[Congressional Record Volume 162, Number 113 (Wednesday, July 13, 2016)]
[Senate]
[Pages S5022-S5028]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2016--CONFERENCE REPORT

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of the conference report to accompany S. 524, 
which the clerk will report.
  The assistant bill clerk read as follows:

       Conference report to accompany S. 524, a bill to authorize 
     the Attorney General to award grants to address the national 
     epidemics of prescription opioid abuse and heroin use.

  The PRESIDING OFFICER. Under the previous order, the time until 11 
a.m. will be equally divided between the two leaders or their 
designees.
  The Senator from Illinois.
  Mr. DURBIN. Mr. President, pending before the Senate is an important 
bill. It is a bill that relates to the opioid epidemic in America--an 
epidemic which is linked directly to the heroin epidemic in America and 
the sad reality of the deaths that are occasioned by heroin overdoses.
  The prescription opioid and heroin epidemic claimed 28,647 American 
lives in 2014--1,652 in my State of Illinois. That is a 30-percent 
increase in just 4 years.
  I have seen this devastation firsthand. I have sat with parents who 
have lost their kids. I have met with young teenagers who were 
addicted. Thank goodness that some of them have been able--with 
treatment, counseling, and strength--to fight off that addiction.
  The reality is obvious. This narcotics epidemic is not an inner city 
problem. It is an American problem. It is a problem that not only 
touches the inner cities of America, but it also touches every other 
community. There is no town too small, no suburb too wealthy to escape 
the opioid and heroin epidemic.
  I have been across my State, from one end to the other, at 
roundtables with law enforcement, with medical professionals, with 
those who do addiction treatment and with those who have lived through 
these addictions. I have seen firsthand what it has done to communities 
and families and lives. We need a forceful response, and we are going 
to vote on one in about an hour. It is called the CARA bill. It is a 
bill that moves us in the right direction when it comes to dealing with 
this addiction.
  The conference report has many important elements to it, and that is 
why I am going to support it. It includes my proposal to require 
reforms at the FDA, or the Food and Drug Administration, to ensure 
better oversight of dangerous and addictive opioid drugs before they 
are approved for sale in our country. My provisions will ensure the FDA 
convenes scientific advisory committees before approving new opioid 
drugs and that the Pediatric Advisory Committee has a voice in the 
decision.
  We require the FDA to consider the public health impacts before 
allowing more addictive products to come onto the market. We direct 
Federal health agencies to develop plans for continuing medical 
education with doctors and other providers who prescribe opioids. We 
require the FDA to encourage drug companies to make abuse-deterrent 
formulations of these dangerous drugs.
  The CARA conference report also includes a proposal I have worked on 
to improve State prescription drug monitoring programs. This 
legislation will make it easier for States to share information about 
overprescribing and overusing opioids, it gives doctors more 
information to better perform their prescribing practices.
  I am pleased the CARA conference report includes new grant programs 
to expand access to naloxone--the lifesaving anecdote--to promote 
treatment alternatives instead of arrests for those suffering from 
addiction and to create flexibility and treatment options for those who 
need medication-assisted therapy or pregnant women who need specialized 
care.
  Having said all of these positive things about what we are to vote 
on, let me state the obvious. When only 12 percent of the people in 
Illinois are able to receive care for their addiction, and there is a 
12-week wait at facilities for vulnerable patients to get into drug 
treatment, authorizing new programs, which this bill does, is good but 
not good enough. We need to make an investment. We need to put 
taxpayers' dollars behind this commitment to end this epidemic, and it 
is needed now.
  That is why Senator Jeanne Shaheen of New Hampshire offered an 
amendment during the Senate floor consideration of this bill. Her 
amendment would have put $600 million into actually making the bill 
work, enforcing it, investing in it. It failed.
  During the CARA conference meetings, Senator Murray and Congressman 
Pallone offered amendments to ensure that Congress would put some money 
into the promise of this bill. They couldn't get it passed in a 
conference dominated by the Republican majority. Why? Why would these 
efforts be blocked when the Republicans are joining us and saying this 
is a national problem that deserves our immediate attention? Because 
Republicans have said they have already proposed to increase funding in 
appropriation bills to take care of this. Yet many Republicans are 
supporting a continuing resolution that freezes funding at this year's 
level and provides for no increase in opioid epidemic treatment. When 
they say they are going to put more money in and then call for a 
continuing resolution, they know and we know that it is a sham.
  The Republicans are opposing an increase in funding for this bill by 
saying they already proposed increased funding in another bill, but at 
the same time they are advocating a freeze, or flat-funding a 
continuing resolution. They can't have it both ways.
  It is confusing, but those of us who live in this world know what 
they are up to. They want to take the credit for passing this bill and 
the promise of funding it in the future into the election in November 
but not provide the money that is needed to make it work. That is 
playing games with people's lives. America deserves better.
  Failing to provide the dollars today is not going to help those who 
are currently suffering. It is not going to help that mother who was 
awake all last night worrying about a son or a daughter who is facing 
an addiction, praying they can get that child they love into treatment 
in time to break that addiction and save their lives.

