[Congressional Record Volume 163, Number 147 (Tuesday, September 12, 2017)]
[House]
[Pages H7288-H7291]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     DEPARTMENT OF THE INTERIOR, ENVIRONMENT, AND RELATED AGENCIES 
                       APPROPRIATIONS ACT, 2018.

  The SPEAKER pro tempore (Mr. Mitchell). Pursuant to House Resolution 
504 and rule XVIII, the Chair declares the House in the Committee of 
the Whole House on the state of the Union for the further consideration 
of the bill, H.R. 3354.
  Will the gentleman from Illinois (Mr. Rodney Davis) kindly resume the 
chair.

                              {time}  1856


                     In the Committee of the Whole

  Accordingly, the House resolved itself into the Committee of the 
Whole House on the state of the Union for the further consideration of 
the bill (H.R. 3354) making appropriations for the Department of the 
Interior, environment, and related agencies for the fiscal year ending 
September 30, 2018, and for other purposes, with Mr. Rodney Davis of 
Illinois (Acting Chair) in the chair.
  The Clerk read the title of the bill.
  The Acting CHAIR. When the Committee of the Whole rose earlier today, 
a request for a recorded vote on amendment No. 154 printed in House 
Report 115-297 offered by the gentlewoman from Massachusetts (Ms. 
Clark) had been postponed.


        Amendment No. 155 Offered by Mr. Murphy of Pennsylvania

  The Acting CHAIR. It is now in order to consider amendment No. 155 
printed in House Report 115-297.
  Mr. MURPHY of Pennsylvania. Mr. Chair, I have an amendment at the 
desk.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 752, line 19, strike ``$15,000,000'' and insert 
     ``$20,000,000''.

  The Acting CHAIR. Pursuant to House Resolution 504, the gentleman 
from Pennsylvania (Mr. Murphy) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from Pennsylvania.
  Mr. MURPHY of Pennsylvania. Mr. Chair, I want to speak on this 
amendment, which provides some additional funding for assisted 
outpatient treatment.
  The underlying bill has in it $15 million, and we are asking for it 
to be raised to $20 million. First of all, I want to say where the 
money is coming from. This is within the budget of SAMHSA. This is not 
new spending. It is not additional spending. But over my years of 
investigating mental health in the United States and the conditions, 
and then led to my introduction of the Helping Families in Mental 
Health Crisis Act, which, by the way, this House passed 442-2, this 
level of funding was authorized in the bill. It is already authorized 
there. It is to come from the SAMHSA account, not new spending.
  Let me describe what assisted outpatient treatment is. Understanding 
that there are about 60 million Americans with mental illness, and 10 
million have severe mental illness, it is important to note that our 
prisons are filled with people who have mental illness. On some level, 
60 to 80 percent of people in jail have a mental illness. That is no 
place to be treating someone. But, unfortunately, they may have a crime 
they committed, and in many cases it could simply be vagrancy, it could 
be other issues, too, where they may have become violent, they may have 
had other problems associated with that, but a person with mental 
illness is 10 times more likely to be in prison than to be in a 
hospital bed.
  We don't have enough hospital beds. Ninety percent of the psychiatric 
hospital beds in this country have been closed down since the 1950s. 
Now we need 100,000 more, but instead what we do as a society, we throw 
them in prison.
  A few years ago, when New York passed Kendra's Law, when a young 
woman was killed by a mentally ill person, they realized that had he 
been in treatment, it likely never would have happened.

                              {time}  1900

  So rather than having someone, if we can't put them in a hospital, 
can't get

[[Page H7289]]

