
     Vitter
     Wicker

                             NOT VOTING--5

     Cruz
     McCaskill
     Reid
     Rubio
     Sanders
  The PRESIDING OFFICER. On this vote, the yeas are 48, the nays are 
47.
  Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected.
  The point of order is sustained, and the amendment falls.
  The Senator from Iowa.


         Amendment No. 3374, as Modified, to Amendment No. 3378

  Mr. GRASSLEY. Mr. President, I call up Donnelly amendment No. 3374, 
as modified.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Iowa [Mr. Grassley], for Mr. Donnelly, 
     proposes an amendment numbered 3374, as modified, to 
     amendment No. 3378.

  Mr. GRASSLEY. Mr. President, I ask unanimous consent that the reading 
of the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment, as modified, is as follows:

    (Purpose: To provide follow-up services to individuals who have 
                received opioid overdose reversal drugs)

       On page 33, line 9, strike the period and insert ``, which 
     may include an outreach coordinator or team to connect 
     individuals receiving opioid overdose reversal drugs to 
     follow-up services.''.

  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that I, 
Senator Shaheen, and Senator King be recognized for a 15-minute 
colloquy.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 3345

  Mr. WHITEHOUSE. Mr. President, we rise to express our disappointment 
with what just took place. I am one of the authors of the underlying 
bill. I think it is a very good piece of legislation, but it would make 
a very significant difference if it had some funding.
  The simple fact that we have to face is this bill has no funding 
right now. I know colleagues on the other side have come to the floor 
to say there is funding--$80 million, $400 million--but in point of 
fact I must disagree with them. Let me list the points that show, I 
believe, why there is no funding to this bill at this point.
  The first is that the funding they point to was passed out of the 
Appropriations subcommittee 7 months before this bill even had its 
markup. It would have been an astonishing feat of prediction to be 
able--back then--to fund this bill now.
  If that weren't clear enough, there was a change in the bill between 
then and now. Then, if you wished to fund this bill, you would have put 
the bulk of the money through the CJS Appropriations Subcommittee 
because the bulk of this bill was written in the CJS Appropriations 
Subcommittee. We only changed it this January in response to Republican 
objections that nobody wanted to create new programs. So we rerouted 
the new programs through existing programs. That is when it became a 
Labor-HHS-dominated bill. So there is no way that last June, when this 
money came through that Appropriations subcommittee, they knew it was 
going to this.
  Moreover, if you go to the agency that is responsible for 
distributing this money, they are bidding the money out right now. They 
have a use right now for every dollar of it. If we don't pass this 
bill, they will put the money out and it will be spent. If we do pass 
this bill, they will put the money out and it will be spent. If we 
don't get the bill out soon enough, they will have to pass it out and 
get it spent under existing law. So you simply can't say with a 
straight face that this is a funded bill.
  The only way this is funded is by robbing the accounts that SAMHSA is 
now putting out now to bid to fund, in order to fund this bill. You can 
say the money will be better spent under this legislation. I think that 
is true. I support this bill. I am going to be for the bill all the way 
through, even if it is not funded, but you can't say there is funding.
  This is a very solvable problem. We have done it before. As Senator 
Shaheen pointed out on the floor, when it was the swine flu, on an 
emergency appropriations process, we appropriated $2 billion and when 
it was Ebola, $5 billion. If you say: Well, no, now something has 
changed, we can't do that, we have pay for it--Senator Manchin has a 
pay-for. A penny per milligram of opioid raises over $1 billion. You 
could do half a penny that could be contributed by the pharmaceutical 
industry that is so culpable in this predicament, in this tragedy we 
have, but, no, rather than allow this good program, this bipartisan 
program to be expedited out there, to help the people who are dying--
47,000 in 2014, the last year--what we have done is protect the 
pharmaceutical industry from having to pay any share of the solution.
  I yield to my colleagues.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I appreciate the comments from my 
colleague from Rhode Island, who is the author of the Comprehensive 
Addiction and Recovery Act. That is the underlying bill we were trying 
to amend.
  I would just point out that despite what the honorable chairman of 
the Budget Committee said, the fact is that the emergency supplemental 
funding amendment we introduced is very specific about where the 
funding goes. It goes to programs that are addressed in CARA, expanded, 
and improved; the substance abuse prevention and treatment block grants 
that go to the States to be distributed, funding the law enforcement 
through the Byrne-JAG and COPS grants that are very specific in how 
they can be used to fight heroin and opioid abuse.
  Like my colleague, I am disappointed--not surprised but disappointed. 
I very much appreciate those people who voted for this amendment, who 
were willing--particularly some of my colleagues from the other side of 
the aisle--who were willing to step forward and say, if we are going to 
address this problem, we have to provide the resources that 
communities, that States need to fight this addiction.
  The question I have for those people who didn't vote to support this 
amendment is, How many more people have to die before we are willing to 
provide the resources that are needed to fight this epidemic--47,000 
people in 2014. In New Hampshire, we are losing more than a person a 
day. In 2015, we lost over 400 people to overdose deaths from opioid 
and heroin, three times as many people as we lost in traffic accidents. 
So many communities will continue to be ravaged because we are not 
willing to commit the resources to tackle this pandemic.
  What do we tell the families of those people who have overdosed? What 
do we tell the parents of young people such as Courtney Griffin, whose 
father came and testified at a hearing Senator Ayotte and I had last 
fall in New Hampshire. He talked about the difficulties of getting 
Courtney treatment before she overdosed and died.
  I met a man at a treatment center in Lebanon, NH, a man in recovery 
who had been in and out of prison. I thought he put it very well when 
he said: You know, it costs about $35,000 a year to keep somebody in 
prison. Wouldn't it make more sense to put dollars into treatment 
because it is a whole lot less expensive to provide the funding to

[[Page S1207]]

treat people who are using opioids and heroin, who are substance 
abusers, than to put them in jail?
  To all of my colleagues, I am disappointed, but I am not defeated. 
The fact is, this is coming back. It will come back in the 
appropriations process, and it will come back at every opportunity 
because I am not going to quit on those families in New Hampshire who 
need help. I am not going to quit on the treatment professionals who 
are trying to provide treatment for the people who are in need. I am 
not going to quit on the law enforcement, the police officers, the 
sheriffs, and all of the people in law enforcement in New Hampshire who 
are trying to put pushers behind bars and trying to get people off the 
streets and into treatment.
  I hope at some point the rest of the Members of this body are willing 
to take up this cause and provide the resources people need because I 
will tell you it is certainly worth it to address the 47,000 people we 
lost. We were willing to put $5.4 billion into Ebola, and we lost one 
person in America. We were willing to put $2 billion into fighting 
swine flu, and we lost about 12,000 people in the swine flu epidemic. 
We have not been willing to put funding in to address the thousands, 
the tens of thousands of people we are losing each year in this 
country.
  So we are going to keep at it. We are going to keep fighting until we 
get the resources that families and communities need to fight this 
scourge.
  I yield to my colleague from Maine, who has been--like my colleague 
from Rhode Island--a real leader in trying to address this issue.
  The PRESIDING OFFICER. The Senator from Maine.
  Mr. KING. Mr. President, I rise in disappointment, surprise, and some 
confusion that we have this bill. We spent a week--I went to the 
Judiciary Committee. The bill came out of the committee unanimously. 
There is tremendous interest in this subject. When I have talked about 
it at home, I have said to my people in Maine, this is something we are 
going to be able to do because every Member of this body is being 
affected by this tragedy that is engulfing our country. This is 
something we are going to be able to do together and indeed we have 
done a lot together. We have a good bill. We have passed some good 
amendments. One of the President's amendments was in the bill that we 
passed this afternoon. This is important work, but it has to be 
funded--the old saying in Maine, and I suspect everywhere else, put 
your money where your mouth is.
  I was on a teleconference with some folks in Maine just 2 hours ago 
talking about this, and one of the chiefs of police said: It is time to 
move from talking about being interested in this to investing in it. We 
cannot solve this problem without money. It would be nice if we could. 
There is a drastic and dramatic shortage of treatment facilities in 
this country, and the only way we are going to be able to do it is to 
pay for it.
  We had a point of order on the budget. I have to tell you I am 
confused because I stood here less than 3 months ago when we passed the 
budget bill and $680 billion of tax extenders. Where was the point of 
order then? It wasn't funded. A dime of it wasn't funded. Maybe there 
was a point of order, but it was rejected and overwritten so fast that 
none of us noticed it. It was the speed of light.
  My mother used to say we strain at gnats and swallow camels. We 
swallowed $680 billion of entirely unfunded tax extenders, and we 
cannot solve it and bring it into our hearts to save lives for one one-
thousandth of that amount, $500 million--one one-thousandth of the 
amount that we passed in a matter of minutes last December. I am 
confused by this. I don't understand it.
  By the way, 47,000 people, that sounds like a lot, but this is what 
really sounds like a lot. Since this debate started at 2 o'clock this 
afternoon, 10 people have died; 10 people have died in the last 2 
hours; 47,000 people is 5 people every hour, 24 hours a day, 365 days 
of the year. We are not talking about abstractions here, we are talking 
about people's lives. We are talking about what I consider one of the 
most serious problems I have ever seen in my State. We talk about 
Ebola. We talk about ISIS. We talk about all of these challenges we 
have. Yet this is something that is killing five people an hour, and we 
are not willing to put the funds in to do it. It is a false promise.
  I believe this bill is going to do a lot of good, but it is not going 
to meet the promise we are making to the American people by all of this 
drama this week about drug abuse and that we are going to do something 
about it. We are not going to do enough about it because in order to 
deal with this problem--and this is true everywhere--it is going to 
take money to provide treatment for people who need it.
  As I talked about this morning, the tragedy is when someone is ready 
to change their life and ready to try to defeat this awful disease--and 
they cannot find any place to give them treatment. I was at a detox 
center in Portland just last week. They are turning away 100 people a 
month from a detox center--not even a treatment center but a detox 
center--because they do not have the beds.