[[Page S5023]]

  You know what else is missing from this CARA conference report? Many 
of these measures in the bill deal with addiction after it has taken 
hold. We have to do things to prevent addiction on the front end. The 
best way is to ensure people don't get addicted in the first place. I 
have introduced the Addiction Prevention and Responsible Opioid 
Practices Act, or the A-PROP Act. It is going to help shut off the 
spigot for fueling this crisis.
  Here is something most people don't understand or realize. The Drug 
Enforcement Administration sounds like the kind of law enforcement 
agency that polices America to reduce the likelihood that narcotics are 
going to be found in our homes, in our neighborhoods, in our 
communities, and in our States. It also has another responsibility. 
Each year pharma, the major pharmaceutical companies, comes to this 
agency and asks for the approval to make even more narcotics. These 
are prescription narcotics like opioids. The DEA has to sign off on 
this increase in production each year.

  If we are going to take a look at the seriousness of this opioid 
problem and its growth in America, take a look at the growth of 
production in America that has been approved by this Federal agency. 
Between 1993 and 2015, the Drug Enforcement Administration-approved 
quotas for oxycodone increased almost 40 times. In 1993, they were 
producing about 3\1/2\ tons of these opioid pills. Now they are 
producing 150 tons of these opioid pills.
  The DEA has approved pharma to produce enough opioid narcotic pills 
to provide--listen closely--every adult in America a 1-month 
prescription each year to opioid narcotics--every adult in America. 
That goes way beyond any medical need. It is pharma's effort to make 
more money and to feed the beast of this opioid epidemic, and DEA each 
year gives the seal of approval. That is wrong.
  Once these pills are produced, it takes a doctor or a dentist or some 
other authorized medical professional to prescribe them. How they are 
making it through that process onto the streets and into the homes of 
America is the next question beyond this DEA approval of pharma's 
overproduction.
  We need continuing medical education to be mandated. Incidentally, 
DEA approves doctors to give them the authority and power to prescribe 
narcotics. They can monitor this, as well, and see where the abuse is 
taking place. We need an all-hands-on-deck approach to this epidemic. 
Each stakeholder needs to play a role.
  I am going to vote for this CARA conference report. On its face, it 
is hard to vote against, but I want to do it with the knowledge of 
having said in this statement on the floor that it isn't enough. Unless 
we pass Senator Jeanne Shaheen's amendment, unless we follow up on 
Senator Patty Murray's amendment in conference and fund this effort to 
stop this epidemic, we are basically sending a very nice greeting to 
America that we recognize the problem but we are not paying to solve 
it. People across America understand this epidemic. It is time for us 
to take it seriously, not for political posturing.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. SCHUMER. Mr. President, first, let me thank my colleague from 
Illinois for his remarks on the funding issue. I couldn't agree more.
  There is no question that this body should be working to help curb 
opioid abuse in this country, to improve mental health services, to 
improve the way we treat addiction and speed up recovery. Everyone in 
this Chamber knows it. But the bill before us, the Comprehensive 
Addiction and Recovery Act, is woefully insufficient for dealing with 
the opioid and heroin crisis. It makes a whole lot of changes, but it 
doesn't support a single one with new resources.
  It would authorize block grants to States to treat people who are 
hooked on these dangerously addictive prescription painkillers, but it 
doesn't provide any actual money to give. It would authorize programs 
to help law enforcement crack down on this scourge, but it doesn't 
provide a single plugged nickel to our cops.
  Without actual appropriations, this bill is like a Hollywood movie 
set--something that appears real on the surface but has no substance 
and no life behind its facade. Let me say that again. Without actual 
appropriations, this bill is like a Hollywood movie set--something that 
appears real on the surface but has no substance and no life behind its 
false facade.
  I want to clear one thing up. I have heard many of my Republican 
colleagues say that we should pass this bill, and we can just fill in 
the money later. Forgive me for being skeptical that they will actually 
follow through on that promise, because my friends on the other side of 
the aisle have been fighting for years to cut, not increase, the exact 
same programs they are now touting in this bill--what a sham.
  With the rise of the tea party, the hard-right conservative factions 
in the House and Senate brought devastating proposed cuts to the health 
programs that combat the opioid problem, and my colleagues here who are 
not members of the tea party went along. Now that there is an opioid 
crisis, now that some are worried about reelection, oh, they are out 
there. Where were they last year and the year before? Where are they 
going to be this year in terms of actually getting some funding?
  Last year, Republicans proposed billions of dollars in cuts to the 
Labor-HHS appropriations bill--the main funding source for substance 
abuse treatment. Without the bipartisan budget agreement, this would 
have cut $9 billion. In fact, the Senate Appropriations Committee 
proposed cutting the Substance Abuse and Mental Health Services 
Administration, or SAMHSA, by $160 million before Democrats pushed to 
restore it. We didn't hear much of an outcry from the very same people 
who are out there saying they are doing things on opioids.
  On the other side of the Capitol, the tea party Republicans have gone 
even further. In 2012, they proposed cutting SAMHSA by $283 million. 
The latest Paul Ryan budgets--the holy grail of Republican fiscal 
austerity--took a meat cleaver to this agency. He proposed cutting an 
estimated $400 million from SAMHSA in 2013 and 2014.
  The Republican record on actually funding these programs is, frankly, 
abysmal. When you hear treatment centers and when you hear law 
enforcement say that we don't have the resources to do what we need to 
do to go after the opioid crisis, ask yourself why, because our 
colleagues on the other side of the aisle have fought increases in 
funding.
  You can't have an additional counselor. I have held parents in my 
arms who said: My son or daughter didn't make it as they were waiting 
in line for treatment. There were not enough counselors, not enough 
slots. I have talked to law enforcement officials who say they want to 
do much more, but their hands are tied because they don't have enough 
cops, enough intelligence, enough follow-through on going after these 
evil drug dealers who are just despicable.
  We want to say to our colleagues on the other side of the aisle that 
what they probably would have done to us is to block this bill so we 
should have no accomplishments. That is what happened in 2013 and 2014. 
We are not going to do that. This has a few good things, but it is not 
close to enough.
  The way the appropriations process has proceeded this session, I see 
no reason to believe how any of this is going to change. So far the 
majority has been utterly unable to pass bills that contain increases 
in funding. Why? Why wouldn't good people here who say they want to 
fight opioids and come home and talk about it do it? I will tell you 
why. Because the hard right has a stranglehold. They say no increase in 
funding for anything, except maybe Defense, and even a lot of the hard 
right people don't want that. Everyone goes along. They are afraid of 
the Koch brothers, who want to cut, cut, cut. They are afraid of the 
Heritage Foundation that wants to cut, cut, cut, and so they give 
speeches and even pass a bill that makes some small improvements, but 
they don't get the funding. It is not that they are malicious, but they 
don't have the courage and strength to stand up and do what is needed, 
and then they are hypocritical when they go back and say they are 
leading the fight to go after opioid addiction. That is the problem 
here. After years of opposing funding for mental health and substance 
abuse programs, no one should believe that Republicans are going to 
honor their promises