them treatment, the idea of assisted outpatient treatment is, when a 
patient can be stabilized by remaining on their medication, by having 
their counseling, perhaps supportive housing, supportive education, 
supportive employment, their life can turn around.
  So what happens is, a court, a judge, protecting this person's own 
rights, civil rights on every level, will say to this person: I am not 
going to involuntarily commit you to a hospital. Your crime doesn't 
rise to the level--it is not a felony or something like that--it 
doesn't rise to the level of prison, but what they say is: We are going 
to require, however, that you stay in treatment, require that you take 
your medication, that you stay in counseling, and you do other things 
as prescribed by the court.
  Now, most States allow this, but here is the problem: in many 
counties in America, they don't have the ability to pay the 
administrative costs to handle this. So this amendment provides a 
mechanism whereby people can do this.
  So understand, the assisted outpatient treatment is a civil-legal 
procedure whereby a judge can order an individual with a serious mental 
illness to follow a court ordered treatment plan in the community.
  Here is another thing about this: Does it work? And the answer is 
yes. In a Duke University study of the New York AOT program, it said 90 
percent of the people said that AOT made them more likely to keep 
appointments or to take medication; 88 percent said they and their case 
manager agreed on what is important for them to work on; 87 percent of 
them said they were competent in their case manager's ability to help 
them; 87 percent had fewer incarcerations; 83 percent had fewer 
experienced arrests--and the point is, they had an increased number of 
arrests prior to being in AOT, and then afterwards it declined 
precipitously.
  Eighty-one percent said AOT helped them get and to stay well; 77 
percent fewer experienced psychiatric hospitalizations; 75 percent 
reported that AOT helped them gain control of their life; 74 percent 
fewer experienced homelessness; 55 percent fewer experienced suicide 
attempts or physical harm to themselves; 49 percent fewer abused 
alcohol; 48 percent fewer abused drugs; 47 percent fewer physically 
harmed others; 46 percent fewer damaged and destroyed property; and 
costs were cut in half.
  This small amount of money--and believe me, it would cost perhaps 10 
or 20 times more to really do this thoroughly--is there to help people 
in mental health crisis. We could either continue to throw people in 
jail, continue to see crimes happen--and by the way, when a mentally 
ill person is in prison, 80 percent of them get no treatment. We put 
them back on the streets and the problems occur again.
  The House passed this. It came out of committee unanimously. We need 
to do this for America. We don't want to read more statistics on a 
mentally ill person who harmed someone, primarily because they were not 
in treatment.
  This is our opportunity to save lives. This is our opportunity to do 
something about this. And I do ask that the House pass this small 
amendment out of an existing budget, no new spending, to provide an 
additional $5 million for assisted outpatient treatment.
  Madam Chair, I reserve the balance of my time.
  Mr. COLE. Madam Chair, I claim the time in opposition.
  The Acting CHAIR (Ms. Foxx). The gentleman from Oklahoma is 
recognized for 5 minutes.
  Mr. COLE. Madam Chair, I thank the gentlewoman and want to begin by 
acknowledging that my very good friend is the recognized expert in this 
House on all matters related to mental health and has probably done 
more on behalf of this cause than anybody in this Chamber in very many 
years. So it is with great reluctance that I opposed this particular 
amendment, earlier, when we actually accepted.
  But the amendment increases funding for programs currently funded at 
$15 million, the same as last year. As my friend knows, our committee 
actually received an allocation that was lower than last year, and we 
had limited resources to provide increases.
  But in recognition of the importance of the Assisted Outpatient 
Treatment Program, my committee maintained funding for the program at 
its current levels.
  I want to assure my friend, I intend to work with him during the 
process as we negotiate with the Senate. I would expect we probably 
will have a different allocation. We may be able to revisit this issue, 
and I would hope that we can, and certainly will, work with my friend.
  But at this time, I simply must oppose the amendment so we can stay 
within our current allocation.
  Madam Chair, I yield 2\1/2\ minutes to the gentlewoman from 
California (Ms. Lee).
  Ms. LEE. Madam Chair, before I discuss this amendment, I would just 
like to take a minute to offer my and all of our condolences to honor 
the memory of Congresswoman DeLauro's dear mother, Luisa DeLauro, who 
passed away at the age of 103 this weekend. As Congresswoman DeLauro 
always said, her mother was a fearless champion for women's equality, 
and I hope that tonight we can really think about Congresswoman 
DeLauro, her family, and her mother, and offer our sincere condolences 
to her.
  Madam Chair, I rise in opposition to this amendment which would shift 
an additional $5 million away from SAMHSA's existing mental health 
programs. In the bill under consideration today, SAMHSA's mental health 
programs, they are already cut by $231 million. That is a 20 percent 
cut
  Unfortunately, this amendment would further reduce funding for 
critical SAMHSA programs such as Mental Health First Aid, Suicide 
Prevention, and the National Child Traumatic Stress Network. We need to 
be increasing support for mental health services, not robbing Peter to 
pay Paul by shifting funds from one program to another.
  Now, by profession, I am a psychiatric social worker, and I founded a 
community mental health center. Believe me, I personally know the 
impact and the need, the unmet need, for additional funding for mental 
health services.
  As my colleagues and I have noted, the allocations approved by the 
committee are approximately $5 billion below the nondefense level 
allowed under the Budget Control Act. That is $5 billion down.
  We have the resources available, yet the majority refuses to allocate 
them to support critical programs such as mental health and substance 
abuse services. This bill is $5 billion below the fiscal 2017 funding 
level.
  That is why Members are being forced to rob critical programs to 
transfer funding to other programs. We need to negotiate a bipartisan 
budget deal that lifts the sequestration caps and provides significant 
funding for mental health and substance abuse programs for individuals 
who need them.
  Madam Chair, I urge my colleagues to oppose this amendment.
  Mr. MURPHY of Pennsylvania. Madam Chair, I reserve the balance of my 
time.
  Ms. EDDIE BERNICE JOHNSON of Texas. Madam Chair, as the designee of 
Ranking Member Lowey, I move to strike the last word.
  The Acting CHAIR. The gentlewoman is recognized for 5 minutes.
  Ms. EDDIE BERNICE JOHNSON of Texas. Madam Chair, I rise today in 
support of amendment 155, the assisted outpatient treatment, $5 million 
increase; $20 million total.
  As the original cosponsor of H.R. 2646, the Helping Families in 
Mental Health Crisis Act of 2016, I recognize the importance of funding 
for outpatient treatment.
  As a former chief psychiatric nurse at the VA hospital in Dallas, 
Texas, I have witnessed the unintended consequences of the 
deinstitutionalization process. Many of my own patients, diagnosed with 
severe mental illnesses, were discharged with 30 days of prescription 
medicines and did not have stable housing.
  Once they ran out of their prescriptions, their condition worsened, 
they suffered psychotic breaks, and they became homeless or 
incarcerated. Individuals with untreated psychiatric illness now make 
up one-third of the Nation's estimated homeless population. That totals 
600,000.
  In Texas, there are 35,000 incarcerated individuals with a severe 
mental illness, but only 4,500 psychiatric beds are available in all of 
the Texas hospitals combined.
  This amendment increases court-ordered assisted outpatient treatment 
by