  I am delighted we are working on this bill. I am delighted we are 
passing it. I think there is a lot of good in it, and it is, in fact, a 
bipartisan bill. But to venture up to the edge of this problem and then 
step away because we are not willing to pay for what, in my mind, is 
one of the most serious emergencies we have faced since I have been in 
public life is disappointing, surprising, and it is a great missed 
opportunity for the country.
  I join my colleagues in regretting the decision that was just made. I 
think it was an opportunity where we could have spoken as one to 
realistically attack this scourge that is devastating our people. We 
are losing lives, we are squandering treasure, and we are breaking 
hearts. The only way we are going to be able to solve this problem or 
at least make a dent in it is to provide the wherewithal to the 
programs throughout the country that are struggling manfully and 
mightily to confront the problem and defeat it.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Gardner). The Senator from Ohio.
  Mr. PORTMAN. Mr. President, I thank my colleague from Nevada for 
yielding to me to speak for a moment in response to the comments made 
by my colleagues about the legislation before us, which is legislation 
to address the horrible problem we have in all our States of the 
addictions caused by heroin and prescription drugs. About 100 people 
will die today from overdoses, and that is just the tip of the iceberg 
because there are so many other people whose lives are being ruined, 
families being torn apart, and communities being devastated.
  Senator Whitehouse, other Members of this body, and I drafted this 
legislation over the period of the last few years, including five 
summits we had in this Congress to bring in experts from all over the 
country on prevention, education, treatment, and recovery--dealing with 
the law enforcement side and the importance of having Narcan available 
and also helping to get prescription drugs off bathroom shelves and 
ensure we had drug-monitoring programs. It is a comprehensive approach.
  I will say I disagree a little with my coauthor, my colleague from 
Rhode Island, in saying that if we could pass this bill, there would be 
no funding for it somehow. There was a huge increase in funding, as 
everyone knows, at the end of the year for opioids. Senator Whitehouse, 
others, and I approached the appropriators and asked them to be sure 
that funding was consistent with where we were on CARA at that time--in 
the middle of the Judiciary Committee. When we had some jurisdictional 
issues, we worked hard to draft the legislation so that if we could get 
it enacted this fiscal year--that is between now and September 30--
there would be funding to help us accomplish what is in the 
legislation.
  However, as my colleagues know, this bill is an authorization bill. 
What does that mean? It means it is a bill that directs how funding 
will be spent. It is not a spending bill.
  Having said all that, as Senator Shaheen knows, I supported her 
efforts to add additional resources over and above what could be spent 
this year on CARA because I believe this is such an urgent problem, and 
I believe it does rise to the level of being an emergency. That is 
saying a lot. I am a fiscal conservative. But that means it is not paid 
for by offsetting other programs. It is

[[Page S1208]]

just additional funding because it is such an urgent need.
  We have done this on other occasions with health care emergencies 
when we have had something like the Ebola crisis. Well, I think this is 
a crisis too, so I voted with Senator Shaheen today. I am a cosponsor 
of her amendment. I support it, but I don't support the efforts of some 
who say somehow there is no money in here. This is an authorization 
bill. This is the first step toward getting the money, not just this 
year but into the future. That is the point.
  Back in the House, I was the author of the Drug-Free Communities Act. 
Some 19 years later, $1.3 billion has been spent in support of the 
Drug-Free Communities Act, helping to create over 2,000 community 
coalitions, including in just about every State represented in this 
body. Was that a spending bill? No. It was like this--an authorization 
bill to direct the spending based on a lot of research and effort, 
evidence-based practices we know would work. That is what this is. This 
is taking it to the next level.
  Specifically directed to the points my good friend from Maine just 
mentioned about treatment centers being filled and detox centers not 
having room for someone to go to get the detox and then get into 
treatment, these are real problems in our communities now. That is what 
this legislation is meant to address, not just by appropriations for 1 
year but by changing the law for the future.
  If we do this, and do it right, in another 19 years in this 
legislation, we will spend even more than we spent on the Drug-Free 
Communities Act. It will be well over $2 billion that will have been 
spent that would otherwise not have gone out because of this 
legislation. So just as Senator Whitehouse said that he strongly 
supports this bill because it is evidence based, because we spent the 
right time putting the effort into making sure it would be money well 
spent, this bill is really important.
  I appreciate the support of my colleagues--Senators Shaheen, King, 
and Whitehouse. Senator Whitehouse and I have been at this for a few 
years together. It is the right thing to do for our country at a time 
when we do face a crisis.
  Again, I will support the additional spending because I think this is 
so critical. But let's not go forward with this sense that somehow this 
doesn't matter. This does matter in a very big way. This is a necessary 
first step. And in terms of this year, because we increased funding 
dramatically at the end of the year for this fiscal year--not one penny 
of that has been outlaid, by the way; it has been appropriated but 
there has been no outlay yet--I believe anything we could get done this 
year--getting it through the House, getting it through the Senate, and 
the President signing it--would be funding we could use for these 
important CARA programs just in the 7 months of this fiscal year.
  Certainly we should right now--as I have done and I know Senator 
Whitehouse is doing and others are doing--go to the Committee on 
Appropriations and say: With regard to next fiscal year, let's be sure 
that we have the entire bill funded. And again, I would support even 
additional funding beyond that. But at a minimum, let's get this done. 
This is an opportunity on a bipartisan basis to actually get something 
done to help people who are crying out for our help. Communities need 
our help. Families that are being broken apart need our help.
  I appreciate the fact Senator Shaheen made her best effort today. She 
was right, in my view, but let's also continue to work together to get 
this legislation passed with whatever funding we can add to it. That is 
great with me, but let's get this bill passed to ensure that going into 
the future we are directing this funding effectively and increasing 
this funding to help those who need it most.
  Again, I appreciate my colleague from Nevada, and I am sorry to take 
so much of his time.
  I yield the floor.
  Mr. WHITEHOUSE. Mr. President, if I can have 1 minute before the 
Senator departs.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. WHITEHOUSE. I thank the Chair.
  I would like to end this conversation on a happy note, after what I 
consider to be a very unhappy vote, and that is to express my 
appreciation to Senator Portman for his collegiality and his work over 
many years to get this bill to where it is now in the Senate. I express 
my appreciation to him for voting for the amendment of Senator Shaheen. 
I express my appreciation to him for publicly pledging to work as hard 
as we can together to get funding for this bill into the appropriations 
process that is underway right now.
  I look forward to working with him on all those endeavors. I do 
believe that we missed a big opportunity, because Senator Shaheen's 
bill, had it passed, would have flooded a lot more money, a lot faster, 
into the solution of this problem.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Nevada.
  Mr. HELLER. Mr. President, I want to thank my colleagues on both 
sides of the aisle on this particular piece of legislation. I know 
there is a lot of passion behind this, and there should be, and I do 
believe at the end of the day there will be an appropriate 
authorization and spending level so we can get this bill passed, which 
is something I support.
  I also want to thank Chairman Grassley, Ranking Member Leahy, and all 
those who have been involved in this particular topic of bringing 
opioid abuse to the forefront. Opioid abuse is an issue every Member of 
the Senate hears about when they go home. For many Nevadans, substance 
abuse is an issue that hits close. It is an issue I read about in 
constituents' letters and hear in far too many calls that come in to my 
office on this issue.
  Like many of my colleagues, I have heard from those who are 
struggling with addiction or who have lost a loved one to this 
epidemic. In my home State of Nevada, there were 545 drug overdose 
deaths in 2014 alone. I have heard countless stories from young 
Nevadans who have experienced addiction themselves or seen their 
friends slip into this scary spiral of abuse.
  I recently met a young man from Reno who was advocating on behalf of 
multiple friends whom he had lost to heroin overdose. He said it 
started with experimenting with leftover painkillers in his friend's 
parents' medicine cabinet. Eventually, the pills were gone, and the 
group of friends started experimenting with harder and cheaper drugs. 
Some of their friends fell into the juvenile court system after being 
caught with illegal drugs.
  Unfortunately, the court system wasn't equipped to adequately treat 
their addiction. They slipped back into their old habits, and the young 
man from Reno has now gone to multiple funerals.
  I am glad he had the courage to tell his friends' stories. Opioid 
abuse and addiction has stolen the lives of far too many Nevadans, and 
it is time we do something about it.
  I know my colleagues also hear the same stories in their offices on a 
daily basis. In 2014, opioids were involved in almost 30,000 American 
deaths. That means more Americans now die each year from drug overdoses 
than they do from car crashes.
  The unfortunate reality of opioid abuse has become a major public 
health concern, and something needs to be done. We know this epidemic 
hits all ages, all socioeconomic levels, all races, and all genders.
  Opioid use often starts with treating legitimate pain needs. There 
are two groups of Nevadans that are extremely important, and I have 
focused my efforts today on these two very important populations: our 
veterans and our seniors.
  First, I have two amendments that improve access to treatment for our 
Nation's veterans. My first amendment, Heller amendment No. 3346, would 
include veterans service organizations in the Pain Management Best 
Practices Interagency Task Force. Giving VSOs a seat at the table on 
this task force will help us better understand the unique circumstances 
our Nation's veterans face that drive them to use opioids in the first 
place.
  My second amendment, Heller amendment No. 3351, would allow veterans 
nonprofit organizations to be eligible for grants from the Building 
Communities of Recovery program. The Building Communities of Recovery 
program is designed to pool community resources to help those affected 
by

[[Page S1209]]

opioid abuse seek the proper treatment to recover from these highly 
addictive pain medications and avoid slipping into a cycle of chronic 
drug abuse.
  Including veterans nonprofit organizations in this grant program will 
allow places like Veterans Village in Las Vegas to access more 
resources to treat the servicemen and -women in our State. As a member 
of the Senate Veterans' Affairs Committee, I am concerned about how 
opioid abuse impacts America's heroes. Some of these veterans are in 
severe pain due to the injuries they sustained during service to our 
Nation, and numerous veterans have reached out to my office for help 
when the VA's policies are negatively impacting them.
  As we debate the Comprehensive Addiction and Recovery Act, it is 
critical for Congress to ensure VSOs have a voice. These organizations 
understand the unique challenges veterans face with opioids and how to 
resolve these issues. That is why I have filed two amendments to allow 
this important stakeholder to come to the table and help reduce opioid 
abuse.
  I encourage my colleagues to accept these amendments, and I would 
like to continue to work with the bill managers as we find a path 
forward on them.
  The senior population is another group of Nevadans that face unique 
circumstances on how they become dependent on opioids. They are 
prescribed opioids to cope with chronic pain and discomfort after 
surgery and, obviously, rightfully so. In fact, about 40 percent of 
Nevada's seniors are on some type of opioid, but opioids have qualities 
that make them highly addictive and prone to abuse.
  Pain is a highly complex issue, and there are many barriers to pain 
management. Just recently I had a constituent reach out to my office 
because they were being denied access to a lifesaving opioid pain 
medication for a very rare and serious condition. Fortunately, we were 
able to help resolve the situation, but it was disappointing that this 
Nevadan had to go to such extremes to receive the treatment they 
deserved.
  No doubt Congress should play a role in addressing opioid addiction 
and this epidemic, and I think there are ways to accomplish this goal 
while ensuring that seniors in Nevada and throughout the United States 
continue to receive the care they need. One of those ways is to 
permanently repeal the Medicare caps on therapy services. Right now, 
current law places an annual per-beneficiary payment limit of $1,880 
for all outpatient therapy services.
  I firmly believe that if patients had better access to physical 
therapy, they would not be as dependent on highly addictive pain 
medication. Seniors would also have a higher quality of life by 
treating the sources of the pain and rebuilding their strength. With 
proper access to care, seniors will be able to enjoy a happy and 
healthy retirement rather than cope with the pain through highly 
addictive medication that only masks their discomfort.
  Senator Cardin and I have been working on a responsible alternative 
to the Medicare's therapy cap. I believe more work needs to be done to 
ensure that these proposals will solve the problem and ensure that 
these seniors have access to the therapies and treatments they need.
  Right now, the cap has been lifted until March of 2017. We have until 
early next year to come up with a permanent solution to the therapy cap 
issue, and I have no doubt that Senator Cardin and I will be able to 
deliver results for seniors across this country.
  The American people want us to put partisan politics aside and come 
up with solutions to the problems we see every day. CARA is an example 
that Congress can, and should, come together to solve these problems. 
The epidemic of opioid abuse has reached a serious point in our debate. 
I believe the Comprehensive Addiction and Recovery Act is a step in the 
right direction.
  I encourage my colleagues to pass this important legislation, and I 
am hopeful that we can do it this week, showing Nevadans and all 
Americans that we are serious about addressing this problem.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Ms. KLOBUCHAR. Mr. President, I rise today to talk about the Supreme 
Court vacancy for the second time on the floor, but I did want to thank 
the cosponsors of our bill, Senator Portman, Senator Whitehouse, and 
Senator Ayotte, and also Senator Shaheen for her strong amendment that 
I think would have made such a difference if we could get some 
immediate emergency funding.
  As we know, there are other important provisions in this bill, 
especially the work I am focused on with prescription drug monitoring, 
the simple idea that when I talk to doctors, they are never sure if 
this is someone who is actually abusing the system. They want to do 
well. They have been trained to do well to get people out of pain. But 
so often there is not a lot of monitoring about what is going on. And 
this is going to help get the States to start doing their work. I again 
thank Senators Whitehouse, Portman, Ayotte, and Shaheen for their work 
on this bill.


