[Congressional Record Volume 162, Number 110 (Friday, July 8, 2016)]
[House]
[Pages H4554-H4561]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 CONFERENCE REPORT ON S. 524, COMPREHENSIVE ADDICTION AND RECOVERY ACT 
                                OF 2016

  Mr. UPTON. Mr. Speaker, pursuant to House Resolution 809, I call up 
the conference report on the bill (S. 524) to authorize the Attorney 
General to award grants to address the national epidemics of 
prescription opioid abuse and heroin use, and ask for its immediate 
consideration in the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 809, the 
conference report is considered read.
  (For conference report and statement, see proceedings of the House of 
July 6, 2016, at page H4392.)
  The SPEAKER pro tempore. The gentleman from Michigan (Mr. Upton) and 
the gentleman from New Jersey (Mr. Pallone) each will control 30 
minutes.
  The Chair recognizes the gentleman from Michigan.


                             General Leave

  Mr. UPTON. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days to revise and extend their remarks and to 
include extraneous material on the conference report to accompany S. 
524.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Mr. UPTON. Mr. Speaker, I yield myself such time as I may consume.
  The simple truth is that we are in the midst of a real epidemic. 
Nearly every 12 minutes, someone in America dies of a drug overdose. 
The CDC reports over a quarter billion opioid prescriptions were 
written in the year 2012. The abuse of prescription painkillers and 
heroin has impacted, virtually, every single community. It is an 
epidemic that has no boundaries and does not discriminate. In my State 
of Michigan, we are seeing 10 times as many deaths today as there were 
15 years ago. Sadly, the number continues to surge; but behind every 
statistic is a person who was loved, part of a family and community, 
and, yes, who was lost too soon.

                              {time}  1045

  It is a frightening reality, but we have to face this epidemic head 
on, and today's vote is an important step forward. Since the beginning 
of this process, our focus has been, and continues to be, on attacking 
this public health crisis from every side, from zeroing in on treatment 
for addiction and overdoses to reforming prescription practices in the 
delivery of medicines and working with law enforcement of the 
Department of Veterans Affairs.
  Specifically, this conference report addresses prevention care by 
requiring HHS to create an interagency task force to address chronic 
and pain management care and by reauthorizing NASPER, a piece of 
legislation the House has passed with very large bipartisan support.
  The conference report addresses treatment by ensuring opioid reversal 
medication is accessible to patients, their family members and, yes, 
first responders as well. These medications are key to stopping the 
overdose epidemic and getting these patients into proper treatment to 
become productive members of our society.
  The conference report also ensures proper oversight and 
accountability by including the majority leader's OPEN Act.
  The conference report, as a whole, touches on the spectrum of issues 
driving the opioid crisis. While there is no one solution, we are 
making progress in addressing a problem that has rapidly grown.
  So I want to thank all my colleagues--certainly on the Energy and 
Commerce Committee that I chair and those off--for working to advance 
these important bipartisan bills that will make a real difference in 
our communities.
  I am also proud that our final package has achieved the support of 
over 200 of the Nation's leading advocacy groups, groups from across 
the country that are focused on recovery. These advocates are on the 
front lines in this epidemic and truly appreciate the positive impact 
that our solutions will have in every community.
  There is an urgency to our work as drug overdose deaths surge in 
Michigan and beyond. We owe this effort to the past, present, and, 
sadly, future victims of the opioid epidemic; our neighbors, friends, 
family across every part of the family in every demographic group. So 
let's come together and get the job done. What we are doing will save 
lives.
  I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  After much thought, I have decided to support the conference report 
on S. 524. It is not perfect and does not nearly do enough from a 
funding perspective, but it makes some important steps that would allow 
us to begin to address the opioid addiction crisis that is impacting 
our Nation.
  The American people are desperate for relief from the opioid epidemic 
currently devastating our country, and they are depending on this 
Congress to act. By now, we have all heard the stories: young people 
taken from their families in their prime; babies born suffering from 
the cruel effects of opioid withdrawal; and parents who have lost the 
ability to care for their families as they battle their addiction.
  To treat this epidemic as anything less than a national crisis would 
be a terrible mistake. And even though we have already lost far too 
many lives to overdoses, we still have an opportunity to save many 
more.
  This conference report includes many important policies that have 
bipartisan agreement. For example, we will now allow patients and 
doctors to choose to partially fill their opioids so that excess 
medicines are not dispensed unnecessarily. This will reduce the number 
of unused pills in circulation, which will reduce the risk of misuse, 
diversion, and overdose.
  The conference report also allows nurse practitioners and physician 
assistants to treat individuals with

[[Page H4555]]