[[Page H7290]]

$5 million to meet the fully authorized amount of $20 million in 
support of the severely mentally ill, thereby allowing them to get 
treatment in the community without incarceration or hospitalization.
  This outpatient treatment reduces incarceration, homelessness, and 
emergency room visits by upwards of 70 percent.
  I urge support of this amendment. This country has neglected the 
mentally ill, and this country is suffering because of it. We have got 
to recognize the need, and I urge everyone to support this amendment.
  Madam Chair, I yield back the balance of my time.
  Mr. MURPHY of Pennsylvania. Madam Chair, I just want to say, 
investing in the AOT program, Congress says it is worth it to ensure 
the most vulnerable among us have the treatment they need, instead of 
being in ERs, or jails.
  This pilot is extremely important. It saves money. It saves lives. 
And for Members to reflect back on this, I hope they would rather say: 
I helped fund a program known to save lives. SAMHSA has been reported 
many times by the GAO to waste a lot of money. This saves lives, and I 
urge people to vote for this amendment.
  Madam Chair, I yield back the balance of my time.
  Mr. COLE. Madam Chair, I yield back the balance of my time.
  The Acting CHAIR. The question is on the amendment offered by the 
gentleman from Pennsylvania (Mr. Murphy).
  The question was taken; and the Acting Chair announced that the noes 
appeared to have it.
  Mr. MURPHY of Pennsylvania. Madam Chair, I demand a recorded vote.
  The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further 
proceedings on the amendment offered by the gentleman from Pennsylvania 
will be postponed.