                   filling the supreme court vacancy

  Mr. President, I come today to talk about the Supreme Court.
  Last Wednesday, I led a meeting of the steering and outreach 
committee on the Supreme Court and the Senate's constitutional 
responsibilities. We had the opportunity at that meeting to hear from 
four distinguished law professors on the constitutional implications of 
the current vacancy and to put some historical and constitutional 
context about the choice before us. I would like to share some of the 
insights with my colleagues.
  First of all, Jamal Greene, a professor of law at Columbia Law 
School, looked to the original intent of the Framers of the 
Constitution, noting that ``the Framers did not contemplate the use of 
the Senate's advice and consent power solely to run out the clock on a 
presidential appointment. As [Alexander] Hamilton speculated in 
Federalist 76, rejection of a nominee `could only be to make place for 
another nomination by [the President].' ''
  The critical point made by Professor Greene, which was echoed by the 
rest of the panel, is that inaction is not an appropriate response when 
the Constitution says that the President shall nominate and that the 
Senate has a duty to advise and consent. In fact, Professor Gerhardt 
from the University of North Carolina at Chapel Hill noted that the 
only time Members truly abandoned their constitutional duties and left 
this position open was during the Civil War. Think about that. Senators 
before us in this great Chamber--even before we had this Chamber, when 
they were meeting in other places. We have been through World War I, we 
have been through World War II, we have been through the Vietnam war, 
we have been through civil rights tumult, and always the position was 
filled and not left vacant for that year time period. We have to go 
back to the Civil War.
  Another common theme we heard from all of the panelists is that the 
proposed inaction by our colleagues on the other side of the aisle is 
without precedent in our Nation's history. In the last 135 years, no 
President has been refused a vote on a nominee for an open seat on the 
Court. The Senate has confirmed more than a dozen Supreme Court 
Justices in Presidential election years, including five in the last 100 
years. So it is not as if we have to go way back in time; five of them 
were in the last 100 years. Probably the most oft-cited example is the 
example of President Reagan nominating Justice Kennedy in his last few 
years in the White House. He nominated Justice Kennedy, and a 
Democratic Senate confirmed--not just confirmed but confirmed 
unanimously.
  Another member of the panel was Professor Jeff Stone. He is a 
professor at the University of Chicago Law School--actually, my 
professor, my evidence professor. I always enjoy asking my professors 
questions now that I am a Senator as opposed to when they used to ask 
questions of me. He was, of course, a former colleague of Justice 
Scalia's. In fact, when Justice Scalia left the University of Chicago 
to be appointed to the bench, he actually gave his papers and all of 
his notes to Professor Stone. While they had some different political 
views, without a doubt, he had admiration for Professor Stone and 
Professor Stone had admiration for Justice Scalia, as he has written 
about since his death.

[[Page S1210]]

  After reviewing the history of Supreme Court nominations, Professor 
Stone concluded:

       Despite all the fuss and fury over the Supreme Court 
     confirmation process, the plain and simple fact is that the 
     Senate always defers to the president as long as the 
     president puts forth nominees who are clearly qualified and 
     who are reasonably moderate in their views. And this is true 
     even when the Senate is controlled by the opposing party. In 
     short, nominees who are both qualified and moderate are 
     confirmed. Period.

  I think he was using as an example--we know there have been nominees 
who have been turned down by the Senate in past, including in the 
recent past, but the point is, they got a hearing and they got an up-
or-down vote. There are cases where people withdrew their names. There 
are cases where the up-or-down vote was not in their favor. But they 
always were moved forward.
  Although we have been accustomed to a certain level of partisanship 
in Congress, Professor Stone pointed out that the nomination process 
for Supreme Court Justices has remained in large part a bipartisan 
process. Again, people may vote differently, but as a member of the 
Judiciary Committee and a relatively new member in confirmation 
processes for both Justice Kagan and Justice Sotomayor, those hearings 
were very civil. At the time, Senator Sessions was the ranking member 
and Senator Leahy was the chair. At those hearings, people asked the 
questions they wanted to. They went on for a number of days. Then we 
had a final vote, and then we came to the Senate and all was done. As 
we know, among the Justices currently serving, the longest time from 
the nomination to the confirmation was actually 99 days; that was 
Justice Thomas.

  So we have always had a process that has worked. And while the result 
has, sadly, become more partisan--although there have been a number of 
Republicans who voted for the recent nominees, it has been more 
partisan over time. When we look at the unanimous vote Justice Kennedy 
got, the process itself worked, and that is very important to the 
functioning of the Senate.
  The fact is, we may have a very difficult atmosphere around us 
politically and sometimes right here in this Chamber, but we have tried 
to keep our dignity and move forward with our processes, and we find 
ways to work together and we treat each other with respect. For me, 
that is a lot about what this is about, this process for a nominee. 
Yes, it is about what the Constitution says. Yes, it is about 
respecting history. Yes, it is about not leaving a vacancy on the third 
pillar of our government when, in fact, our only job as Senators is not 
to determine what happens in those cases or what the individual 
decisions are, but it is to fund that Court and make sure that 
vacancies are filled in our advice and consent function. But it often 
goes beyond all of that for me. It is about how we function as a body, 
that we keep to our processes, that we move legislation, that we move 
nominees, and that we respect our traditions, we respect the Senate, 
and we respect each other.
  Looking beyond the constitutional duties of the Senate and the 
historical precedent of the Senate considering Supreme Court nominees, 
we have had the opportunity to hear from our panel, as I mentioned, as 
well as from a number of others, about the importance of filling a 
vacancy on the Supreme Court.
  Professor Greene, whom I mentioned before, and others noted that this 
inaction could leave the Court for two full terms without the ability 
to resolve closely contested cases. They don't get the easy cases on 
the Supreme Court. That is not why they are there. That is not why they 
are called the Supreme Court. They get the tough cases. They get the 
cases in the gray area. When the lower courts are in disagreement and 
can't figure out what to do, they are the decisionmaker.
  Professor Greene went on to say in our panel: ``The Supreme Court has 
multiple responsibilities, but one of its main, core functions is to 
resolve those disagreements [among the lower courts], and [this 
vacancy] leaves the law in a state of uncertainty.''
  The people of this country have enough uncertainty to deal with. Of 
course, because of our democratic functions, we do not know who our 
next President will be. There is a lot of blame and a lot of finger-
pointing going on throughout our political system right now. There is a 
lot of uncertainty. There is uncertainty with the way our laws have 
worked. But one of our jobs is to put some certainty in people's lives. 
We did that with the budget at the end of last year. We did that with 
the Transportation bill last year. We did that with a number of pieces 
of legislation that were passed on a bipartisan basis. Now it is our 
job to not leave the entire legal system in a state of uncertainty.
  Former Justice Sandra Day O'Connor has also spoken out. When asked 
about Republicans seeking to wait a year until considering a nominee, 
she said: ``I don't agree. I think we need somebody there to do the job 
now and let's get on with it.''
  In fact, former President Ronald Reagan, who nominated Justice 
O'Connor to the Supreme Court, said in 1987: ``Every day that passes 
with a Supreme Court below full strength impairs the people's business 
in that crucially important body.''
  He made that statement around the same time he nominated Justice 
Kennedy, who was confirmed, as I noted, unanimously by a Senate 
controlled by the opposite party in the last year of a Presidency. That 
is our closest and most recent example--confirmed in the last year of 
the Reagan Presidency by a Democratic Senate, with a Republican 
President.
  We now have a Democratic President who is not running for President 
again--he can't--who is in the last year of his Presidency, with a 
Republican Senate.
  The critical importance of filling this seat is clear, and it is not 
something we can wait on for over a year. Not since the Civil War have 
we had a vacancy for over a year. And, may I add, there is plenty of 
time for the Senate to consider and confirm the nominee. Is it 
convenient? No, it is not convenient. There is a lot going on. It is an 
election year. Things happen. Unexpectedly, Justice Scalia died. And 
many people who knew him well, such as my law professor in Chicago, 
miss him. But he died, and that triggered a duty on the part of the 
President and on our part.
  The Senate has taken an average of only 67 days--about 2 months--from 
the date of the nomination to the confirmation vote since 1975. This 
means that if the President offers a nomination this month, that 
nominee should receive a vote in the Senate by Memorial Day. If for 
some reason that doesn't happen and the hearings take longer than we 
think, I would put one other day forth: We could finish this by the 
Fourth of July. For those who love the Constitution, that is certainly 
a good holiday and end date.
  Looking at the text of the Constitution, the precedent of the Senate, 
and the importance of the circumstances, the matter is clear: It is the 
duty of the Senate to thoughtfully consider the President's nominee to 
the Supreme Court, and anything less than that disregards our oaths of 
office.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida.
  Mr. NELSON. Mr. President, I wish to associate my remarks with the 
Senator from Minnesota and just say that what the Constitution says is 
so clear. It says that the President shall--not may--it says shall 
nominate and then the Senate will advise and consent. That is clear. 
The President is going to nominate. So are we going to wait around for 
a whole year without giving our advice and/or consent? In other words, 
just do your job. So I thank the Senator for her comments.