opioid use disorders with buprenorphine.
  This final report also includes important and proven programs to 
address prevention, treatment, and recovery; but just changing policies 
alone won't be enough. This legislation takes only a small step at a 
time when the American people need us to run.
  Mr. Speaker, how can we truly help the American people without giving 
them the resources to fight this epidemic?
  We cannot wait while lives continue to be destroyed by opiate 
addiction and while treatment options remain out of reach.
  Congressional Democrats, Mr. Speaker, have long advocated for more 
funding in this package and have even proposed bipartisan policies to 
offset the cost, but Republicans have stubbornly refused to commit 
essential funding as part of this overall bill. Time and again they 
have rejected efforts to make a real difference by going beyond the 
important policy changes in this bill and actually supporting 
significant funding to properly take on this growing national epidemic 
today. Instead, Republicans have committed to increasing funding 
through the appropriations process, and we will certainly make sure 
that they live up to the repeated promises they have made in this 
regard.
  I reserve the balance of my time.
  Mr. UPTON. Mr. Speaker, I yield 2 minutes to the gentleman from 
Georgia (Mr. Carter).
  Mr. CARTER of Georgia. Mr. Speaker, I rise today in support of this 
conference report to S. 524. This conference report is one of the 
proudest moments I have had as an elected Member of this body. I 
believe there are numerous challenges that our community healthcare 
providers face, and this bill helps them address those challenges.
  As a lifelong pharmacist, I believe the key first steps to address 
this opioid epidemic is education, improvement of treatment, and a 
reliance on State PDMP programs. This bill does all of that.
  Many of my colleagues have opposed this conference report and this 
bill because it does not authorize enough money or it doesn't provide 
every provision they want. There are things that I would have changed 
in this bill, but we have all had an opportunity to amend these 
provisions, and this has created a bipartisan, bicameral piece of 
legislation. Overall, this should not be the end of this conversation, 
but this bill is a good bill and addresses many of the problems 
Americans face with opioid addiction.
  I would like to commend leadership from both Chambers on this bill, 
and I encourage all of my colleagues to support this legislation.
  Mr. PALLONE. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Wisconsin (Mr. Kind).
  Mr. KIND. Mr. Speaker, I rise in support of the Comprehensive 
Addiction and Recovery Act. There is no question that we have an opiate 
epidemic sweeping our communities throughout Wisconsin and the rest of 
the Nation.
  I spent the better part of the last year holding listening sessions 
back home in my congressional district in western and north central 
Wisconsin, getting feedback from law enforcement, healthcare providers, 
treatment centers, and families that have been impacted by drug 
addiction and the opioid addiction to ensure that this legislation that 
we have pending before us today doesn't get too far out ahead of what 
they actually need.
  There are a lot of good policy changes in this bill, but one thing 
that is lacking that the gentleman also pointed out is the resource 
aspect of this. They do need tools. They do need additional resources.
  I am hoping that later in the year, whether it is through a 
continuing resolution or the funding of these operations, that we can 
find in a bipartisan way the increase of necessary resources for folks 
back home so that they can get out ahead of this curve and do an 
adequate job of turning the trend line away.
  I am also supportive because the legislation before us contains the 
Jason Simcakoski PROMISE Act. Jason Simcakoski was a veteran who died 
at the Tomah VA Medical Center a couple of years ago due to an opioid 
drug overdose. We have, in this legislation, a continuation of reforms 
that are being implemented to ensure that all of our veterans, whether 
in Wisconsin or throughout the Nation, are getting the care and the 
treatment they need; that we continue down the road of revamping the 
pain management practices at places like Tomah. I am confident that 
with the provisions in here, if we do this the right way, that Tomah 
and the VA system could be a model of proper pain management practices 
not just within the VA system, but throughout the entire healthcare 
system.
  There is no question we haven't done a good job of managing pain as a 
nation. That is true of whether it is in the VA. It is true whether it 
is in the private health sector. This legislation before us today gives 
us an opportunity to continue down that road and do a much better job.
  The Jason Simcakoski Act, for instance, will call for clinical 
practice guidelines to be instituted throughout the entire VA system. 
It enhances pain management education and training for our healthcare 
providers. It improves realtime tracking and access to data on opioid 
usage. It also expands opiate safety initiatives throughout all the VA 
centers.
  It expands the patient advocacy program, which is particularly 
important because I think the families are the first line of defense 
when it comes to the care and treatment of all our veterans. They know 
what is working and what isn't. They need greater input and better 
lines of communication to help affect the course of treatment that is 
impacting the veterans in their life.
  It also calls on the VA to explore more complimentary and alternative 
forms of medicine to deal with pain management so we are not just 
loading our veterans up with a cocktail of prescription drugs, which 
oftentimes lead to addiction which can lead to meth and heroin usage.
  I also think that this legislation gives us an opportunity to 
establish that strong partnership that needs to exist at the Federal, 
State, and local level, including private entities, so we can do a 
better job on the opioid addiction problem throughout our Nation.
  This is an all-hands-on-deck moment. As a former special prosecutor 
who had to deal in the criminal system with a lot of it, our response 
cannot just be a criminal justice response. It has to be a public 
health response or we lose this battle going into it.
  I think this legislation does provide crucial tools to help us make 
that pivot, but we also need the crucial resources; and that is 
something that we are going to have to address as this year progresses.
  I encourage my colleagues to support this legislation. I appreciate 
the hard work that the committees and those involved have put into this 
legislation. But it will be a work in progress, and we have to continue 
to listen to the folks on the ground back home to ensure that they are 
getting the help and support that they need.
  Mr. UPTON. Mr. Speaker, I yield 5 minutes to the gentleman from 
Virginia (Mr. Goodlatte), chairman of the House Judiciary Committee.
  Mr. GOODLATTE. Mr. Speaker, I appreciate Chairman Upton's leadership 
and partnership throughout this important effort.
  Today is a proud day in our Nation's history. Today the House will 
complete its work on a comprehensive legislative package to combat the 
terrible epidemic of opioid abuse, which is ravaging our country.
  We have all heard the grim statistics. 129 people die every day from 
drug overdose. That is more than 47,000 a year. These people are our 
neighbors, friends, and loved ones. They come from all walks of life 
and all communities. They need our help. Today, the House is answering 
the call.
  The conference report we are considering today represents a truly 
comprehensive response to the opioid epidemic. It includes provisions 
from 18 bills passed by the House in May and addresses all facets of 
the epidemic. It permits the government to make grants for purposes of 
prevention, treatment and recovery, overdose reversal through the use 
of FDA-approved and appropriately labeled drugs and devices, and law 
enforcement and investigative purposes.
  Significantly, the conference report preserves the provisions of the 
Judiciary Committee's flagship bill, H.R.

[[Page H4556]]

5046, which passed this House in May by an overwhelming 413-5 vote. 
This historic legislation, which was sponsored by Crime Subcommittee 
Chairman Jim Sensenbrenner, creates a comprehensive Justice Department 
grant program to help States fight opioid addiction. It authorizes $103 
million annually over 5 years for the grant program. It directs 
precious taxpayer dollars responsibly by leveraging and streamlining 
existing programs, and it is fully offsetting the legislation in 
compliance with the House's CutGo proposal.
  The conference report authorizes this funding for a wide variety of 
anti-opioid activities, including drug courts which have proven to be 
highly successful and which I support. In fact, it is my expectation, 
Mr. Speaker, that drug courts will continue to receive funding levels 
in future years similar to current funding levels.
  In addition to H.R. 5046, this conference report contains provisions 
from three other Judiciary Committee bills, including H.R. 5052, the 
OPEN Act, which increases the transparency and accountability of the 
comprehensive opioid abuse grant program in H.R. 5046; H.R. 4985, the 
Kingpin Designation Improvement Act, which protects classified 
information from disclosure when a drug kingpin challenges his 
designation as such in a Federal court; and H.R. 5048, the Good 
Samaritan Assessment Act, which requires the GAO to study State and 
local Good Samaritan laws that protect caregivers, law enforcement 
personnel, and first responders who administer opioid overdose reversal 
drugs or devices from criminal or civil liability, as well as those who 
contact emergency service providers in response to an overdose.
  In addition, the Judiciary Committee moved as part of this package S. 
32, the Transnational Drug Trafficking Act. That legislation, which has 
already been signed into law, improves law enforcement's ability to 
pursue international drug manufacturers, brokers, and distributors in 
source nations. Federal prosecutors can now use the important tools in 
that bill to pursue foreign drug traffickers who are poisoning American 
citizens.
  Along with the excellent legislation prepared by our sister 
committees, spearheaded by Chairmen Upton, Miller, and Kline, these 
bills make substantial policy changes within the Federal agencies 
responsible for fighting addiction. They take real steps to address the 
opioid epidemic and provide real relief for a real problem affecting 
real Americans. Members of this body should be proud of these 
accomplishments.