[[Page S5024]]

about CARA--yeah, down the road we will find some funding--until we see 
it.

  Shortly the Senate will pass this bill. As soon as that happens, 
Republican Senators are going to run home to tout its passage as if 
they have single-handedly solved the opioid crisis in this country, but 
that will not be true. They will not mention that the bill has no 
funding and doesn't have the teeth it needs; they will not tell people 
that it doesn't include a dime for a new treatment bed, a dollar for a 
drug counselor's salary, or the needed increases in money for law 
enforcement. What it says is this: that colleagues on the other side of 
the aisle are more interested in showing voters they are doing 
something about opioids than actually doing something because they are 
constricted by a small, narrow, but powerful group of special interests 
in their party that say you can't vote for any increases in funding for 
anything, and it is a shame. This is an issue ripe for bipartisan 
compromise. It is an issue in which we can and must make real progress, 
but as it stands, this bill doesn't get the job done.
  Every day 2,500 teenagers in America abuse prescription drugs for the 
first time. These are our kids, our neighbors, and our friends. We all 
know families that have had the anguish--and the joy that some have had 
as their sons and daughters have recovered. But everyone who knows 
people who have been fighting addiction--whether it is alcohol or 
prescription drug abuse or some other substance--knows that every day 
is a struggle and a fight. You are never sure that they will not go 
back. And then there are those who have lost kids. Sometimes their kids 
are just out on the streets, and their family doesn't know where they 
are, and some of them, of course, are gone. It is nothing we should be 
playing games with, and a small group of hard-right ideologues 
shouldn't be blocking change in America. We don't need a bill designed 
for campaign rhetoric. We need resources.
  I strongly urge my Republican colleagues to schedule a vote on 
legislation that provides robust funding to address the opioid and 
heroin epidemic as soon as possible. Until we pass the increase in 
resources for law enforcement and treatment, both of which are so 
necessary, we cannot say that Congress has done what is necessary to 
solve and fight the opioid crisis.
  Mr. President, I ask unanimous consent that any time spent in quorum 
calls prior to 11 a.m. be equally divided.
  The PRESIDING OFFICER (Mr. Cotton). Without objection, it is so 
ordered.
  Mr. SCHUMER. 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.
  Ms. KLOBUCHAR. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Ms. KLOBUCHAR. Mr. President, I come to the floor today to speak in 
support of the Comprehensive Addiction and Recovery Act. This bill 
represents an important step in tackling the growing crisis of 
prescription drug and heroin addiction in this country. I thank my 
colleagues, especially the original sponsors of this bill. Senator 
Whitehouse, Senator Portman, Senator Ayotte, and I have worked together 
on this legislation for a number of years.
  Drug overdoses from opioids now claim more lives than car accidents 
every year. That is a pretty shocking statistic that I don't think most 
Americans would expect. The crisis is ripping apart families from all 
different backgrounds, and with deaths increasing nearly sixfold since 
the year 2000, it is a crisis on the rise. This deadly trend struck at 
the heart of Minnesota. Last year alone, 336 Minnesotans died after 
overdosing on opioids.
  Since I started working on this bill, I have heard from people in 
communities across my State. In Montevideo, 12-year-olds were courted 
by pushers who said: Hey, kids. If you go in and check your parents' 
medicine cabinets--I'll give you a list--and bring us their 
prescription drugs, we will give you a can of beer. That happened in 
Montevideo, MN.
  Shelly Elkington shared her tragic story. Her daughter, Casey Jo, was 
a champion swimmer and hoped to study nursing like her mom, but in 2008 
she was diagnosed with Crohn's disease, and that is when she started 
taking opioids for pain relief. As we know, four out of five heroin 
users started out by misusing prescription pain killers, and in the end 
the very pills that were supposed to ease Casey Jo's pain didn't work. 
She became addicted and eventually turned to heroin and other drugs, 
and basically this addiction hijacked her life. She is no longer with 
us.
  This is the story for far too many people. In one 7,000-person town 
in Minnesota, 3 young people died of opioid overdoses in just 6 months 
in 2013.
  Our final bill includes a number of proven strategies to help States 
and local communities in the fight against addiction, and one of the 
most important provisions in it for me is looking at solutions for 
unused prescription drugs. Senator Cornyn and I passed a bill back in 
2010 and finally got the rules out after advocating for them from the 
DEA, I believe for 4 years, and we are finally starting to see some 
pharmacies, such as Walgreens, voluntarily taking back unused 