                             Takata Airbags

  Mr. President, I have a very touchy subject to talk about again--the 
ongoing Takata airbag fiasco. It is now a recall fiasco. To this point, 
some 26 million of these airbags that are in the center of the steering 
column that we drive around with right in front of us or in front of 
the passenger's seat or on the sides, side airbags--some 26 million of 
them have already been recalled.
  A little over a week ago, I spoke about this continuing customer 
confusion over this recall fiasco. For the sake of the safety of our 
American consumers who happen to be drivers in these vehicles with 
these Takata airbags, we need to end this confusion. I think the 
process has to begin with having the National Highway Traffic Safety 
Administration, or NHTSA,

[[Page S1211]]

take a hard look at whether they need to start the process of recalling 
all Takata airbags with ammonium nitrate-based inflaters.
  Ammonium nitrate seems to be the problem. It is a chemical compound 
that is ignited when you have a collision. Within less than a second, 
it inflates with gases. This is the airbag that is supposed to save our 
lives. But what is supposed to save lives has been killing lives 
because the explosive force is so great that it starts to shred the 
metal housing. That is sending pieces of shrapnel right into the driver 
or into the passenger.
  Last week, I showed the Senate one of these airbags, and then I 
showed them a piece of metal that became, in effect, shrapnel, like a 
grenade, only this piece was that big and it had killed a lady in 
Orlando, FL. As a matter of fact, when the police got to the 
intersection where she had a collision and the airbag deployed and they 
got there and found her in the car, they thought it was a murder 
because her neck had been slashed. But, in fact, it was this airbag, 
exploding with such force that it shredded the metal. In this case, it 
was a piece that big.
  On February 10, I sent a letter to the NHTSA Administrator, Mark 
Rosekind, asking him to do two things. First, I asked him to use his 
authority to phase out the production of the new Takata ammonium 
nitrate-based airbag inflaters as soon as possible. With all that we 
know about these things, this ammonium nitrate should not be used as 
replacement for the old Takata inflaters, and it certainly shouldn't be 
used in the new cars that are produced and sold to consumers.
  Second, in this letter, I asked him to seriously consider a total 
recall of all Takata ammonium nitrate-based inflaters that are 
currently in vehicles. My goodness, that is a big number. That is 
potentially another 90 million units in this country alone. That could 
be as much as 260 million worldwide. But with all the manipulation of 
data and the serious safety lapses that our staff on the Senate 
Commerce Committee has detailed in two separate reports, I think it is 
something that we should seriously look at. Potentially, it is a big 
number of recalls of this ammonium nitrate-based inflater that is 
currently in vehicles.
  I want to say that I supported Administrator Rosekind's nomination, 
and I think he has done a number of things to try to improve NHTSA. But 
I was not too pleased with his written response to my letter that I 
received from him on February 26, just a few days ago. In my letter, I 
asked him to provide me with the total number of inflaters that Takata 
could supply under existing contracts with automakers. He didn't supply 
that.
  Will Takata continue to produce millions of these things? We don't 
know. We don't know the answer.
  Are consumers today basically getting a newer version of the old 
version that has been so defective? No answer to that either. In other 
words, are we going to replace an old live grenade with a new live 
grenade?
  In the letter, I also asked the Administrator to consider an 
accelerated phaseout of the production of new Takata ammonium nitrate-
based inflaters. In his letter, he declined.
  As to the request for NHTSA to look at a larger recall of Takata 
ammonium nitrate-based airbags, Administrator Rosekind declined to call 
for a larger recall. He based that statement on the fact that most of 
the Takata airbags that have not been recalled contain something called 
desiccant, which removes the moisture and is supposed to stabilize the 
ammonium nitrate in the inflaters.
  That desiccant is there because moisture is considered to be the 
culprit that causes the ammonium nitrate to be defective in its 
explosion. So desiccant is supposed to remove that moisture, and it is 
supposed to stabilize the ammonium nitrate.
  The exact quote in his letter is this: ``In fact, to date, NHTSA is 
unaware of any inflator rupture, in testing or in the field, of a 
Takata inflator using chemical desiccant to counteract the effects of 
moisture.''
  He says that NHTSA is unaware of any inflater rupture using the 
chemical desiccant.
  That statement is not true. On October 15 of last year, General 
Motors recalled about 400 vehicles for Takata side airbags with the 
chemical desiccant. Fortunately, in that testing, nobody was injured. 
But that wasn't correct information given to the Commerce Committee, 
and NHTSA finally admitted their error to our staff on Monday of this 
week.
  Why didn't NHTSA seem to know about it beforehand? This really raises 
serious questions when a regulator doesn't even seem to know about its 
own data. NHTSA had that data. As a result, it continues to raise 
questions about who is really in control of this recall. Is it who 
ought to be, NHTSA, or is it the manufacturer of the defective airbag, 
Takata?
  Deaths and serious injuries have occurred as a result of these 
defective airbags. They have been in Florida, but they have been in 
many other places. The last one was in the Carolinas in December, and a 
Ford driver is dead as a result of it.
  I can tell you that this Senator and many of the members of the 
Senate Commerce Committee are not going to sit quietly and wait for 
this to get sorted out in good time. Lives are at stake. We are going 
to keep pushing until all consumers who have vehicles with Takata 
airbags get answers and get help.
  I wish I didn't have to bring this to the Senate floor, but in the 
safety and sake of consumers we have to.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Ms. HIRONO. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                  Whole Woman's Health v. Hellerstedt

  Ms. HIRONO. Mr. President, I rise to speak on the Texas case that was 
heard by the U.S. Supreme Court, Whole Woman's Health. This morning, I 
joined hundreds of pro-choice advocates on the steps of the Supreme 
Court in advance of the oral arguments. They came from all parts of the 
country with signs such as ``Don't mess with access'' and ``Respect my 
fundamental human dignity.''
  The lead-up to this case was a Texas law, HB2, which imposes 
unnecessary medical requirements on the State's clinics that provide 
abortion services.
  According to the American Medical Association and the American 
College of Obstetricians and Gynecologists, these requirements are not 
necessary to protect the health of women seeking these services. 
Rather, these onerous restrictions, known as targeted regulation of 
abortion providers, or TRAP laws, have only one purpose--to deny 
abortion services to women.
  Three-quarters of clinics in Texas will close if this law is upheld, 
leaving nearly a million women without adequate access to reproductive 
services. By making the false claim that restrictions like those passed 
in Texas will actually protect women's health, opponents of abortion 
hope to conceal their true agenda, which is putting an end to abortion 
and women's reproductive choices.
  The Texas law is just one more example of a litany of legislation and 
other attempts to limit a woman's constitutionally protected right to 
choose. Attacks on reproductive rights, such as misleading undercover 
videos, violence at clinics, and numerous attempts in Congress to roll 
back progress on women's health care continued in 2015.
  Since Roe v. Wade was decided, State legislatures have passed 
hundreds of laws to chip away at a woman's right to choose. In the last 
4 years alone, States have passed 231 anti-choice laws. Among the most 
invasive are those requiring ultrasounds of women seeking abortion 
care, and some of the most ill-conceived laws require providers to give 
medically unsound information to scare women seeking abortion care. 
Laws that are not based on medical science and opposed by medical 
practitioners do not protect a woman's health. No matter how loudly or 
how often these arguments--or these claims--are repeated, they are 
lies. Lies repeated do not become truths.
  While these restrictive laws impact all women, they impact minority 
and lower income women most. For example, the Texas law will result in 
the closure of more and more provider clinics. Women in Texas will have 
to travel farther and farther to get to open clinics. Women who have 
limited resources

[[Page S1212]]

to travel for needed services or cannot afford to take time from work 
to travel these long distances are the most negatively impacted by TRAP 
laws.
  Why do women need to be protected from being able to access the 
reproductive services they need and choose? Fundamentally, what is the 
point of a constitutional right if one is unable to exercise that 
right? I cannot think of any other constitutionally protected right 
that has seen so many restrictions placed upon it, except perhaps the 
right to vote, but that is a subject for another speech.
  It is more than ironic that while many of our anti-choice colleagues 
vehemently speak out in support of constitutional rights, when it comes 
to women's bodies and reproductive choice, they are all too willing to 
set aside their constitutional principles to invade those fundamental 
rights. Neither Congress nor the States have a right to do that.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. ISAKSON. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ISAKSON. Mr. President, I ask unanimous consent to address the 
Senate as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                   Filling the Supreme Court Vacancy

  Mr. ISAKSON. Mr. President, I am not a lawyer. I am a politician. I 
was a businessman before I was elected to the Senate. I watched with 
interest the debates since the death of Antonin Scalia about what the 
Senate and country should do in terms of filling its vacancy, in terms 
of its timing.
  The Constitution tells us what to do. The Constitution tells us that 
the President shall make an appointment, or a nomination, to fill that 
vacancy and the Senate shall offer its advice and consent. There is no 
deadline or trigger date. There are no other rules or guidelines.
  There have been a lot of historic debates on both sides of the aisle 
over whether or not a nomination for a Supreme Court justice should be 
named in the last year of a Presidency. Interestingly enough, if you 
read the history, sometimes it is the Republicans saying they shouldn't 
do it and sometimes it is the Democrats. In fact, if you really go back 
and look, we have all said the same thing. It would just depend on 
whose ox was getting gored in the politics of a particular day.
  I love Joe Biden. He is a personal friend of mine and a great Vice 
President of the United States. I served with him in the Senate and on 
the Foreign Relations Committee, which the Presiding Officer serves on 
today.
  I did a little research on what Joe had to say because I appreciate 
his wisdom. In the last year of the Bush administration--H. W. Bush--in 
1992 on June 25, then-Senator Biden made two statements, and I would 
like to share those statements. The first is the following:

       [I]t would be our pragmatic conclusion that once the 
     political season is under way, and it is, action on a Supreme 
     Court nomination must be put off until after the election 
     campaign is over. That is what is fair to the nominee and is 
     central to the process. Otherwise, it seems to me, we will be 
     in deep trouble as an institution.