                              {time}  1100

  I would like to stress, Mr. Speaker, that opposition to this 
conference report on the basis of funding is wrong and misguided. As I 
stated, this legislation authorizes $103 million just for Justice 
Department programs.
  Under the leadership of Chairmen Rogers, Culberson, Cole, Crenshaw, 
and Dent, the House Committee on Appropriations has responded admirably 
to this epidemic by allocating hundreds of millions of dollars in 
funding for these programs. The CJS appropriations bill contains $103 
million in funding for the DOJ program. The Labor/HHS bill, released 
Wednesday, contains $581 million to address opioid and heroin abuse, 
which is above even the President's budget request. The Financial 
Services and General Government bill has funded High Intensity Drug 
Trafficking Areas and Drug-Free Communities Support Programs at record 
highs. Nobody can come to this floor and credibly claim that the House 
is not putting its money where its mouth is.
  I thank my colleagues for their support and hard work. Yesterday we 
received a letter signed by 233 addiction stakeholder groups, endorsing 
the conference report to S. 524. I urge everyone to support this 
conference report.
  Mr. PALLONE. Mr. Speaker, I yield 1 minute to the gentlewoman from 
California (Ms. Pelosi), our Democratic leader.
  Ms. PELOSI. Mr. Speaker, I thank the gentleman for yielding. I thank 
him for his excellent work in bringing this bipartisan legislation to 
the floor. With all due respect to Mr. Goodlatte, I credibly come to 
the floor to say that this bill does not provide the funding that we 
need to address the opioid crisis in our country.
  I thank Mr. Upton again. I know this is his last year as chairman of 
the committee. I thank him for his openness, his willingness to work in 
a bipartisan way, and I do think that this is a good piece of 
legislation. It is lacking one thing: the resources to get the job 
done.
  I also come to the floor as an appropriator, and to hear Mr. 
Goodlatte say what is coming out of here and coming out of there, in 
our subcommittee on Labor/HHS, we call it the lamb-eat-lamb committee 
because there was no good place to take money from. We had carefully 
and economically husbanded the resources in such a way, when we did 
budget agreements, to use the money very well for its purposes: the 
investments in education and health, et cetera.
  So when an emergency comes along like the opioid epidemic, like Zika, 
like Flint, these are emergencies, and by tradition, this House has 
always declared emergencies--whether a natural disaster or otherwise--
to say that funding would not be lamb-eat-lamb within the 
appropriations process and take funds from very needed initiatives that 
Congress had agreed to in our own authorizations otherwise.
  So it had been my intention for us to come to the floor to oppose 
this bill to be able to sustain a Presidential veto until there would 
be resources. But in the spirit of this day, we come to the floor 
instead to say let's move the process along, but let's also say that 
there are other issues, like opioids, and Zika, and Flint that we 
really have to address in the near term.
  The opioid epidemic, as it has been said by the distinguished 
chairman and ranking member and others, is such an important challenge 
to the well-being of our country. While you may say Flint is in 
Michigan and Zika is down south, the fact is they affect all of us. But 
opioids are right there in all of our communities, and all of the 
Members of Congress immediately see the need for the authorization but 
also for the funding.
  The opioid conference report includes many important authorizing 
provisions in a bipartisan way, but it does not include the new funds 
that are essential to saving lives from opioids.
  Around a dozen law enforcement people were at the White House 
yesterday talking about the opioid epidemic. Many people outside of the 
Congress support the principles in this bill. But do you know that some 
of those law enforcement officials are having separate fundraisers of 
their own in order to help people address their opioid challenge?
  We are just not living up to our responsibility in a timely fashion. 
Within the next week, hopefully, we will leave with some additional 
funding. The President has asked for $1.1 billion to address the 
problem. The distinguished chairman of the Committee on the Judiciary 
says that the appropriators are putting more than that in certain cases 
in opioids; but if they are taking it out of other priorities, other 
investments in the health and well-being and the security of the 
American people, we are doing this at the expense of other good 
investments.
  We will not stop fighting until America's families have the 
prevention, treatment, and recovery resources they need to overcome the 
opioid epidemic, and that is why for today, although the votes are 
there to sustain a Presidential veto, we don't encourage that.
  We encourage our cooperation today with the hope and the promise that 
Mr. Rogers, whom we all respect--I served with him on Appropriations--
and Mrs. Lowey can come to terms in a way that does not have the opioid 
epidemic funded at the expense of other investments important to the 
American people. It is a priority. It is an emergency. In other cases 
we have had emergency spending for just that.
  When we do budget agreements, as we did last year--very difficult 
staying under the caps and the rest--it was not with the idea that 
there would be a $1.1 billion need for opioids or $1.9 billion need for 
Zika funding or there wouldn't be hundreds of millions of dollars for 
Flint. These are extraordinary emergencies. They should be treated that 
way.
  Nonetheless, I congratulate Mr. Upton and Mr. Pallone and all who had 
a role in putting this legislation together. I hope that it is just a 
first

[[Page H4557]]

step that in the very, very near future we will have money to match the 
values that are contained in this legislation.
  Mr. UPTON. Mr. Speaker, may I inquire as to how much time is 
remaining on both sides?
  The SPEAKER pro tempore. The gentleman from Michigan has 21 minutes 
remaining. The gentleman from New Jersey has 22\1/2\ minutes remaining.
  Mr. UPTON. Mr. Speaker, I yield an additional 1 minute to the 
gentleman from Virginia (Mr. Goodlatte) the chairman of the Committee 
on the Judiciary, a partner in this effort from day one.
  Mr. GOODLATTE. Mr. Speaker, I would briefly like to discuss with my 
friend and partner in this effort, the chairman of the Committee on 
Energy and Commerce, how the conference report encourages innovation by 
allowing alternative therapies to qualify for funding while also 
requiring evaluation and reporting on the effectiveness of all 
authorized programs.
  In my district, some nonprofit organizations are using animal-
assisted psychotherapy to successfully address mental health and 
personal development needs, including for veterans, and animals have 
also helped prison inmates achieve life-changing developments.
  It is my understanding that these and other alternative therapies are 
eligible for funding under the grant programs contained in the 
conference report. And I would ask the gentleman from Michigan: Is that 
your understanding as well?