prescription drugs. This bill helps to build on that work.
  CARA also increases the availability of naloxone, which we know can 
be used in overdoses, and, of course, one of the most important things 
in this bill is a start at prescription drug monitoring. I emphasize 
that it is a start because I think a lot more needs to be done with 
prescription drug monitoring. I would have liked to have done it in 
this bill, but now we need to move on and get something done.
  Today, I will be introducing a bill with Senator King and Senator 
Manchin to actually do something about prescription drug monitoring, 
and that is requiring individual States to put in place prescription 
drug monitoring programs and actually submit the data. I have learned--
having Hazelden in my State--that some States have a program, but it 
just means doctors have to sign up. It doesn't actually mean that they 
actually record information or that they share it with other doctors. 
It doesn't even mean they share it between States. Our bill would 
require States that receive Federal funding to combat opioid abuse to 
ensure that their prescription drug monitoring complies with certain 
standards so that we can crack down on this addiction before it starts. 
It would require prescribers to consult with the PDMPs before they hand 
out prescriptions, require dispensers to report back within 24 hours of 
distribution, and would provide for the proactive notification of 
health care professionals when patterns indicative of opioid abuse are 
detected. For people who travel across State lines, it would also 
require States to share information.
  Here is an example: There was a patient at Hazelden Betty Ford who 
had 108 prescriptions for painkillers filled by more than 85 different 
prescribers. Think about that: 85 different medical professionals had 
prescribed these drugs.
  I met a rehab guy up in Moorhead who had a patient with a similar 
story, who had filled prescriptions from doctors in North Dakota, South 
Dakota, Minnesota, and Wisconsin. That is what is going on. If we don't 
require States to share information with other States, it is as if we 
don't really have a prescription drug program to begin with.
  CARA is an important bill, but there are two things that we need to 
change in order to improve the work we are doing in Congress. No. 1 is 
the money for treatment that I know Senator Schumer just addressed, 
which is in Senator Shaheen's bill, which would appropriate emergency 
funding and, second, not just say we are doing something about 
prescription drug monitoring but actually do something about 
prescription drug monitoring, and that is why I am introducing this 
bill today.
  There is a lot of work ahead, but I want to conclude my remarks by 
acknowledging the major step we are taking by passing the Comprehensive 
Addiction and Recovery Act and sending it to the President's desk to be 
signed into law.
  I thank my colleagues for their support.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Alabama.

[[Page S5025]]

  



                       Trans-Pacific Partnership

  Mr. SESSIONS. Mr. President, I continue to be concerned by the 
determination of a number of people to move through the Senate the 
Trans-Pacific Partnership trade deal, the 5,554-page document, which 
the American people have clearly rejected and do not favor, even though 
powerful forces continue to push for it. It has been reported that both 
Presidential candidates oppose it; however, it does appear that 
Secretary Clinton's opposition is in doubt, and there was a troubling 
report yesterday.
  Her top Asia policy adviser, who served as her Assistant Secretary of 
State for East Asia, Kurt Campbell, told an Australian news outlet that 
Clinton's opposition to TPP is not real. He said: ``Every trade 
agreement goes through the deepest, darkest tunnel before it is 
ultimately passed.'' Her top adviser is saying to our Australian allies 
that it is going to pass, and that is contrary to what she has been 
telling the American people. In fact, I think it is fair to say that 
the worst-kept secret in Washington is that Hillary Clinton, if 
elected, intends--in some way and some fashion--to see that the TPP 
becomes law. She made 45 different statements during her time before 
this lawless agreement was being negotiated--up to the very end of 
Congressional debate over fast track--that she supported it. This 
statement by her top adviser is not only shocking but really confirms 
the fears that so many people have had--that her opposition to the TPP 
on the campaign trail is a result of the pressure of the voters and is 
not a real conversion.
  After voicing her support for the 5,554-page agreement 45 times 
before running for President, and after refusing to take a position on 
it when asked about it for months during her campaign, she has since 
made statements to the American people that she opposes the 
agreement. Her senior policy advisor is overseas touting the benefits 
of TPP. Just as her email scandal problem proves, Mrs. Clinton tends to 
say one thing to the American people but another thing to her globalist 
friends.