  Let's take that quote and apply it to the current contemporary time 
we are in today. We are in a politically unknown territory. Yesterday 
was Super Tuesday, and 15 States went to the polls. We had newcomers 
getting the most votes, and we had old-timers getting the most in one 
primary. We have women getting votes. We have men getting votes. We 
have conservatives and we have liberals. We don't know who our 
President is going to be or what party he or she will be from. But we 
do know that when they are elected and sworn in January of next year, 
they will be the President of the United States most contemporarily 
appointed and elected by the people of the United States of America.
  The Supreme Court is the ultimate arbitrator of what the executive 
and legislative branches do. It is only appropriate that the Supreme 
Court majority, as it is cast, be made up of nine people, five of whom 
are in the majority, who were appointed freely and without political 
influence, judged for their best political and legal acumen and in the 
best interest of the country.
  I don't think going to the current President, Mr. Obama, who is in 
the last year of his term, and getting him to make an appointment that 
will only last a few months of his last year in office is the right way 
to go.
  I think we need to say the following: The President of the United 
States who is elected this November and sworn in next January will be 
the President of all the people most contemporarily voted by the people 
of America. That is the President who should make the nomination, and 
that is the Senate that should make the confirmation.
  I urge my colleagues who argued about going ahead and moving 
forthrightly and quickly on filling Antonin Scalia's seat to think 
about this. Next year the Senate will be a new Senate. It won't be this 
Senate. Many of us are up for reelection. I may not be here. I don't 
know who will be here. I am trying. I don't know who will be here. I 
want to get here, but I don't know if I will be here.
  We don't know who the President will be. Each of us, Republicans and 
Democrats, have our pick. We hope it is our President. We hope it is 
the man or woman we want, but we don't know that. But we do know that 
on the first Tuesday in November, we will elect a new President. In 
January, that President will be sworn in, and it will be his or her 
opportunity, if we wait, to make the nomination for whomever will fill 
Antonin Scalia's place. It will be the new Senate's place to confirm 
that nomination. The Senators who are elected will be the ones most 
recently elected to the Senate, and the President who is elected will 
be the most recently elected President of the United States. That is 
the person who should make that appointment, and that Senate should 
make that confirmation.
  Think about this. Ronald Reagan appointed Antonin Scalia in 1986. 
Antonin Scalia served on the Court for 30 years until 2016. The next 
person appointed to take his place may serve 30 years as well. That 
takes us to 2046. That is a long time from now. Shouldn't we take the 
most contemporarily elected President to make that appointment rather 
than one who is going away and will be in the history books? I think it 
is right to allow the President who has been most recently elected to 
make that nomination and allow the newest Senate to make the 
confirmation and do what is right for the American people.
  This is not a Republican or Democratic thing. I respect my colleagues 
on both sides of the aisle. We have all made the same statements. It 
would just depend on whether it was our President or the other guy's 
President, whether it was our Senate or the other guy's Senate.
  In fact, I will close my remarks by again quoting my friend Joe Biden 
from the same speech he made on June 25, 1992. He said: ``Others may 
fret that this approach would leave the court with only eight members 
for some time, but as I see it, the cost of such a result . . . [is] 
quite minor compared to the cost that a nominee, the President, the 
Senate, and the Nation would have to pay for what would assuredly be a 
bitter fight, no matter how good a person is nominated by the 
President.''
  Vice President Biden made that statement when he was a Senator and 
faced the same situation that we face today. He was smart and wise 
beyond his years. He said: It is best to look to the future for the 
appointment, the next President for the nomination, and the next Senate 
for the confirmation and look to the future of the of the Court, 
because it is the Supreme Court--many times on a vote of 5 to 4--that 
will decide the fate of legislative and executive action. It is only 
right that we have the best and most contemporarily appointed Court 
that we could possibly have, and the only way to do that is to make 
sure that the next President makes the appointment.
  I underscore what I said at the beginning. It is not a Republican or 
Democratic thing. It is a political thing. We are all politicians and 
creatures to our politics. All of us have said the same thing. It would 
just depend on who was in charge at the time as to whether we spoke 
like Joe Biden as a Republican or spoke like Joe Biden as a Democrat.

[[Page S1213]]

  I commend Antonin Scalia for being a great servant to the American 
people. He was a great jurist, a great writer, and a great judge. He 
will be missed.
  Somewhere out there in America today, there is another Antonin Scalia 
just waiting to be nominated and confirmed by the Senate. I don't know 
who it is, but I know this: I want them to be found by the next 
President of the United States elected this November and confirmed next 
January by this Senate. That is the right person. That is the right 
way, and I submit that is the way I recommend we do it.
  I yield back the remainder of my time.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. BLUMENTHAL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Lee). Without objection, it is so ordered.


                     Women's Health Protection Act

  Mr. BLUMENTHAL. Mr. President, earlier today I joined a number of my 
colleagues outside the Supreme Court to work with advocates who were 
gathered there, thousands of people, including many young people. 
Looking into their faces, I realized that for them Roe v. Wade is 
history, but my mind went back to 1974, the year after Roe v. Wade, 
when I was a law clerk to Justice Blackmun. I heard similar voices from 
the serene, contemplative chambers of Justice Blackmun and thought 
then--in fact all of us thought then--that Roe v. Wade would settle for 
all time, at least for the next decades, the reproductive rights of 
women in the United States of America, and we were wrong. We were wrong 
that the law would be settled, that rights would be protected, that Roe 
would be accepted, and that privacy would become enshrined as a matter 
of constitutional law or at least accepted politically. We were wrong.
  Today, in a historic case, the U.S. Supreme Court heard arguments on 
a challenge to the basic fundamental right of privacy with practical 
implications that will alter the lives of women in Texas, where the 
case rose, and throughout the country.
  I know firsthand from my experience as a law clerk, but even more so 
in the decades since as an advocate for reproductive rights and women's 
health care, as U.S. attorney, as a member of the Connecticut General 
Assembly, first as a member of the House and then in the State Senate, 
and as our State attorney general, working and fighting to enshrine in 
State law the rights protected by Roe v. Wade and then protect them 
from physical threat and intrusion at the clinics where those rights 
were made real.
  Those rights mean nothing if they are unprotected. If women need to 
travel hundreds of miles, if women need to leave their jobs and their 
children for days, if women have no access to those rights, they are 
unreal for them. That is the net fact of the law that is 
underchallenged in the case before the U.S. Supreme Court, Whole 
Woman's Health v. Hellerstedt. That law, HB2, in effect, so restricts 
the availability of reproductive rights in practical, real terms as to 
place an insurmountable burden for many women on the exercise of those 
rights. Those rights are prevented from being real for them, for 
countless others, and they will be put out of reach for countless women 
across the country if this law is not struck down.
  That is what we are asking the Supreme Court to do: to strike down 
this law that under the pretense of protecting women's health, imposes 
restrictions that deny rights, rights to privacy that are basic to the 
human condition. They are constitutional rights, but nothing is more 
basic than the right to control your own body. Nothing is more 
essential than protection of rights to decide when to have a child. 
These issues of control over one's body involve control over one's 
faith, rights of privacy, and power to make basic life decisions.
  That is what it means to have a right to privacy. It is the right to 
be left alone--as one of our Supreme Court Justices said, the right to 
be left alone from unwarranted and unnecessary government intrusion. 
The Supreme Court will have to make a judgment about whether the burden 
placed on that right is justified by this supposed protection of 
women's health.
  Anybody familiar with this case knows that supposed reason for these 
laws that require many privileges for doctors or particular widths of 
hallways in clinics is a ruse, a pretense, in fact, a falsehood.
  My view is the outcome should be clear in this deliberative battle 
before the Court, but the ramifications, the practical impacts, are 
severe for those women in Texas who would have no access to 
reproductive health care, and for women around the country because the 
simple stark fact is, since 2011, State legislatures have enacted 288 
laws like the one in Texas, designed to restrict access to reproductive 
rights. We are not talking about a situation limited to Texas. In State 
after State, legislature after legislature, these rights would be 
restricted by similar laws.

  That is the reason I have introduced the Women's Health Protection 
Act, to stop this invasion--it is truly an invasion--of women's 
reproductive rights. The measure I have introduced would, in effect, 
strike down such measures, prevent them, so as to reduce, and hopefully 
even eliminate, the cost and the time required for litigation 
challenging them in State after State, like what happened in Texas 
where women have been denied the certain assurance, the basic security 
of knowing that this care will be available to them, because of the 
continuing litigation, the costs of lawsuits, and the time-consuming 
contention and controversy that arises from it.
  The arbitrary and arcane restrictions imposed by the Texas law 
concerning admitting privilege requirements and building specifications 
are unrelated to health and safety and clearly create an undue burden 
on women's right to choose. That is the legal principle, the core 
tenant that needs to be upheld by the U.S. Supreme Court.
  I joined with a number of my colleagues, and in fact led the amicus 
brief to the Supreme Court, which urges them to reach the right result 
and strike down this law. My hope is that the outcome will not only be 
right for Texas and the women of Texas--and the people of Texas because 
the right of privacy is not guaranteed only to women, it is to men, and 
the decisions that women make affect families and children as well as 
their spouses. I hope the Supreme Court finally does what Roe v. Wade 
was thought to do in clear, bright-line text that will prevent States 
from intruding with these pretense, ruse laws, supposedly protecting 
health when, in fact, all they do is restrict the right to privacy.
  I am proud to join with my colleagues in fighting these attacks on 
women's health care. But I hope that the clerks, as I once was, in the 
Supreme Court will look from those windows today and think to 
themselves that this case will, in fact, finally settle these issues, 
finally give women the assurance and security they need.
  There is no need to keep returning and relitigating these issues. 
There is no need for this body to consume time and energy on defunding 
Planned Parenthood. There is no need for these kinds of repeated 
battles over rights that should be secure and unchallengeable in 21st 
Century America. Rehashing this fight simply costs us in time and other 
precious commodities that we should be spending on jobs, economic 
progress, veterans, national security, investment in infrastructure, 
investment in our human capital, and college affordability. All of the 
present issues--those and others of this day--are what should occupy us 
on this floor and occupy the country as we move forward, hopefully 
guaranteeing that the rights in Roe will be real for every American 
woman.
  Thank you, Mr. President.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. MANCHIN. Mr. President, I ask unanimous consent that the order 
for the quorum call be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. MANCHIN. Mr. President, I rise today to speak in support of the 
Comprehensive Addiction and Recovery Act of 2015, which is bipartisan, 
I might