  Mr. UPTON. Will the gentleman yield?
  Mr. GOODLATTE. I yield to the gentleman from Michigan.
  Mr. UPTON. Absolutely is the answer, yes. Section 601, the State 
demonstration grants for comprehensive opioid abuse response, is 
designed to allow States the flexibility to do what is right and aid in 
establishing a comprehensive response. Under this grant, we emphasize 
prevention and treatment, but those are not the only two ways to 
address the opioid epidemic. Recovery, like the good work that Chairman 
Goodlatte cited in his district, as it is in mine, is equally as 
important.
  We need a comprehensive response to the crisis that should leave no 
stone unturned in our quest for helping those in need. I want to thank 
the chairman for his help in that effort, and I absolutely agree with 
his reading of the bill.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, my Republican colleagues argue that we will pass this 
authorization bill today, and then sometime down the line we will 
provide funding through the regular appropriations process. But the 
problem is that that response does not match the urgency of the crisis.
  To understand why, let's just take a quick look at the 2016 
appropriations process. While the fiscal year 2016 began on October 1, 
2015, the omnibus fiscal year 2016 appropriations act did not become 
law until December 18, 2015. If, as expected, the fiscal year 2017 
process is similar, it will be at least 6 months before we can provide 
funding through the fiscal year 2017 appropriations process; and that 
is 6 months in which more people will die from potentially preventable 
overdose deaths and more individuals and families in need of treatment 
options will be unable to access them.
  There is also no guarantee that additional funds will be made 
available through the appropriations process. The fiscal austerity 
policies of my Republican colleagues also make this option untenable. 
Due to the sequestration caps demanded by the Republicans, an increase 
in spending for one program can only occur with the cutting of funding 
for another program.
  While the Republicans will say they introduced a Labor/HHS bill with 
$500 million in funding for a comprehensive State grant program for 
substance abuse treatment, what they don't say is that to provide that 
funding, we will have to agree to cut funding for other critical 
programs. The Republican Labor/HHS appropriations bill proposes 
eliminating funding for ObamaCare, title X family planning services, 
education programs, and employment training and development programs.
  Not only are these cuts objectionable, we don't have to make such 
choices. We have bipartisan pay-fors available to offset the direct 
appropriations of funding now, and we cannot afford to wait. So this is 
truly an urgent crisis, and we should treat it as such by providing 
critical funding immediately. Failure to act will unacceptably lead to 
more deaths, and our communities cannot afford to wait any longer.
  Mr. Speaker, I reserve the balance of my time.
  Mr. UPTON. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
New Jersey (Mr. Lance), a fellow conferee and member of the Committee 
on Energy and Commerce.
  Mr. LANCE. Mr. Speaker, I rise today in strong support of this 
conference report. It is a great step forward in the fight against the 
scourge of drug addiction. I was proud to serve on the conference 
committee that crafted this package, and I thank Chairman Upton and 
Chairman Grassley for their tremendous leadership on the issue.
  This measure includes language that I authored with my Democratic 
colleague, Congressman Sean Patrick Maloney of the Hudson Valley in New 
York State, that targets opioid addiction's strong ties to prescription 
drug abuse and the issue of overprescription. It is one part of a 
comprehensive plan that will make serious progress on this challenge 
that strains law enforcement and taxpayer resources and cuts too many 
lives tragically short.
  This package comes the same week we secured passage of a landmark 
overhaul of our Nation's mental health care system. These are major 
priorities of the American people, and this is how Congress should 
work, gaining ideas and insight from the constituencies across the 
Nation and working together in a bipartisan fashion to address the 
important issues confronting the United States.
  On this very sad day, given the horrific events in Dallas last night, 
we are reminded that a great many issues face our country. I hope the 
spirit of cooperation that secured this week's productivity will guide 
us on the other challenges we face as a nation. I want to work on what 
unites us in the United States and on the priorities of all Americans. 
This conference report is one of those priorities, and I urge a ``yes'' 
vote.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, as I said before, this conference report does include 
important and proven programs to address prevention, treatment, and 
recovery with regard to opioid abuse, and I did want to mention a few.
  There is authorization to create a grant program for eligible 
entities to promote the prescribing of opioid reversal drugs, naloxone, 
in conjunction with opiates for patients at an elevated risk of 
overdose.
  There is a program to reauthorize SAMHSA grants for the funding of 
residential treatment programs for pregnant and postpartum women with 
substance use disorders.
  There is a demonstration grant program to States to streamline State 
requirements and procedures in order to assist veterans who have 
completed military emergency medical technician training to meet 
requirements for becoming an emergency medical technician in the State.
  There is also a State grant program to increase the implementation of 
standing orders for opioid overdose reversal medication, again, 
naloxone.
  As I have said before, there are a number of very important programs 
here that authorize grants to States to deal with the prevention, 
treatment, and recovery from opioids. But, again, these programs will 
not be effective without some significant funding provided pursuant to 
those authorizations. So I want to stress, again, as Democrats, we 
support this bill because it does have authorization for many programs 
that will help with opioid addiction, but we need to hold the 
Republicans' feet to the fire to make sure that this funding is 
actually provided.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1115

  Mr. UPTON. Mr. Speaker, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Meehan), a fellow conferee and a member of the Ways 
and Means Committee.

[[Page H4558]]

  

  Mr. MEEHAN. I thank the chairman for his leadership on this important 
bill.
  Mr. Speaker, the statistics are staggering. We are losing 120 a 
people a day to opioid abuse.
  Earlier this year, southeastern Pennsylvania lost an accomplished 
young man, John Decker, who succumbed to his battle with addiction. As 
a teenager, John injured his knee playing basketball. His physician 
prescribed opioids to manage the pain after surgery. John became 
addicted to the painkillers and moved on to using heroin.
  I introduced the John Thomas Decker Act with the goal of preventing 
injured youth and adolescent athletes from getting addicted to opioids 
and turning to heroin. But I use John's name because it is not about 
statistics; it is to demonstrate that we are talking about real people 
and struggling families here.
  The legislation, which is included in section 104 of the conference 
report, directs the United States Department of Health and Human 
Services to study what information and resources are available to youth 
athletes and their families regarding the dangers of opioid use and 
abuse, nonopioid treatment options, and how to seek addiction 
treatment. The Department must report its findings and work with 
stakeholders to disseminate resources to students, parents, and those 
involved in treating sports injuries, and that is how this can work 
together with things that are already happening in the community.
  I want to acknowledge what is going on in communities all across the 
country.
  Just last week, I visited Adapt Pharma, a constituent company, in 
Radnor, Pennsylvania. The company makes a Narcan nasal spray and is 
providing the antidote to high schools. Adapt Pharma and the National 
Association of School Nurses are working together to ensure that 
educational materials are available to students and their families 
about prescription drug abuse as well as treatment and recovery options 
that will work perfectly in tandem with this particular section.
  So, whether you are young athletes, pregnant mothers, struggling 
veterans, or suffering families, so many are going to be helped.
  I urge my colleagues to stand with the families who have suffered the 
effects of addiction and support the conference report.
  Mr. PALLONE. Mr. Speaker, I yield 5 minutes to the gentleman from 
Michigan (Mr. Conyers), the dean of the House and the ranking member of 
the Judiciary Committee.
  Mr. CONYERS. Mr. Speaker, the crisis of opioid abuse and addiction 
clearly requires our immediate attention. I believe that that is now 
happening.
  I am grateful for the tireless work of my colleagues on the Judiciary 
Committee. I thank Chairman Goodlatte; Crime, Terrorism, Homeland 
Security, and Investigations Subcommittee chairman, Jim Sensenbrenner; 
Crime Terrorism, Homeland Security, and Investigations Subcommittee 
ranking member, Sheila Jackson Lee; and their staffs. And I also 
congratulate Congresswoman Suzan DelBene, who worked so hard to ensure 
this bill would find promising approaches to opioid abuse that were 
pioneered in her district. Finally, I wish to thank the ranking member, 
Frank Pallone of the Energy and Commerce Committee, and his staff for 
their assistance and coordination in this effort.
  Our work has focused on the need to address an urgent crisis. In my 
State of Michigan, there were 1,745 drug overdoses in the year 2014, 
and more than half of those overdose deaths were caused by opioids and 
heroin. Each day, 78 Americans die from an opioid overdose.
  Fortunately, we now have a better way of addressing issues of 
addiction, and we know that incarceration is not the answer. For 
instance, the Judiciary Committee's Crime, Terrorism, Homeland 
Security, and Investigations Subcommittee held a hearing last year that 
examined, among other things, the promising use of the Law Enforcement 
Assisted Diversion approach employed in cities such as Seattle, 
Washington, and Santa Fe, New Mexico.
  We know that there are effective ways to get addicts to treatment and 
to quickly provide them with needed services that address their 
addiction and prevent recidivism, and we know that evidence-based 
treatment and alternatives to incarceration work.
  Title II of this bill reflects much of this approach in the grant 
program, as reported by the Judiciary Committee and passed by the House 
in May of this year. While I have supported this effort, I have also 
supported alternative approaches that provide separate grant programs 
for many of these worthy purposes.
  Regardless of which approach we take, we must do more than simply 
authorize funding. We must provide real dollars that are urgently 
needed by those fighting this crisis, and I am disappointed that this 
bill does not do this.
  Mr. UPTON. Mr. Speaker, I yield 1 minute to the gentleman from the 
great State of Michigan (Mr. Trott), a fellow conferee.
  Mr. TROTT. Mr. Speaker, I am proud to support the conference report 
that we are considering today. And as my colleague, Mr. Conyers, just 
mentioned, 1,745 individuals died of a drug overdose in Michigan in 
2014, and 449 of those individuals were in my home district in Oakland 
and Wayne Counties. So a disproportionate number of people were 
affected.
  As has been mentioned, this bill contains some good solutions toward 
fighting this epidemic: a comprehensive grant program, changes to 
existing law, and some new programs to help end the tragedies. Some 
have suggested, however, that our response is inadequate or too small 
of a step to fight this problem. I disagree.
  Let me say to those people who are listening, particularly those who 
have suffered from addiction or lost a loved one through the tragedy of 
an overdose, that Republicans and Democrats and the President recognize 
this epidemic. We are united in our commitment to defeat the abuse and 
tragedy. We in Congress will revisit our programs and solutions and the 
money we are spending to make sure that they are making a difference, 
and we will revisit the solutions and make sure that adequate resources 
are in place so we can end the terrible drug abuse and heroin overdoses 
that are affecting our communities.
  I thank the gentleman for the opportunity to serve on the conference 
committee.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I want to stress that President Obama recently announced 
additional actions to expand access to treatment, strengthen 
prescription drug monitoring, enable safe disposal of unneeded drugs, 
and accelerate research on pain and opioid misuse and overdose. The 
President, I think, has made it clear that addressing this epidemic is 
a priority for his administration.
  While Federal agencies have been using their authority to take every 
available action they can, Congress needs to provide additional funding 
to make lifesaving treatment available to everyone who needs it. The 
President has called for $1.1 billion in new funding to help Americans 
who want treatment wherever they live. Every day that passes without 
congressional action to provide these additional resources is a missed 
opportunity to get treatment to those who want it, help prevent 
overdoses, and support communities across the country impacted by this 
epidemic.