  The TPP creates a 12-country Pacific union, whereby each country gets 
a single vote. This will allow the union to legislate and change its 
own rules. It is described as a living agreement. They can even change 
their own rules. They can pass laws and regulations that make it very 
difficult--virtually impossible--for the American people to have 
control over it. It is going to be very difficult to contain this union 
where each country gets one vote. The United States gets one vote. The 
Sultan of Brunei gets one vote. Vietnam gets one vote. This makes no 
sense. We absolutely should not pass this massive agreement that erodes 
the economic strength of America, giving our competitors the same votes 
on important issues as we have.
  Even the rosiest Trans-Pacific Partnership projections cited by the 
Obama administration estimate that this agreement--their own estimate 
is it will slow the growth of manufacturing in the United States and 
cost us 120,000 manufacturing jobs over the next 15 years. But other 
studies show the United States could lose much more. A Tufts University 
study said we could lose 400,000 jobs. That is their analysis of it.
  Secretary Clinton's adviser, Kurt Campbell, and other expansive trade 
advocates always believe in these free-trade agreements no matter what 
is in them. They seem to remain oblivious to the impacts that such a 
massive trade deal will have on the already-struggling economy and 
middle America. Mr. Campbell's statements are further confirmation that 
the Obama administration and Hillary Clinton have not given up on this 
deal. Indeed, President Obama continues to push for it openly and 
without apology. They fully intend to do everything they can to sneak 
the TPP through Congress, with perhaps some cosmetic changes to say 
they have fixed the problem, after the election--most likely during the 
lameduck session of the House or the Senate--when many Members are no 
longer accountable to the American people, or it could be even in the 
next Congress.
  While talking with the newspaper The Australian, the former Assistant 
Secretary of State, Mr. Campbell, also found time to denigrate and talk 
bad about the presumptive nominee of one of our national parties, 
Donald Trump. The Australian reported that the former Australian 
Foreign Minister has written that Mr. Campbell ``will be Secretary of 
State if Mrs. Clinton becomes the President at the end of the year.'' 
Well, that is the first I have heard of that. We learned that maybe 
from Australia.
  I believe this is another example of the kind of political duplicity 
that irritates, frustrates, and angers--legitimately--the American 
people. They have their leader saying one thing, promising one thing 
during the election season, all the while they are working to advance a 
different agenda entirely.
  It is the same about fixing illegal immigration. They always promise 
it during the campaign, but when we get in the Senate and start 
actually voting on the things that would be necessary to create a 
lawful system of immigration that protects the national interests, it 
never seems to happen.
  So it is pretty clear Hillary Clinton really supports the TPP. It was 
only an election-cycle diversion that caused her to back off of it, and 
she refuses to rule out its passage entirely. The media should demand 
that she clarify her position. Why will she not rule out passing it? 
Does her top adviser to Asia, meeting with Asian nations that would 
participate in this TPP--does he speak for her or not?
  As quoted by PolitiFact, Mrs. Clinton said: ``I waited until it had 
actually been negotiated''--she is explaining why she now opposes it 
when she supported it previously. She said: ``I waited until it had 
actually been negotiated because I did want to give the benefit of the 
doubt to the (Obama) administration. Once I saw the outcome, I opposed 
it.''
  Well, that was not a very satisfactory answer to me at the time. I 
was very uneasy about that conversion to opposition, and now we have 
her top adviser to Asia saying something entirely different.
  This is what the Australian newspaper said about him and this 
agreement. He says that--he did acknowledge globalization has sometimes 
been disruptive to politics, disruptive in countries like the United 
States. He is talking about disruptive for jobs and workers in the 
United States. I think he is certainly correct about that.
  How did PolitiFact analyze Mrs. Clinton's statements? Here are some 
of the things they reported in their analysis. ``Once I saw what the 
outcome was, I opposed it.''
  That is a pretty clear statement, it appears.
  Speaking in Australia in 2012, however, she hailed the deal as 
``setting the gold standard.''

  She said: ``This TPP sets the gold standard in trade agreements to 
open, free, transparent, fair trade, the kind of environment that has 
the rule of law and a level playing field.''
  It seems to me to be a total commitment to supporting the trade deal.
  Remember, as Secretary of State, she is the chief diplomatic official 
for the United States. The Trade Representative does most of the 
negotiations, but the Secretary of State is involved in these 
negotiations. It involved the economic relationship of the United 
States with 11 other Pacific nations. So she knows what is going on in 
these negotiations and should be well aware of them. If she wasn't, she 
was not doing her job.
  Hillary Clinton's support for the TPP goes on as she said that it 
would create ``Better jobs with higher wages and safer working 
conditions, including for women, migrant workers and others too often 
in the past excluded from the formal economy will help build Asia's 
middle class and rebalance the global economy.''
  Well, I don't have any doubt that if this trade agreement is like the 
other trade agreements--and I believe it is--it will definitely help 
Asian trade competitors of ours. The question is, who is representing 
the American people? That is whom our legal, moral, and political 
responsibility is to--the American people. Is it going to be a better 
transaction for them or not? They don't think so, I don't think so, and 
a growing number of economists are beginning to understand why these 
trade deals I have so often supported in the past are not working 
effectively.
  PolitiFact reported in October that she also described this trade 
deal over