[[Page S1214]]

add, and to discuss several amendments that I have submitted.
  Mr. President, our country is facing a prescription drug epidemic, 
and today is a good step toward addressing this crisis. This is a 
crisis I have been dealing with since my days as Governor of the great 
State of West Virginia. Opioid abuse is ravaging my State of West 
Virginia and many other States. I know the Presiding Officer has the 
same problem in Utah. Our State has been hit harder than any other 
State in the country. Drug overdose deaths have soared more than 700 
percent since 1999. We lost 627 West Virginians to opioids last year 
alone. Mr. President, 61,000 West Virginians used prescription pain 
medication for nonmedical purposes in 2014. This includes 6,000 
teenagers. Our State is not unique. Every day in our country, 51 
Americans die from opioid abuse. Since 1999 we have lost almost 200,000 
Americans to prescription opioid abuse.
  The fact that we have with the bill in front of us is simply this: It 
is an important first step. It will authorize $77.9 million in grant 
funding for prevention and recovery efforts, which we need, and expand 
prevention and education efforts particularly aimed at teens, parents 
and other caretakers, and aging populations. It will also prevent the 
abuse of opioids and heroin and promote treatment and recovery. It will 
expand the availability of naloxone to law enforcement agencies and 
other first responders to help in the reversal of overdoses to save 
lives. It will expand disposal sites for unwanted medication to keep 
them out of the hands of our children and adolescents. It will also 
launch an evidence-based opioid and heroin treatment and intervention 
program to expand best practices throughout the country. It will 
strengthen prescription drug monitoring programs to help States monitor 
and track prescription drug diversion.
  While the bill is a good start and addresses critical problems, there 
is more that needs to be done. I have a few amendments I want to speak 
about and explain that I think will improve the bill by changing the 
FDA mission statement, providing grants for consumer education, and 
requiring prescription prescriber training.
  First of all, I firmly believe we need cultural change at the FDA. 
That is why I submitted the Changing the Culture of the FDA Act as an 
amendment to this bill. This amendment would strengthen the actions 
that the FDA recently announced that they were committed to taking into 
consideration the public health impact of approving opioid medications. 
Mind you, what they said is that they were committed to taking it into 
consideration. I don't think that is much of a change, and it is 
definitely not a cultural change. It is a movement in the right 
direction, which I acknowledge. By solidifying this commitment in the 
agency's mission statement, we ensure that the agency oversees the 
approval of these dangerous drugs and cannot waiver from their stated 
goals.
  The language in my amendment is similar to the language in the FDA's 
current mission statement regarding tobacco, and we all know the 
devastating effects of tobacco. The mission statement says simply this: 
``FDA also has the responsibility for regulating the manufacturing, 
marketing, and distribution of tobacco products to protect the public 
health and to reduce tobacco use by minors.''
  If we think it is that serious that we put this in the mission 
statement for tobacco, why can't we do it for opiates? Tobacco kills 
hundreds of thousands of Americans every year, and we have rightly 
recognized this as a public health crisis. However, opiates killed more 
than 18,000 people just by the end of 2014. That is 51 people every 
day. This, too, is a public health crisis. It is absolutely ridiculous 
that the FDA has treated opiates like any other drug up for approval.
  To date, the agency has failed to consider the devastating public 
health impact of their repeated decisions to approve dangerously 
addictive opiates. We have seen that in their resistance to 
rescheduling hydrocodone, their approval of Zohydro against the advice 
of their own advisory committee, and their refusal to consult an 
advisory committee on other dangerous opioid approvals, including their 
decision to allow the use of OxyContin in children as young as 11 years 
old. Opioids are simply different from many types of drugs the FDA 
oversees. As I noted before, they have killed almost 200,000 people 
since 1999 and have ruined the lives of countless others.
  The FDA must be held accountable for their actions. Like our efforts 
to protect the public--particularly children--from the dangers of 
tobacco, the U.S. Congress must take action to ensure that the FDA 
does, in fact, do what it has promised to do and take the devastating 
public health impact of opiate addiction into account when approving 
new drugs. It is putting it on par with tobacco, that is all. In a 
mission statement, one has more responsibility than just passing it 
through as a business plan.
  My second amendment also relates to the critical role the FDA plays 
in addressing the opiate epidemic. It would require the FDA to seek the 
advice of its advisory committee before approving any new opiate 
medication. These are experts, scientists, people who know the makeup 
and composites of these chemicals and what they do to human beings. If 
the FDA approves a drug against the advice of the advisory committee--
that means if they do not take the recommendation by their own experts 
and they wish to put this drug on the market--the agency would be 
required to submit a report to us, the people's representatives, the 
Congress, justifying that decision. The approval will be delayed until 
the report is submitted. Tell us why you won't take the advice of your 
experts and why you even subvert and basically pay no attention.
  The FDA plays a critical role in addressing the opiate epidemic as 
the agency overseeing the approval of these drugs. Under the FDA's own 
rules, they are supposed to convene a committee of scientific experts 
when a matter is of significant public interest, highly controversial, 
or in need of a specific type of expertise. With 51 people dying every 
day in the country from an overdose of prescription opiates, it is 
clear that the approval of opiates meets every one of these standards 
and that the FDA should seek the counsel of its expert panel and adhere 
to its recommendations with regard to approving dangerously addictive 
opioids.

  Unfortunately, this hasn't happened. It truly hasn't happened. Let me 
give an example. It took us 3 years just to get rescheduled from a 
schedule III to a Schedule II all opiates--Zohydro, Vicodin. These are 
the most widely prescribed opiates. It took us 3 years, which what 
should have been a 3-week turnaround.
  The week after they even approved the taking down of these drugs from 
a schedule III to a schedule II, which took over 1 billion pills off 
the market, they came right back and they recommended a drug called 
Zohydro. This is a drug that their expert panel had basically advised 
11 to 2 not to put on the market. They failed to seek their council's 
advice on the concerns with the safety of this drug.
  Since that time, three new extended-release opioid medications--
Targiniq, Hysingla, and Morphabond--have been approved without any 
advisory committee meeting at all. Let me give my reasoning on why I 
think this happened. There was so much pushback on Zohydro from the 
Governors, Senators, and Congress people for putting this high-powered 
drug on the market against the advice of their own council that they 
didn't want to go through that again, so basically they just skipped it 
altogether and brought these drugs right to market. They also approved 
OxyContin for use in children as young as 11, again without seeking the 
advice of a pediatric advisory committee. This is a dangerous precedent 
and must stop.
  I am encouraged that in the FDA's recent announcement on opioid 
approvals, the FDA has finally agreed that the approval of these 
powerful drugs must be subject to an advisory committee. I am very 
concerned, however, that the FDA will continue to exempt abuse-
deterrent opioids from this process and has not promised to abide by 
the advice. They said they will take it under consideration. They are 
not bound to take the advice of the advisory committee.
  While abuse-deterrent formulations, which are harder to crush or 
liquify, have a role to play in reducing the impact of this epidemic, 
these drugs are

[[Page S1215]]

no less addictive than traditional opiates. In addition, in the real 
world, we have seen these so-called abuse-deterrent properties easily 
overcome. The tragic HIV outbreak we saw in Scott County, IN, last year 
occurred after hundreds of people in that community shared needles to 
shoot up Opana. They used the same needle to shoot up Opana--something 
that should have not been possible if it were truly abuse-deterrent.
  This amendment would solidify the FDA's commitment to seek the advice 
of an advisory committee when approving opioid medications and would 
strengthen it by extending that commitment to all opioids and by 
holding the FDA accountable. The FDA does not listen to its own 
experts. This is such a reasonable request and such a reasonable 
amendment to protect all the people in all of our States. It is a 
commonsense measure that would ensure that the FDA is fully considering 
the public health impact and the many lives lost as a result of these 
dangerous opioid medications.
  Another amendment I have is on mandatory prescriber education. This 
epidemic is one that needs to be fought on all fronts, but most 
importantly, we need to fight it on the frontlines with prescribers, 
which is precisely what my third amendment seeks to do. It requires 
medical practitioners, our doctors--the people we trust--it basically 
requires them to receive training. You would think they are getting 
training on this now, but they are not. There is no specific training, 
going through school or at any other time, on the safe prescribing of 
opiates prior to receiving and renewing their DEA license to prescribe 
a controlled substance. That is all we are saying. This training must 
include information on safe opioid prescribing guidelines, the risks of 
overprescribing opioid medication, pain management, early detection of 
opiate addiction, and the treatment of opiate-dependent patients. This 
is something only the doctors can do. These are the people writing on 
their prescription pads, sending them to the pharmacists, and 
fulfilling all of our prescriptions. We are asking for them to have 
that type of required training when they get their DEA license and 
renew their DEA license.
  This must be fought on all fronts, but most importantly we need to 
fight it on the frontlines with the prescribers. According to the 
National Institutes of Health, more than 259 million prescriptions were 
written in 2012. Think about that--259 million prescriptions were 
written in 2012 just in the United States for opiate painkillers. That 
equals one bottle of pain pills for every adult in the United States of 
America. We are the most addicted country on planet Earth. With a 
population of less than 5 percent of us living in this great country of 
ours, we consume 80 percent of the opiates produced in the world. The 
other 6.7 billion people don't use what we use. Why? That is a 400-
percent increase in the number of prescriptions since 1999. In a little 
over a decade, there has been a 400-percent increase, and we are 
pumping out more pills, thinking this is going to cure America. This is 
without a corresponding increase in reported pain. They are not 
complaining any more about pain; they are just getting more pills. But 
it has come with a corresponding 400-percent increase in overdose 
deaths. So if overdose deaths are related to the increase of pills on 
the market, don't you think we ought to do something about it? It is 
pretty simple.
  I have too many stories from my constituents that they receive 
significantly more pain medication than they need to treat their pain, 
and those extra pills increase the risk of addiction for individuals 
and are dangerous for society if diverted. Someone can get their teeth 
worked on, get their teeth extracted, and they will get 30 days of pain 
pills when they may only need them for 1 or 2 days. It is ridiculous.
  I hear from physicians themselves that they do not receive enough 
training. These are doctors telling us it is not in their basic 
education as they go through medical school--prescribing these drugs--
or even after they leave medical school. There is no continuing 
education demanded about this. Until we ensure that every prescriber 
has a strong understanding of the state of opiate prescribing practices 
and the very great risk of opiate addiction, abuse, and overdose 
deaths, we will continue to see too many people prescribed these 
dangerous drugs which can lead them down the tragic path of addiction.
  Finally, we must improve our consumer education efforts. My fourth 
amendment would establish consumer education grants through SAMHSA to 
raise awareness about the risks of opiate addiction and overdose. There 
are 2.1 million Americans addicted to opiates. Many of these 
individuals began the road to addiction with a seemingly innocent 
prescription and little or no warning about the danger from a 
physician. They weren't told they could be addicted. They weren't told 
they would be hooked and it would change their life forever. Or it 
began when a friend offered a pill that they thought couldn't be that 
dangerous because a doctor had given it to them: Here, I have got 
something that will help you. Try this.