  Recovery from opioid and other substance use disorders is possible, 
and many Americans are able to recover because they get the treatment 
and care they need. But too many still are not able to get treatment. 
That is why the President has called on Congress to provide the 
resources needed to ensure that every American with an opioid use 
disorder who wants treatment can get it and start on the road to 
recovery.
  Mr. Speaker, I reserve the balance of my time.
  Mr. UPTON. Mr. Speaker, I yield 2 minutes to the gentleman from 
Florida (Mr. Bilirakis), also a conferee and a member of the Energy and 
Commerce Committee.
  Mr. BILIRAKIS. Mr. Speaker, I rise today in support of the 
Comprehensive Addiction and Recovery Act. We all have experienced the 
opioid epidemic in some way, whether it is through family, friends, or 
heartbreaking stories from constituents back home.

[[Page H4559]]

  Opioid addiction is prevalent in our veteran community, and I am 
proud many of my provisions to help our heroes were included in this 
legislation. I want to thank the chairman for including those 
provisions in this particular conference report.
  My bills, the PROMISE Act and COVER Act, will update the clinical 
practice guidelines used to treat our servicemembers for pain 
management and provide a pathway forward to implement complementary and 
integrative health alternatives within the VA.
  With this bill, we can help our struggling heroes and others battling 
addiction across the Nation. I urge my colleagues to support this 
important piece of legislation.
  Mr. PALLONE. Mr. Speaker, may I inquire as to the time remaining on 
each side.
  The SPEAKER pro tempore. The gentleman from New Jersey has 14 minutes 
remaining. The gentleman from Michigan has 14\1/2\ minutes remaining.
  Mr. PALLONE. Mr. Speaker, I reserve the balance of my time.
  Mr. UPTON. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Indiana (Mrs. Walorski), my partner in terms of a contiguous border and 
also a conferee.
  Mrs. WALORSKI. Mr. Speaker, I rise today in strong support of S. 524, 
the Comprehensive Addiction and Recovery Act. This vital bill will help 
address the prescription drug epidemic we have seen plague our 
communities for so long.
  Dozens of Americans die each day from prescription drug overdoses. 
This has to stop. It is time for us to come together as a nation to 
tackle the issue that has infected every fabric of our society.
  I am very honored to have served on this conference committee for the 
bill, and I am thankful it is being considered today by the House.
  As a member of the House Veterans' Affairs Committee, I have seen the 
opioid epidemic's effects on our Nation's veterans. Veterans are more 
vulnerable to chronic pain, more susceptible to addiction, but some VA 
facilities still overprescribe these powerful drugs. I have seen the 
problem firsthand with veterans coming into my office, often carrying a 
large box or bag of pills.
  In my home State of Indiana, the DEA raided the VA Medical Center in 
Marion after noticing the volume of narcotics and opioids purchased by 
the facility.
  For too long, the VA has relied too heavily on opioids to treat 
chronic pain. This bill addresses that by requiring the VA and the DOD 
to focus on improving their prescribing practices. It includes my piece 
of legislation requiring the VA to report to State Prescription Drug 
Monitoring Programs, which are important and effective tools for 
stopping overprescription. It also allows the VA to consider nonopioid 
treatments for veterans with chronic pain.
  Mr. Speaker, there is a long battle ahead of us--we have got a long 
way to go, and a lot of damage has been done--but this bill represents 
an important step forward as we seek to stop overprescription and 
opioid addiction in our country.
  I urge my colleagues to support this bill.
  Mr. UPTON. Mr. Speaker, I yield 1 minute to the gentlewoman from 
California (Mrs. Mimi Walters).
  Mrs. MIMI WALTERS of California. Mr. Speaker, across the United 
States, we are faced with a substance abuse epidemic that results in 
overdose, addiction, and far too many deaths.
  From opioids to heroin, no community--not even Orange County, the 
place that I have called home for over 50 years--is immune. Last year, 
the number of deaths in Orange County caused by drug overdose rose to 
400, the highest level in at least a decade. More than two-thirds of 
these untimely deaths involved opioids. Nationwide, nearly 130 people 
die every single day from drug abuse.
  Though this is a nationwide epidemic, there is not a one-size-fits-
all cure to addiction. That is why this legislation is so important. I 
thank all of my colleagues who have worked so intently on these 
lifesaving policies.
  I urge my colleagues to join me in supporting this measure so that we 
can send it to the President's desk. As soon as this law is 
implemented, it will save lives and help Americans suffering from 
addiction reclaim their lives.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  I just want to again point out that the effort here is not only 
bipartisan, but we are also working with the administration to try to 
address this epidemic. And one of the things that we were trying to do 
with the legislation, but it became unnecessary because of the 
President's executive action, was with regard to bup.