[[Page S5026]]

time as ``exciting, innovative, ambitious, groundbreaking, cutting-
edge, high-quality, and high-standard.'' That is the way she has 
described it over the years.
  PolitiFact concludes with this: ``Nonetheless, her comments at the 
time were so positive and so definitive, it becomes disingenuous to 
argue, as she's doing now, that she didn't endorse it before it was 
finalized.''
  So that is where we are.
  I will yield the floor if someone else arrives. That is the main 
point I wanted to make.
  I would urge our colleagues to understand what is happening. There 
has been an analysis and a growing understanding within the developed 
nations of the world that their middle-class working people are being 
hammered by these trade agreements. Last year, it was reported that 55 
percent of the people in Germany supported the transatlantic trade 
agreement, and this is a follow-on to the TPP, all part of the fast-
track authority Congress gave to the Trade Representative of the United 
States. I opposed it, but Congress voted to approve it. He is 
negotiating right now with the Europeans on a matching-type treaty that 
will also be monumental involving the Atlantic trade deal.
  Last year, 55 percent of the people in Germany supported this 
agreement. A recent poll in Germany showed now only 17 percent support 
it.
  In recent weeks, clear messages have also been sent by the people of 
the United Kingdom, our British allies; they don't like being placed in 
these large international trade organizations where the UK only gets 
one vote. If they get that in the European Union, I don't know if they 
have a single vote--and they don't believe it has been working in their 
interests. That was a factor in them voting to withdraw from the EU, 
even though the EU is pushing this trade deal--the TTIP--exceedingly 
hard.
  What has been the impact on our trade deals in the past? In 2011, I 
supported the South Korea trade deal. It was an important deal, one of 
our biggest trade agreements, and they are allies. I believe in the 
South Koreans. They are good people. So we voted for it. Congress 
passed it. President Obama advocated for it and signed it. At the time, 
he declared that our exports to South Korea would increase $10 billion 
a year and that would help create manufacturing jobs in the United 
States; that it would be a win-win: Korea would import more to us, but 
we would export more to Korea too, the trade deficit would not 
increase, and it would be a job creator in the United States. So 
Congress voted for it--a big vote for it.
  Well, what has happened since 2011? Last year, our exports to Korea 
were not $10 billion, not $1 billion but $30 million. Their exports to 
us from South Korea were $15 billion. So what happened? The data, the 
projections were not right. That is very damaging for America. Our 
trade deficit with South Korea more than doubled.
  I would say to my colleagues somebody needs to be asking: What is 
happening to jobs in America? What is happening to wages in America? 
The situation is not good. Since 1999, wages in America have declined 
$4,186, adjusted for inflation. That is the way to calculate it 
properly. Median family income is down over $4,000 since 1999. Make no 
mistake, bad trade deals are a part of that. Another part of that is, 
when you bring in more workers than you have jobs for, you create a 
surplus of labor and wages go down, if there are any free-market people 
left on Wall Street, they understand that.
  So we have had a double whammy, in addition to high regulations and 
stupid taxes that we impose on the economy. All of these things have 
created a situation in which we are not healthy economically. Wages are 
declining. Middle-class Americans are hurting. They have a right to 
ask: Who in Washington is looking out for my interests? That is the way 
I see it.
  This trade agreement--5,500-some-odd pages--is bad. We do not need to 
pass it, and we absolutely do not need to go into another European 
Union-like trade agreement where the United States gets only one vote 
even though we have by far the dominant economy.