  And they get started. There is simply too little understanding about 
the dangers of these drugs, and too many get sucked into opioid 
addiction because they don't understand the risk and because the people 
close to them don't know how to recognize the signs of addiction or 
know how to access the resources to help their loved ones.
  It is the silent killer. It is the one we all keep quiet--every one 
of us. Every one of us in America knows somebody--either in our 
immediate family, extended family or a close friend--who has been 
affected, but we say nothing. Use and abuse of prescription drugs cost 
the country an estimated $53.4 billion a year in lost productivity. 
These are people who can't function, who can't work, and are basically 
drawing off of their unemployment or off of their insurance.
  Medical costs and criminal justice costs--you name it. You talk to 
any law enforcement anywhere in the United States of America and they 
will all tell you a minimum of 80 percent of the crimes that are 
reported that they have to go and serve are drug related--80 percent. 
So the cost is probably even higher than that.
  This amendment provides $15 million a year to help prevent these 
costs in the first place. It makes sense. That is $15 million. OK, you 
are going to say: Oh, that is a lot of money.
  Let me just tell say that as a society we regularly invest in efforts 
to prevent unnecessary deaths. We already have done that, and we 
continue to do that. Thirty thousand people died in car accidents in 
2013, and we invested $668 million in motor vehicle safety and accident 
prevention. That is more than $22,000 per death that we have invested 
trying to prevent people from getting killed in automobile accidents, 
driving safely, DUI, everything. With 28,000 people dying of 
prescription opioid or heroin overdose in 2014, this $15 million 
funding represents an investment of $500 per person for a life that we 
could save. We spend $22,000 trying to prevent accidents in 
automobiles.
  As to opiates, all we are asking for is a $500 investment to save 
their lives. We have to put our priorities where our values are, and we 
can do that. The grants that would be authorized under this amendment 
would help those on the frontlines of this terrible epidemic to provide 
their communities with the information they need to help stop the 
spread of opioid addiction and to help people seek treatment. This 
funding will better enable us to educate individuals about the dangers 
of opioid abuse.
  There are practices to prevent opioid abuse, including the safe 
disposal of unused medication and how to detect the warnings of early 
addiction. I would venture to say that most people do not know how to 
look at their children and know that there is a chance that they may 
get addicted or are getting addicted. It is sometimes too late.
  It will help us save lives by raising awareness about the dangers of 
prescription opioid medications to prevent opioid addiction in the 
first place and ensuring that loved ones know how to help when a friend 
or family member becomes addicted.
  This amendment that we are asking for, this amendment that I am 
asking for is one that really makes sense. If we can't educate the 
public, then we have little chance of ever curing this epidemic.

[[Page S1216]]

  We have had a lot of talk about the funds and how much money we are 
spending. We just had a final amendment that I would like to address, 
as there is a great need for funding to pay for substance abuse 
treatment.
  Well, I strongly agree with my colleagues who supported Senator 
Shaheen's amendment to provide $600 million in funding, which we 
desperately need to support Federal programs that work to prevent 
opioid abuse and provide much needed treatment.
  If you look at the amount of money it is costing now for 
incarceration, all the lost time, all of the drug-related crimes that 
have been committed, it would have been an investment well made, but I 
know there are people who believe differently.
  In 2014, 42,000 West Virginians, including 4,000 youths, sought 
treatment for illegal drug use but failed to receive it. There was no 
place to get it. In your State and my State people are looking. 
Sometimes they are looking for this, and there is no place to put them. 
If you have day courts or drug courts in your State, they will tell 
you: We have no place to put them. There is no place to get the 
treatment to cure a person who truly is looking for a cure. This is 
just unacceptable. There are people who recognize that they need it, 
and they beg for it. They have been turned away because there simply 
weren't enough facilities, beds or health care providers in their 
community.
  But we spend money every year building new prisons all over the 
country. We have a backlog, and we have an overcrowding prison 
population. We know from long experience that when a person asks for 
help, that is our opportunity. If we turn them away, they will never 
come back. They just don't when they are turned away. That is why I 
wish to introduce this amendment, and I would like a very vigorous 
discussion on it.
  We have tobacco, which we know is very dangerous and kills people. It 
is harmful, and we spend a lot of money trying to prevent people from 
using it and young people from starting to use it. We even tax it. We 
tax it so that basically we can deter the use of it.
  We have alcohol. We know alcohol can be very addictive and, 
basically, it ruins people's lives. We know that and we tax that. We 
have nothing on opioids--nothing.
  What we are asking for is consideration of a 1-cent fee on every 
milligram of opiates that are produced--one penny per milligram. This 
fee would be levied on the pharmaceutical company, and the money raised 
will be used to create a permanent funding stream to strengthen the 
substance abuse prevention and treatment block grant.
  I know so many people have taken a pledge: We are not going to pass 
any new taxes.
  I understand that. We are really at a crunch. We basically have cut 
back, and our military is struggling. Every part of a program that we 
think is near and dear to our States and to the people in our States is 
having trouble. I am not asking to take away from another one. I am 
asking that this one penny per milligram of opioids that are produced 
in this country would give us permanent funding to start having the 
treatment centers that we so desperately need. I don't know of any 
other way to do it in a more compassionate way. We do it for 
cigarettes; we do it for alcohol. We have opiates killing more than all 
of that. I am just asking for that dialog, that consideration. It could 
be something of a bipartisan movement, because this silent killer--
opiates--doesn't have a partisan home. It is not Democratic. It is not 
Republican. It is not Independent. It is killing Americans--all of us.
  The substance abuse prevention and treatment block grant goes to the 
States to pay for critical substance abuse treatment programs. The new 
funding raised, which is based on past opiate sales--I am basing it on 
past opiate sales--could be anywhere between $1.5 billion to $2 billion 
a year, and all the States will be able to participate. Every State 
would participate in these moneys that would be available. They could 
be used by States to establish new addiction treatment facilities, to 
improve access to drug courts, to operate support programs for 
recovering addicts, to care for babies born with neonatal abstinence 
syndrome or to meet any other treatment need that your State or my 
State might face. These treatments save lives and strengthened 
communities. We are losing a generation, a whole generation.
  Opioid producers have made billions of dollars selling their drugs 
over the past several decades. I am not here railing against the 
pharmaceuticals. They do a lot of good for our country and save a lot 
of lives too. This is one that doesn't, and this one has been proven 
that it is a killer.
  This amendment asks them to contribute a small portion of their 
profits to help pay for this treatment. Everyone says: They are going 
to pass it on. Don't worry; you will be paying more. This is one time, 
one penny--one penny a milligram. That is all we are asking.
  For the 2.1 million Americans who are addicted to their products, my 
amendment also provides exemptions. I am talking about the exemptions 
now because I know people are going to say: What about our veterans? 
What about those in severe chronic pain? What about those who are 
terminally ill?
  We have, basically, exemptions built into this amendment for those 
people, so they are not put into hardship, and for the neediest in our 
country. They are not going to be put in a hardship.
  This is a cost that if we look at it, I don't know of any other way 
to fix it. I really don't. I know people have taken pledges: We are not 
going to do this, not going to do that, not going to consider it. Well, 
you ought to consider the damage that is doing to America. I am not 
asking for any other program to be sacrificed at all. So I think this 
is responsible. This one penny. That is all I am asking for--one penny.
  I am pleased the Senate is addressing this epidemic. It is in a 
bipartisan way. We have the CARA package in front of us. I appreciate 
that, and I know we all have a great passion for trying to cure this.
  This is how we need to work to solve the major challenges in our 
country that face us. I am pleased to see we are going through regular 
order. We have amendments that we are able to put on and talk about. I 
think it is worthy to have these discussions. We must provide the 
critical resources needed, and I think we have a solution to that. I 
hope we can have that discussion. I hope all of us can have an adult 
discussion about how we save Americans, how we save our families, our 
children, and the next generations to come.
  I look forward to working with all of my colleagues and with you to 
see if there is a better way we can strengthen and make a piece of 
legislation better than what it is.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Mr. President, I appreciate the comments from my friend 
from West Virginia and his work on this issue that has hit West 
Virginia and, particularly, southeast Ohio kind of first and hardest. 
But it has spread to so many other places and caused so much heartache 
and so much family disruption--not just for the young men or women, in 
the case of young people who are addicted, but the whole family. As one 
mother of a teenager said to me in Youngstown, OH, or in Warren, OH, 
one day, this is really a family affair.
  I am pleased to see bipartisan support for finally tackling the 
opioid addiction epidemic. It has touched every State and almost every 
community in our country. In 2014, more people died from drug overdoses 
than any year on record, with 2,482 in Ohio. That is a record number of 
prescription drug overdoses and a record 1,177 overdoses related to 
heroin. People often start with pain medication, sometimes 
overprescribed prescription medicine that will, in far too many cases, 
lead to heroin addiction. Heroin is cheaper to buy on the street than 
for people to get OxyContin or oxycodone or Percocet or any number of 
legal morphine pain medications.
  These numbers mean that in 1 year alone, 2,500 Ohioan families lost a 
loved one to addiction. What those numbers don't account for are the 
thousands of other families and hundreds of other communities that 
continue to struggle with opioid abuse. It should not be easier for 
Americans to get their hands on opioids than it is for them to get help 
to treat their addiction. It should not be easier for Americans to get 
their hands on opioids than it is to get help to treat their addiction.
  Addiction is not an individual problem. It surely is not a character 
flaw,

[[Page S1217]]

as many people half a generation ago liked to say when it was people 
who didn't look like them. But the fact is it was not a character flaw 
then and it is not a character flaw now. It is a chronic disease.
  When left untreated, it places a massive burden on our health care 
system and a terrible, terrible cost on families who have an addicted 
family member. When we think about this epidemic, we have in our minds 
a young worker who turned to painkillers after a back injury or a car 
accident, someone who started with oxycodone--maybe as a party drug--
and then turned to heroin. This problem is bigger than that.
  Our national conversation forgets the hundreds of thousands of 
seniors who often are given unsafe and duplicative prescriptions for 
opioids. It is not uncommon for seniors to be treated by multiple 
specialists and physicians. Doctors may not know they are prescribing 
duplicative painkillers, meaning this doctor prescribed a painkiller--
maybe oxycodone or OxyContin or Vicodin or another--and this other 
doctor may have done the same thing. They weren't communicating, and 
didn't know. Seniors find it difficult to manage all of their different 
prescriptions far too often.
  Take, for example, Ohioan Dennis Michelson. I met him at the Benjamin 
Rose Institute on Aging in Cleveland last August. He is one of the 
estimated 170,000 Medicare beneficiaries who recently battled an 
addiction to pain medication.
  He was prescribed pain medication by his doctor to manage chronic 
migraines. When his primary care doctor sought to wean him off the 
medication, he went to other doctors and pharmacists to obtain those 
opioids. He was eventually arrested and charged with felonies for 
tampering with prescriptions. He has since recovered. He is now an 
advocate for reform to address the prescription drug epidemic.
  After hearing his story, it strikes me that if a patient with 
legitimate and sometimes complex medical needs winds up getting pain 
medication from several different doctors--you could see how that would 
happen; none of those doctors know about one another--the system has 
failed the patient.
  It is why I worked with Senator Toomey from Pennsylvania to introduce 
the Stopping Medication Abuse and Protecting Seniors Act. I was proud 
to see this body support it as an amendment today. We already have a 
proven tool to address the problem of patients getting duplicative 
opioids from multiple doctors and pharmacists. It is called Patient 
Review & Restriction Programs. But despite their success in State 
Medicaid programs and commercial plans, these programs aren't available 
in Medicare prescriptions under current law. That is the purpose of the 
Toomey-Brown amendment and what we are trying to fix.
  The amendment will ensure that a small number of seniors who receive 
high doses of addictive opioids from multiple doctors get those 
painkillers from one doctor and one pharmacist. It is what we did on 
so-called Medicaid lock-in--for people who were abusing the system on 
purpose or more likely those who sort of fell into this trap and went 
from doctor to doctor, pharmacist to pharmacist, in some sense doctor 
shopping or pharmacy shopping--so that practice would end. We have done 
the same sort of thing now with so-called Medicare lock-in. It would 
save taxpayers $100 million over the next decade. It will reduce 
overprescribing, and it will crack down on fraud.