                              {time}  1130

  This is a painkiller, if you will, that is used as an alternative to 
the addictive painkillers that cause the opiate problem. And until 
recently, under the law, a physician could only have up to 100 patients 
to whom he was administering bup, but now, in the last week or so, the 
President announced that that cap has been lifted to 275.
  Now, in the legislation, we do expand the types of providers who can 
treat opioid dependence using bup, but, at the same time, it was 
necessary, I believe, to raise that cap because there is a waiting 
list--a rather extensive waiting list--for people who would like to 
take advantage of bup. So I just wanted to say that that is one of the 
most important things that actually was done by the President.
  And it is very important for us to work together not only in terms of 
what we authorize, but also providing the funding for many of these 
programs, both what we are now authorizing pursuant to grants in this 
legislation, as well as what the administration is doing through agency 
action.
  Mr. Speaker, I reserve the balance of my time.
  Mr. UPTON. Mr. Speaker, I yield 1 minute to the gentleman from 
Pennsylvania (Mr. Rothfus).
  Mr. ROTHFUS. Mr. Speaker, I commend the chairman, the ranking member, 
the conferees, on this work that they have accomplished.
  The opioid and heroin epidemic has hit western Pennsylvania hard. 
Nothing brings this crisis into sharper focus than when you are 
speaking with a parent who has lost a child, or a family member 
watching a loved one go through revolving doors of treatment and still 
be slipping away.
  This conference report has been a bipartisan, all-hands-on-deck 
effort reflective of the collaboration we see happening at the 
grassroots of our communities. I am pleased to see the conference 
report include the provision my colleague from across the aisle, 
Congressman Keating, and I championed in the House legislation to 
establish coprescribing guidelines for overdose antidotes such as 
naloxone.
  I am also pleased with how this legislation gives the proper focus to 
our veterans. This conference report is a necessary step in moving 
forward to address this crisis. Let us continue to work together to 
combat this deadly scourge. I urge its passage.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume 
to close.
  Again, Mr. Speaker, I will say that, after thoughtful consideration, 
I not only support the conference report, but I would urge my 
colleagues on the Democratic side to support the conference report.
  While I continue to believe that we cannot turn the tide on this 
epidemic without dedicated additional resources for States, the 
underlying policies included in this bill are important steps forward.
  As you know, Democratic conferees, along with the Democratic 
leadership, have worked tirelessly these past few weeks to try to 
include money for States to help treat our communities who are 
suffering. Republicans still, so far, refuse to commit the essential 
funding as part of this overall bill, but they have committed to 
increasing funding through the appropriations process, and I will 
continue to fight to ensure that they stand by that commitment.
  The American people are desperate for relief. We must answer their 
call and continue our efforts in Washington, and one way to do that, 
certainly, is to pass this conference report.
  I yield back the balance of my time.
  Mr. UPTON. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, first I want to thank my friend and partner, Mr. 
Pallone. We moved a majority of these bills

[[Page H4560]]

through the committee on a bipartisan basis. We had those votes here on 
the floor, a very strong vote as the process moved.
  Mr. Speaker, this bill is about treatment. It is about prevention. It 
is about recovery, helping law enforcement, particularly with our drug 
courts, and it adds new resources to help communities suffering from 
this terrible opioid epidemic.
  The Comprehensive Addiction and Recovery Act represents the most 
serious and comprehensive effort ever undertaken by this body to tackle 
the problem. CARA is a bipartisan blend of the best ideas from the 
House and the Senate. These bills passed with a combined 494 votes in 
the House and the Senate and, coupled with the great work led just this 
week by the House Appropriations Committee to add $581 million to help 
fund and prioritize these programs, it shows that we are tackling the 
problem head-on.
  Now, this is an authorization bill, not an appropriation bill. That 
is why, coupled with the appropriators, I think that we will get the 
job done. As I have said, at the end of the day, the money will be 
there.
  So those on the front lines fighting the opioid epidemic deserve a 
strong vote in the people's House. I would urge my colleagues to vote 
``yes.''
  Mr. Speaker, I yield 30 seconds to the gentlewoman from Texas (Ms. 
Jackson Lee).
  Ms. JACKSON LEE. Mr. Speaker, I thank the gentleman for yielding.
  I just want to add my voice and thank Mr. Upton, as the chair of the 
conference, and Mr. Pallone, and all of the conferees, for what I 
thought was a significant historical moment.
  We have passed legislation, as a member of the Judiciary Committee, 
with no mandatory minimums. Our CARA bill speaks about grants, helping 
people overcome their addiction, but more importantly, helping 
communities. My community alone is suffering from something called 
Kush. That is not heroin, but all of these issues have to be confronted 
as a health epidemic.
  I thank the gentleman for accepting my amendment dealing with other 
drugs, about dealing with a public health epidemic, and I ask for 
support of the conference report.
  Mr. Speaker, I rise to discuss the conference report for S. 524, the 
Comprehensive Addiction and Recovery Act.
  The conference report is the product of a long process of 
consultation and hard work between Congress and experts and advocates 
representing a wide range of interests--including victims, addiction 
treatment specialists, and law enforcement.
  In many respects, this bill is a compromise--but it does reflect 
advances in our approach to substance addiction issues.
  As a Member of the Bipartisan Task Force to Combat the Heroin 
Epidemic I have worked with my colleagues to come together with a 
comprehensive legislative package to address this national epidemic.
  I was an original cosponsor of the lead legislative measure and 
primary contribution of the House Judiciary Committee, H.R. 5046, the 
Comprehensive Opioid Abuse Reduction Act, and I was a cosponsor of the 
predecessor bill, which is substantially similar to the Senate-passed 
version of S. 524.
  The text of H.R. 5046 is largely incorporated into the conference 
report, and would establish a grant program, to be administered by the 
Department of Justice, to assist states and local governments, 
particularly by helping criminal justice agencies to tackle the opioid 
problem from a variety of angles.
  It would encourage the development of alternatives to incarceration 
that provide treatment as a solution to the underlying motivation for 
criminal behavior or conduct associated with mental disorders.
  Combined with other treatment programs under the jurisdiction of 
other Committees, the approach Congress is taking with the crisis of 
heroin and other opioids is thoughtful and comprehensive.
  I hope it signals a departure from some of the failed approaches 
concerning other drug crises in the past.
  For instance, our response to the surge in crack cocaine in the 1980s 
was to enact draconian mandatory minimum penalties with vastly 
disparate treatment for crack and powder cocaine.
  At that time, Congress took action that we are still trying to 
rectify.
  At one point, more than 80 percent of the defendants sentenced for 
crack offenses were African American, despite the fact that more than 
66 percent of crack users are white or Hispanic.
  As we work on other legislation to address the enforcement and 
sentencing disparities related to the crack issue, we must re-examine 
our approach to that and other drug issues.
  I am grateful for the assistance of my colleague, Bob Goodlatte, the 
Chairman of the Judiciary Committee, for working with me to include in 
this bill my amendment to express the sense of the Congress that an 
effective and fiscally responsible approach to addressing substance 
abuse epidemics--no matter which drug is involved--requires treating 
such epidemics as a public health emergencies emphasizing prevention, 
treatment, and recovery.
  Provided in Section 708 of the Report, the Sense of Congress 
Regarding Treatment of Substance Abuse Epidemics expresses that decades 
of experience and research have demonstrated that a fiscally 
responsible approach to addressing the opioid abuse epidemic and other 
substance abuse epidemics requires treating such epidemics as a public 
health emergency emphasizing prevention, treatment and recovery.
  Indeed, we must adopt a public health approach with regard to 
substance abuse issues going forward.
  And I am heartened that, in this bill, we are not raising sentences 
or impacting mandatory minimums that add to mass incarceration, but we 
are supporting proven anti-addiction mechanisms.
  However, the conference committee had the opportunity to do even 
more--as is necessary given the urgency of the current crisis--and 
provide real money, right now, to implement the programs the bill 
authorizes.
  Unfortunately, this bill does not do that and our communities remain 
in dire need of resources to save lives that are in immediate jeopardy.
  That is the unfinished business of this effort and we must not rest 
until we have done all that we can in Congress to help protect our 
communities from opioid abuse.
  In contrast to the way we are dealing with the opioid crisis is the 
ill-advised strict ``law-enforcement'' centered approach Congress took 
in addressing crack cocaine crisis in the 1980s that that we are still 
trying to rectify.
  At one point, more than 80 percent of the defendants sentenced for 
crack offenses were African American, despite the fact that more than 
66 percent of crack users are white or Hispanic.
  While we are now engaged in a comprehensive ``public health'' 
approach centered on public health in addressing the crisis involving 
heroin and other opioids, we must not forget that there is unfinished 
work to be done to address the enforcement and sentencing disparities 
related to the crack cocaine.
  We are not raising sentences or impacting mandatory minimums but we 
are funding anti-addiction mechanisms such as treatment alternatives to 
incarceration.
  We are not adding to mass incarceration--with all of the related and 
devastating collateral consequences--but instead we are incentivizing 
state and local governments to prevent, treat, and heal.
  That is what we should be doing, and that is what we should have done 
for crack and cocaine addicts.
  But it is not too late--we should find a way, before this Congress 
adjourns sine die to apply this more comprehensive approach, including 
treatment alternatives, to those suffering from crack and cocaine 
addiction.