  What do all of these countries want first and foremost? It is 
understandable. It is not evil. They want to sell in our market. They 
want to bring home American dollars. That is their goal.
  When we enter into a trade agreement with somebody who wants to sell 
here, we should make sure that we do it in a way that protects American 
workers and makes sure that our trading partners open their markets to 
us so that we can export as much to them as we allow them to import to 
us.
  Mr. President, I thank the Chair, and I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. BLUMENTHAL. I thank my colleagues for the vote we will take in a 
very short time on the Comprehensive Addiction and Recovery Act known 
as CARA. This legislation holds great promise to help families and 
communities combat the opioid epidemic that has truly been ravaging our 
Nation.
  The epidemic is a public health crisis, causing death and destruction 
to families and communities, and this legislation is barely a symbolic 
step. The rhetoric on the floor today and throughout our consideration 
of this bill, unfortunately, is unmatched by real dollars. Until we 
commit resources, our words will be a glass half empty, and we must 
fill that glass with the resources necessary to truly make a 
difference, as I have seen from the roundtables I have held around the 
State of Connecticut where law enforcement, community activists, 
families whose loved ones have suffered from addiction, and addicts 
themselves recovering from this disease--it is a disease, and we must 
recognize it as a disease that can be treated if we commit the 
resources.
  I thank Senator Coats for joining me in authoring the Expanding 
Access to Prescription Drug Monitoring Programs Act, which is among the 
measures included in this bill. This provision would allow nurse 
practitioners and physician assistants to access State prescription 
drug monitoring programs and view the patient's prescription opioid 
history to determine if a patient has a history of addiction.
  Although nurse practitioners and physician assistants write over 30 
million opioid prescriptions every year, including in 2013, few States 
allow them to consult and submit prescribing data to these important 
State databases. Allowing them to access more information about a 
patient's history enables them to help address potential addiction 
before it becomes a serious problem.
  Critically, we must recognize the key role nurse practitioners and 
physician assistants can play in curbing prescription drug abuse and 
diversion. That is why this provision allowing those nurse 
practitioners and physician assistants to access State prescription 
drug monitoring programs is so important.
  I thank my colleague Senator Baldwin for her tireless effort in 
advancing the Jason Simcakoski Memorial Opioid Safety Act to address 
overprescribing and accountability at the VA. Her leadership on behalf 
of Jason's family and their courage and strength, particularly his 
mother Linda, widow Heather, and daughter Anaya, were impressive and 
instrumental in incorporating this measure.
  The provisions from Senator Baldwin's legislation that have been 
included in CARA will require the VA to expand the use of opioid safety 
initiatives within all VA facilities--a profoundly important step 
because it will enable the VA to better facilitate use of State 
prescription drug monitoring programs and ensure that all VA facilities 
provide naloxone to at-risk veterans without a copay. That is a 
profoundly significant step.
  I hope monitoring and tracking programs will be further improved so 
that State boundaries can be more easily overcome in terms of 
information flow, and the effectiveness can include not only the VA but 
our civilian programs.
  Additionally, improvements to the VA Patient Advocacy Program will 
truly help the VA better serve our veterans.
  These provisions are also included in the Veterans First Act. I am 
hopeful that this body will move forward on the Veterans First Act.
  I appreciate the bipartisan work of my colleagues in addressing the 
opioid crisis. I am pleased to support this bill but again emphasize 
that it is a short-term solution.
  I yield the floor.

[[Page S5027]]

  The PRESIDING OFFICER. The Senator from Utah.
  Mr. LEE. Mr. President, I ask unanimous consent to speak for up to 12 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                        Tribute to James Wallner

  Mr. LEE. Mr. President, Capitol Hill is a famously transient place. 
Every 2 years, the membership of the House of Representatives changes, 
the membership of the Senate changes, and in the interim, the coming 
and going of congressional staffers is virtually constant. But when you 
take a step back and look through the wide lens of history, you can see 
certain pillars of permanence, certain exceptional individuals who 
stand out from and rise above the fleeting crowd. These are the 
institutional giants of Congress, the men and women whose extraordinary 
talents and devotion to the Constitution have shaped the character and 
the course of government and whose legacies continue to influence 
Congress long after the individuals behind them have gone.
  For the past 5\1/2\ years, I have had the pleasure of working with 
and learning from one such individual, a true master of the Senate, 
James Wallner.
  Friday will be James's last day as executive director of the Senate 
steering committee--although the optimist in me hopes that he will be 
back in the Senate someday. Starting next week, he will join the 
Heritage Foundation as the group vice president of research, where he 
will oversee all of the think tank's research papers, projects, and 
initiatives. For this, James is eminently qualified. James has been 
studying politics in the classroom and in real life on Capitol Hill 
throughout his entire adult life. In all his spare time, in between 
advising Senators and raising his two children, Graham and Quinn, with 
his wife Kimberly, James has been busy becoming a scholar, earning two 
master's degrees and a doctoral degree in politics, and an accomplished 
author, having published one book, with another forthcoming.
  Aside from what must be the best time-management skills in the world, 
coupled with the fact that the man probably never sleeps, this is what 
you first notice about James: just how freakishly smart he is.
  I will never forget the first time I met James, which was back in 
2011, not too long after I had been sworn in to office as a Senator. As 
a brandnew Senator with a brandnew staff, one of my top priorities was 
to find someone who could help mentor and guide me and my staff--
someone outside of my staff. My staff included a lot of people who had 
never worked in Washington before, so we needed someone on the outside 
of our staff to help teach us how the Senate really works and how 
Congress really works.
  I asked around for suggestions, and one name kept coming up: James 
Wallner. If you need someone to give a crash course or an extended, 
semester-length course or a course lasting 5\1/2\ years on Senate 
procedure, politics, and policy, James Wallner is the man.
  This was some of the best advice I had ever received--to consult 
James Wallner on these and other issues. The instruction and guidance 
James provided to me and my staff far exceeded expectations. James's 
knowledge of the Senate is encyclopedic. Working with him is like 
having your own personal Parliamentarian by your side, always ready and 
eager to give comprehensive answers to virtually every question that 
might come up, even those dealing with the most arcane procedural 
mechanics within the Senate.
  Most people in Washington operate on the premise that connections are 
what you need to succeed in politics. Some might even assume that they 
are all you need to succeed in politics. James, although known and 
esteemed by many, has flipped this conventional wisdom on its head. For 
him, it is not who he knows but what he knows that has made him an 
invaluable resource for so many Members in Congress and so many 
staffers on both sides of the Capital over the years.
  While his formidable intellect has set him apart over the 10 years in 
the Senate, the qualities I always admired most in James are his deep 
and abiding love for this country, for its history, its people, and its 
institutions, and his uncompromising commitment to the self-evident 
truths upon which it was founded and the truths built into our 
governing document, the U.S. Constitution.
  One of my favorite examples of this is exemplified by James's annual 
tradition of reading, start to finish, the official and complete notes 
from the Constitutional Convention of 1787. Of course, for James, it is 
not enough to simply read and re-read this voluminous text every year; 
he makes sure to do it between May 25 and September 17 so that he can 
read each day's notes on the very day or the very anniversary of the 
very day on which they were originally recorded.
  James brought the same passion and appreciation for our 
constitutional heritage to his work as the executive director of the 
Senate steering committee, a position which he has held since 2012. The 
purpose and mission of the steering committee is to encourage 
innovative thinking and bold action within the Senate's Republican 
conference. This is no easy task, of course. In a town that is not 
exactly known for innovation or boldness, many may see this as a 
mission impossible, but James saw it as a moral imperative because he 
understands that many of our government's and our country's most urgent 
problems today are caused by an unnatural timidity and sclerosis within 
the legislative branch.
  The job may be difficult, but James carried it out with an admirable 
combination of tenacity, patience, courage, and grace, and always with 
an unrelenting devotion to recovering America's founding principles and 
thereby putting the Congress back to work for the American people.
  As James knows better than most, placing principle over party and 
elevating the interests of the American people over the interests of 
political elites is unlikely to win a popularity contest in Washington, 
but it will earn you the respect of your colleagues and anyone 
happening to be watching.
  Few on Capitol Hill respect James more than two of his former bosses, 
Senator Pat Toomey and Senator Jeff Sessions. This is what each of them 
had to say about James on the occasion of his departure from the 
Senate.
  Senator Toomey said:

       James Wallner not only understands a wide range of policy 
     issues, but he is a master of the congressional rules and 
     procedures needed to turn conservative philosophies into 
     action. He is an exceptionally smart strategist and is 
     willing to work hard to advance the ideas needed to restore 
     an American government that is limited in scope, efficient 
     with taxpayers' money, and accountable to the voters.

  Senator Sessions said:

       It has been an honor to work with James in the Senate. I am 
     proud to say that James began his Senate career in my office 
     as a Legislative Assistant and later became my Legislative 
     Director. In these roles, James demonstrated a mastery of 
     congressional procedure and policy. He has supported not only 
     me, but the entire party in developing and working to 
     implement conservative, pro-growth policies that help place 
     our nation on a more sustainable path. The Heritage 
     Foundation is fortunate to have hired a man of such skill and 
     I am confident that he will serve them well. James is without 
     a doubt one of the most talented and dedicated staffers I 
     have ever worked with or known in the Senate.

  For 10 years, James Wallner has been an exceptionally articulate, 
passionate, knowledgeable, and steadfast champion of the very things 
that make the Senate great and that make the Senate unique--especially 
open, robust debate and deliberation. The Senate is better because of 
him.
  He will be missed. But with so many challenges looming over the 
horizon and with so much work yet ahead of us to be completed, 
something tells me this will not be the last time the Senate hears from 
James Wallner.
  Thank you, Mr. President.


                             Cloture Motion

  The PRESIDING OFFICER (Mr. Sullivan). Pursuant to rule XXII, the 
Chair lays before the Senate the pending cloture motion, which the 
clerk will state.
  The senior assistant legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     do hereby move to bring to a close debate on the conference 
     report to accompany S. 524, a bill to authorize the Attorney 
     General to award grants to address the national epidemics of 
     prescription opioid abuse and heroin use.
         Mitch McConnell, James M. Inhofe, Pat Roberts, John 
           Boozman, Johnny Isakson, Chuck Grassley, John Cornyn,

[[Page S5028]]

           Thom Tillis, John Hoeven, Kelly Ayotte, John McCain, 
           Rob Portman, John Barrasso, Lamar Alexander, Richard 
           Burr, John Thune, Orrin G. Hatch.

  The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 
call has been waived.
  The question is, Is it the sense of the Senate that debate on the 
conference report to accompany S. 524, a bill to authorize the Attorney 
General to award grants to address the national epidemics of 
prescription opioid abuse and heroin abuse, shall be brought to a 
close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. CORNYN. The following Senators are necessarily absent: the 
Senator from Mississippi (Mr. Cochran), the Senator from Oklahoma (Mr. 
Inhofe), the Senator from Kansas (Mr. Roberts), the Senator from South 
Dakota (Mr. Rounds), the Senator from Alabama (Mr. Sessions), the 
Senator from Alabama (Mr. Shelby), the Senator from Louisiana (Mr. 
Vitter), and the Senator from Mississippi (Mr. Wicker).
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 90, nays 2, as follows:

                      [Rollcall Vote No. 126 Leg.]

                                YEAS--90

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

                                NAYS--2

     Lee
     Sasse
       

                             NOT VOTING--8

     Cochran
     Inhofe
     Roberts
     Rounds
     Sessions
     Shelby
     Vitter
     Wicker
  The PRESIDING OFFICER. On this vote, the yeas are 90, the nays are 2.
  Three-fifths of the Senators duly chosen and sworn having voted in 
the affirmative, the motion is agreed to.

                          ____________________