  I am pleased we have bipartisan support for this commonsense measure, 
but this amendment and this bill are a step. We need a comprehensive 
approach that addresses the entire spectrum of addiction from crisis to 
recovery. I have introduced the Heroin and Prescription Drug Abuse 
Prevention and Reduction Act. It will boost prevention efforts, it will 
improve tools for crisis response, it will expand access to treatment, 
and it will provide support for lifelong recovery.
  Addiction is chronic. It doesn't mean that when somebody overcomes 
their addiction and seems to defeat it, it won't come back later in 
life. If we are serious about fighting this epidemic, we have to make 
sure we provide a serious investment that will deliver results long 
term.
  My colleagues, Senator Shaheen of New Hampshire and Senator 
Whitehouse of Rhode Island, introduced an amendment that would have 
provided $600 million to fight this epidemic. It would have gone 
directly to public health workers, directly to law enforcement 
officials who are working on the frontlines of this battle every day. 
It would have shown constituents we are serious about addressing this 
crisis.
  I was disappointed this body was unwilling and unable to find the 
money necessary to address these problems. This legislation is a good 
bill. Without the money, it is a good bill, but it is really only half 
a good bill because my colleagues are simply unwilling--maybe it is the 
tea party influence, maybe they are afraid of a Republican rightwing 
primary, whatever it is--to ante up the dollars that would fully help 
us deal with this epidemic. We can't do this without an investment.
  I met with a number of tuberculosis experts in my office today. We 
have been successful in this country with eliminating smallpox, 
eliminating polio, and keeping Ebola from being contracted in the 
United States and killing any Americans. We have done all of that 
because we invested in a public health system. We can't address this 
opioid epidemic without dollars. Yet my colleagues will simply always 
back off and say: Well, we can't afford to do this. They can afford tax 
cuts for wealthy people, and they can afford continuing to pump money 
into expensive weapons systems, but they will not spend money to 
address probably the most serious public health crisis we have seen in 
this country in years.
  Once again, I say that it should not be easier for Americans to get 
their hands on opioids than it is to get help to treat their addiction. 
This Senate should get serious about this. We should pass this bill, to 
be sure, but there is so much else. I am distressed my colleagues chose 
not to step up to the plate and do what deep down they know we should 
do.


                            vote explanation

  Mr. REID. Mr. President, earlier today, I missed the vote on the 
Shaheen amendment No. 3345. If I had voted, I would have voted yea.
  (At the request of Mr. Reid, the following statement was ordered to 
be printed in the Record.)
 Mrs. McCASKILL. Mr. President, I was necessarily absent for 
today's amendment votes in relation to S. 524, the Comprehensive 
Addiction and Recovery Act of 2015.
  On amendment No. 3362 by Senator Feinstein, I would have voted yea.
  On the motion to waive the Budget Act with respect to amendment No. 
3395 by Senator Wyden, I would have voted yea.
  On the motion to waive the Budget Act with respect to amendment No. 
3345 by Senator Shaheen, I would have voted yea.
  Mrs. FEINSTEIN. Mr. President, today I wish to join my colleagues in 
supporting the Comprehensive Addiction and Recovery Act.
  This bipartisan legislation takes a strong and balanced approach to 
tackling the prescription drug and heroin epidemic our Nation faces, 
and I am proud to be a cosponsor.
  I would like to note the hard work by many of my colleagues and their 
staffs--Senators Whitehouse, Ayotte, Coons, Kirk, Klobuchar, and 
Portman. Their States have been especially hard hit by this epidemic, 
and this bill would help alleviate some of the suffering.
  We are all well aware of the sobering statistics. Drug overdoses kill 
more than 120 Americans each day--more than motor vehicle crashes or 
gunshot wounds. Opioid and heroin overdoses account for more than half 
of these deaths. According to the Centers for Disease Control and 
Prevention, in 2014, 25,760 people died from prescription drugs, and of 
that, 18,893 deaths were caused by opioid painkillers. Heroin caused an 
additional 10,574 deaths.
  These numbers have continually increased over the past 15 years, and 
today we are in the midst of an epidemic. That is why we need this 
bill. We need a comprehensive response to a problem that has touched 
every State of our country.

[[Page S1218]]

  The Comprehensive Addiction and Recovery Act strengthens our 
substance abuse prevention, treatment, recovery, and law enforcement 
infrastructure. While it focuses on prescription opioid abuse and 
heroin use, it also has the potential to help other drug problems that 
we face. Specifically, it authorizes a number of programs to: ensure 
access to appropriate, evidence-based medical treatment; address local 
and emerging drug threats and trends; equip first responders with 
lifesaving tools, such as Naloxone, an opioid overdose-reversal drug; 
and strengthen prescription drug monitoring programs to reduce 
overprescribing, doctor shopping, and ultimately overdose deaths. The 
bill also establishes an interagency task force on pain management and 
opioid painkiller prescribing. The overprescription and overuse of 
these drugs are a major factor in this epidemic.
  Lastly, to examine ways to improve access to drug treatment, the bill 
requires a Government Accountability Office study on the 16-bed limit 
for Medicaid reimbursement to drug treatment programs, also known as 
the Institutions for Mental Disease exclusion.
  The holistic nature of this bill is a clear step in the right 
direction. It also supports the administration's efforts to confront 
this epidemic and can help accomplish the goals laid out in the 2015 
National Drug Control Strategy.
  However, there are two things that I believe would have made this 
comprehensive bill even more effective: 1, addressing the sheer volume 
and availability of opioid painkillers; and 2, full funding.
  First, on the widespread availability of prescription opioids, I 
would like to outline a few often-cited facts from the Centers for 
Disease Control and Prevention. Health care providers wrote 259 million 
prescriptions for opioid painkillers in 2012. This was enough for every 
American adult to have their own bottle of pills. Since 1999, the sale 
of prescription opioid painkillers has increased by 300 percent. At the 
same time, there has been no change in the amount of pain patients 
reported. During this same time period, deaths from overdose of 
prescription opioid painkillers quadrupled.
  Additionally, according to the National Institute on Drug Abuse, 20 
percent of people ages 12 and older have used prescription drugs 
nonmedically at least once. The majority of those who abuse 
prescription opioids get them for free from a friend or relative, often 
from legitimate prescriptions written in excess.
  And, over the past 5 years, the Drug Enforcement Administration has 
collected more than 5.5 million pounds of unused or unwanted drugs, 
including opioids.
  Moreover, data from Express Scripts shows that while there are fewer 
individuals filling prescriptions for opioids, the overall number of 
prescriptions filled, as well as the number of days per prescription, 
both increased.
  All of this shows there are simply too many pills available for 
diversion and abuse, and I believe better prescribing practices can 
play an important role in reducing excess supply.
  Our doctors and health care providers must improve the way they 
prescribe these opioids, to ensure safe and effective pain relief, but 
also to prevent misuse and overdose. At the same time, we must also 
maintain appropriate access for legitimate medical needs.
  Updated guidelines, such as those the Centers for Disease Control and 
Prevention will soon release, will help improve prescribing practices. 
Increased prescriber education can also help.
  I am also looking into the possibility of responsibly regulating 
initial opioid prescriptions to reduce risk for misuse, addiction, and 
diversion. In my view, a patient who has a simple dental procedure does 
not need a 30-day supply of Vicodin. This is the type of prescribing 
that I believe we need to fix. Second, a bill like this can only have a 
positive impact if its programs are actually funded.
  My colleague from New Hampshire, Senator Shaheen, has introduced an 
amendment that would provide emergency funding for the programs 
authorized in this bill, and I urge its passage.
  I do not need to tell you that opioid and heroin abuse are very 
serious problems, but today we have an opportunity to address the issue 
head-on and save lives. I encourage my colleagues to join me in voting 
for this important bill.
  Thank you.
  Mrs. BOXER. Mr. President, the United States is in the midst of a 
full-blown drug crisis. More people died from drug overdoses in 2014 
than any previous year on record, claiming more lives than car 
accidents across the country. Since 2000, there has been a 200 percent 
increase in the rate of overdose deaths involving opioid pain relievers 
and heroin, with 61 percent of all drug overdose deaths in 2014 
involving some type of opioid.
  These tragedies are proof of the fierce bonds of addiction, and it 
seems no State has been spared from the opioid epidemic. In my State of 
California, deaths involving prescription pain medications have 
increased by 16.5 percent since 2006. In fact, there were more than 
1,800 opioid-related deaths in 2012 alone, and 72 percent of those 
involved prescription pain medications.
  We cannot ignore the opioid crisis anymore. This is not a problem for 
only the local communities or State officials. This is a nationwide 
crisis and addressing it requires a multi-pronged response at all 
levels of government. Last year, California was one of only 16 States 
selected to receive funding from the Centers for Disease Control and 
Prevention, CDC to help improve safe prescribing of opioid painkillers, 
an important step forward in tackling the root cause of this 
debilitating drug crisis.
  The pain and sorrow of drug addiction knows no limits. This is a 
tragedy that impacts families from all backgrounds, including our 
servicemembers and veterans. There is substantial evidence that 
prescription drug use and abuse is a major contributing factor to 
military and veteran suicides. This has been a concern of mine for 
several years, and I was proud to work with my colleagues in 2013 to 
ensure that military and veterans hospitals were included in the Drug 
Enforcement Administration's prescription drug takeback efforts so that 
our military personnel, veterans, and their families could voluntarily 
dispose of unwanted or unused prescription drugs.
  However, much more must be done to combat this epidemic. To address 
this emergency fully and effectively, we need to provide immediate 
funding to the key grant programs included in the Comprehensive 
Addiction and Recovery Act, CARA. I applaud Senator Shaheen and Senator 
Whitehouse for introducing an amendment to give the Department of 
Justice, DOJ, and the Department of Health and Human Services, HHS, the 
tools they need to fund the essential prevention, treatment, and law 
enforcement programs to help the families and communities torn apart by 
drug abuse.
  American lives are on the line, and we cannot wait to act. I urge my 
colleagues to support this legislation.
  Mr. BROWN. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Tillis). The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________