                  legislation supported by jackson lee

  1. Regarding bipartisan comprehensive legislation:
  H.R. 953--Comprehensive Addiction and Recovery Act of 2015
  Rep. Sensenbrenner, F. James, Jr. [R-WI-5] (Introduced 2/12/15) 124 
Cosponsors (84 Dems--including SJL, 40 Reps) *No Sentencing 
Enhancements or Penalties
  H.R. 3719--``Stop the Overdose Problem Already Becoming a Universal 
Substance Epidemic Act of 2015'' or the ``STOP ABUSE Act of 2015''
  Rep. Guinta, Frank C. [R-NH-1] (Introduced 10/08/2015) 8 Cosponsors 
(4 Dems, 4 Reps) *No Sentencing Enhancements or Penalties
  H.R. 4697--Prevent Drug Addiction Act of 2016
  Rep. Esty, Elizabeth H. [D-CT-5] (Introduced 03/03/2016) 2 Cosponsors 
(Reps) *No Sentencing Enhancements or Penalties
  2. Legislation to improve pain management practices:
  H.R. 4499--the ``Promoting Responsible Opioid Prescribing Act of 
2016'' and as the ``PROP Act of 2016''
  Rep. Mooney, Alexander X. [R-WV-2] (Introduced 02/09/2016) 31 
Cosponsors (18 Rep, 13 Dem) *No Sentencing Enhancements or Penalties
  Mr. UPTON. Mr. Speaker, I appreciate the gentlewoman's words. I was 
very pleased to work with her on the successful amendment that we added 
in the conference as part of this agreement, and I look for its swift 
passage today.

[[Page H4561]]

  I yield back the balance of my time.
  Mr. VAN HOLLEN. Mr. Speaker, I rise in support of the conference 
report of S. 524, the Comprehensive Addiction and Recovery Act (CARA). 
Families devastated by opioid addiction deserve action, and this 
legislation will take some important steps to reduce the toll on our 
communities. None of our districts is immune to this epidemic that is 
causing so much death and heartache.
  The conference report includes elements from both the bipartisan 
House and Senate versions of their respective opioid measures recently 
approved almost unanimously. It includes provisions that incorporate 
prevention tactics and expanded access to treatment, recovery support 
services, and overdose reversals. Additionally, the report encourages 
criminal justice agencies to integrate and sustain Medication-Assisted 
Treatment (MAT) programs.
  Although this report includes vital and much needed measures, we 
cannot pretend that it will solve the problem. I am disappointed that 
this legislation does not include adequate funding to fully help us get 
ahead of this crisis.
  During conference, my Democratic colleagues from both chambers 
offered amendments that would provide funding for the authorizations 
within the package. Unfortunately, they were turned down, so we must 
continue to fight for the resources necessary to meaningfully implement 
this package.
  I request my colleagues to support this report and to continue to 
work on a bipartisan basis to provide the resources needed to save 
lives.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 809, the previous question is ordered.
  The question is on the conference report.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. UPTON. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 9 of rule XX, this 15-
minute vote on the adoption of the conference report will be followed 
by a 5-minute vote on the motion to permit closed conference meetings 
on S. 2943, if offered.
  The vote was taken by electronic device, and there were--yeas 407, 
nays 5, not voting 21, as follows:

                             [Roll No. 399]

                               YEAS--407

     Abraham
     Adams
     Aderholt
     Aguilar
     Allen
     Amodei
     Ashford
     Babin
     Barletta
     Barr
     Barton
     Bass
     Beatty
     Becerra
     Benishek
     Bera
     Beyer
     Bilirakis
     Bishop (GA)
     Bishop (MI)
     Bishop (UT)
     Black
     Blackburn
     Blum
     Blumenauer
     Bonamici
     Boustany
     Boyle, Brendan F.
     Brady (PA)
     Brady (TX)
     Bridenstine
     Brooks (IN)
     Brownley (CA)
     Buchanan
     Buck
     Bucshon
     Burgess
     Bustos
     Butterfield
     Byrne
     Calvert
     Capps
     Capuano
     Cardenas
     Carney
     Carson (IN)
     Carter (GA)
     Carter (TX)
     Castor (FL)
     Castro (TX)
     Chabot
     Chaffetz
     Chu, Judy
     Cicilline
     Clark (MA)
     Clarke (NY)
     Clawson (FL)
     Clay
     Cleaver
     Clyburn
     Coffman
     Cohen
     Cole
     Collins (GA)
     Collins (NY)
     Comstock
     Conaway
     Connolly
     Conyers
     Cook
     Cooper
     Costa
     Costello (PA)
     Courtney
     Cramer
     Crawford
     Crenshaw
     Crowley
     Cuellar
     Culberson
     Curbelo (FL)
     Davidson
     Davis (CA)
     Davis, Danny
     Davis, Rodney
     DeFazio
     DeGette
     DeLauro
     DelBene
     Denham
     Dent
     DeSantis
     DeSaulnier
     DesJarlais
     Deutch
     Diaz-Balart
     Dingell
     Doggett
     Dold
     Donovan
     Doyle, Michael F.
     Duckworth
     Duffy
     Duncan (SC)
     Duncan (TN)
     Edwards
     Ellison
     Ellmers (NC)
     Emmer (MN)
     Engel
     Eshoo
     Esty
     Farenthold
     Farr
     Fitzpatrick
     Fleischmann
     Fleming
     Flores
     Forbes
     Fortenberry
     Foster
     Foxx
     Frankel (FL)
     Franks (AZ)
     Frelinghuysen
     Fudge
     Gabbard
     Gallego
     Garamendi
     Garrett
     Gibbs
     Gibson
     Goodlatte
     Gosar
     Gowdy
     Graham
     Granger
     Graves (GA)
     Graves (LA)
     Graves (MO)
     Grayson
     Green, Al
     Griffith
     Grijalva
     Grothman
     Guinta
     Guthrie
     Gutierrez
     Hahn
     Hanna
     Hardy
     Harper
     Harris
     Hartzler
     Heck (NV)
     Heck (WA)
     Hensarling
     Herrera Beutler
     Hice, Jody B.
     Higgins
     Hill
     Himes
     Hinojosa
     Holding
     Honda
     Hoyer
     Hudson
     Huelskamp
     Huffman
     Huizenga (MI)
     Hultgren
     Hunter
     Hurd (TX)
     Israel
     Issa
     Jackson Lee
     Jeffries
     Jenkins (KS)
     Jenkins (WV)
     Johnson (GA)
     Johnson (OH)
     Johnson, E. B.
     Johnson, Sam
     Jolly
     Jones
     Jordan
     Joyce
     Kaptur
     Katko
     Keating
     Kelly (IL)
     Kelly (MS)
     Kelly (PA)
     Kennedy
     Kildee
     Kilmer
     Kind
     King (IA)
     King (NY)
     Kinzinger (IL)
     Kline
     Knight
     Kuster
     Labrador
     LaHood
     LaMalfa
     Lamborn
     Lance
     Langevin
     Larsen (WA)
     Larson (CT)
     Latta
     Lawrence
     Lee
     Levin
     Lewis
     Lieu, Ted
     Lipinski
     LoBiondo
     Loebsack
     Lofgren
     Long
     Loudermilk
     Love
     Lowenthal
     Lowey
     Lucas
     Luetkemeyer
     Lujan Grisham (NM)
     Lujan, Ben Ray (NM)
     Lummis
     Lynch
     MacArthur
     Maloney, Carolyn
     Maloney, Sean
     Marchant
     Marino
     Matsui
     McCarthy
     McCaul
     McClintock
     McCollum
     McDermott
     McGovern
     McHenry
     McKinley
     McMorris Rodgers
     McNerney
     McSally
     Meadows
     Meehan
     Meeks
     Meng
     Messer
     Mica
     Miller (FL)
     Miller (MI)
     Moolenaar
     Mooney (WV)
     Moore
     Moulton
     Mullin
     Mulvaney
     Murphy (FL)
     Murphy (PA)
     Napolitano
     Neal
     Neugebauer
     Newhouse
     Noem
     Nolan
     Norcross
     Nunes
     O'Rourke
     Olson
     Palazzo
     Pallone
     Palmer
     Pascrell
     Paulsen
     Pearce
     Pelosi
     Perlmutter
     Perry
     Peters
     Peterson
     Pingree
     Pittenger
     Pitts
     Pocan
     Poliquin
     Polis
     Pompeo
     Posey
     Price (NC)
     Price, Tom
     Quigley
     Rangel
     Ratcliffe
     Reed
     Reichert
     Renacci
     Ribble
     Rice (NY)
     Rice (SC)
     Richmond
     Rigell
     Roby
     Roe (TN)
     Rogers (KY)
     Rohrabacher
     Rokita
     Rooney (FL)
     Ros-Lehtinen
     Roskam
     Ross
     Rothfus
     Rouzer
     Roybal-Allard
     Royce
     Ruiz
     Ruppersberger
     Rush
     Russell
     Ryan (OH)
     Salmon
     Sanchez, Linda T.
     Sanchez, Loretta
     Sarbanes
     Scalise
     Schakowsky
     Schiff
     Schrader
     Schweikert
     Scott (VA)
     Scott, Austin
     Scott, David
     Sensenbrenner
     Serrano
     Sessions
     Sewell (AL)
     Sherman
     Shimkus
     Shuster
     Simpson
     Sinema
     Sires
     Slaughter
     Smith (MO)
     Smith (NE)
     Smith (NJ)
     Smith (TX)
     Smith (WA)
     Speier
     Stefanik
     Stewart
     Stivers
     Stutzman
     Swalwell (CA)
     Takano
     Thompson (CA)
     Thompson (PA)
     Thornberry
     Tiberi
     Tipton
     Titus
     Tonko
     Torres
     Trott
     Tsongas
     Upton
     Valadao
     Van Hollen
     Vargas
     Veasey
     Vela
     Velazquez
     Visclosky
     Wagner
     Walberg
     Walden
     Walker
     Walorski
     Walters, Mimi
     Walz
     Wasserman Schultz
     Watson Coleman
     Weber (TX)
     Webster (FL)
     Welch
     Wenstrup
     Westerman
     Westmoreland
     Whitfield
     Williams
     Wilson (FL)
     Wilson (SC)
     Wittman
     Womack
     Woodall
     Yoder
     Yoho
     Young (AK)
     Young (IA)
     Young (IN)
     Zeldin
     Zinke

                                NAYS--5

     Amash
     Brooks (AL)
     Gohmert
     Massie
     Sanford

                             NOT VOTING--21

     Bost
     Brat
     Brown (FL)
     Cartwright
     Cummings
     Delaney
     Fincher
     Green, Gene
     Hastings
     Hurt (VA)
     Kirkpatrick
     Nadler
     Nugent
     Payne
     Poe (TX)
     Rogers (AL)
     Takai
     Thompson (MS)
     Turner
     Waters, Maxine
     Yarmuth

                              {time}  1157

  Mses. VELAZQUEZ and MOORE changed their vote from ``nay'' to ``yea.''
  So the conference report was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  Stated for:
  Mr. GENE GREEN of Texas. Mr. Speaker, I was unavoidably detained. Had 
I been present, I would have voted ``yea'' on rollcall No. 399.
  Mr. BRAT. Mr. Speaker, on rollcall No. 399, I was unavoidably 
detained. Had I been present, I would have voted ``yea.''
  Mr. HURT of Virginia. Mr. Speaker, I was not present for rollcall 
vote No. 399 on agreeing to the Conference Report on S. 524, the 
Comprehensive Addiction and Recovery Act of 2016. Had I been present, I 
would have voted ``yes.''

                          ____________________