         Amendment No. 156 Offered by Mr. Kelly of Pennsylvania

  The Acting CHAIR. It is now in order to consider amendment No. 156 
printed in House Report 115-297.
  Mr. KELLY of Pennsylvania. Madam Chair, I have an amendment at the 
desk.
  The Acting CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:

       Page 763, line 3, after the first dollar amount, insert 
     ``(reduced by $5,000,000) (increased by $5,000,000)''.

  The Acting CHAIR. Pursuant to House Resolution 504, the gentleman 
from Pennsylvania (Mr. Kelly) and a Member opposed each will control 5 
minutes.
  The Chair recognizes the gentleman from Pennsylvania.
  Mr. KELLY of Pennsylvania. Madam Chair, I rise in support of my 
amendment No. 156.
  Over the past 25 years, infant adoptions have decreased, and only 
about 1 percent of pregnant women choose adoption. While there are 
approximately 2 million couples waiting to adopt in the United States, 
there were only 18,329 domestic infant adoptions in 2014.
  Unfortunately, too many women who have encountered unplanned 
pregnancies report not receiving adequate information about adoption. 
Everyone facing an unplanned pregnancy should have access to timely, 
accurate, and noncoercive information about adoption that helps them 
make their own fully informed decision.
  In 2000, Congress authorized the Infant Adoption Awareness Training 
Program. This program awards grants to adoption organizations to train 
healthcare workers who offer health services to expectant mothers and 
are trained to provide adoption information and referral.
  In the year 2000, the program annually delivered training to an 
estimated 10,000 healthcare workers nationwide. This program was phased 
out in 2010.
  This bill funds adoption awareness programs at $39.1 million. My 
amendment designates $5 million of that funding to restart the Infant 
Adoption Awareness Training Program with the goal of ensuring that 
expectant mothers have access to timely, accurate information about 
adoptions.
  I also support the administration's effort to fund activities to 
improve hospital-based adoption support services for our expectant 
mothers. I urge them to continue this hospital-based program to ensure 
that mothers who wish to make an adoption have access to comprehensive 
support throughout the entire adoption process.
  Adoption is a bipartisan issue, and it is vital that individuals who 
are providing health services to expectant mothers are trained to 
properly provide adoption information and referral.
  Madam Chair, I urge adoption of this amendment.
  Mr. COLE. Will the gentleman yield?
  Mr. KELLY of Pennsylvania. I yield to the gentleman from Oklahoma.
  Mr. COLE. Madam Chair, I don't rise to oppose. I just wanted to 
commend my friend for bringing this issue and highlighting it. We think 
it is very important.
  We wanted to note that we support what he is trying to do. We 
certainly accept the amendment, and we look forward to working with him 
through the process to help achieve the objectives that he stated.
  Mr. KELLY of Pennsylvania. I reserve the balance of my time.

                              {time}  1915

  Ms. LEE. Madam Chair, I claim the time in opposition to this 
amendment.
  The Acting CHAIR. The gentlewoman from California is recognized for 5 
minutes.
  Ms. LEE. Madam Chair, this amendment cuts $5 million from the account 
that funds, mind you, Head Start, Runaway and Homeless Youth grants, 
and the Community Services Block Grant, among other critical programs, 
and uses it to provide $5 million in new funding for the Infant 
Adoption Awareness Training program. Now, this program did not receive 
funding in fiscal year `17.
  Women should have access to all options when considering the impacts 
of an unintended pregnancy, of which one is adoption. But we should not 
ignore the irreplaceable role of preventing unintended pregnancy by 
providing education and health services.
  The underlying bill limits women's access to care by prohibiting 
funding to the Title X Family Planning program, a program specifically 
created to ensure women have access to high-quality family planning 
services to prevent unintended pregnancies and access reproductive care 
services. By denying women access to comprehensive family planning and 
preventative health services, the bill would have a devastating impact 
on women and families, especially low-income women and women in rural 
communities.
  In 2014, Title X Family Planning centers helped women avert 904,000--
that is 904,000--unintended pregnancies. Without the services provided 
by these Title X clinics, the rates of unintended pregnancy in the 
United States, unplanned birth and abortion, each would have been 33 
percent higher, and the teen pregnancy rate would have been 30 percent 
higher.
  In addition, Title X providers are required to offer pregnant women 
the opportunity to provide information and counseling regarding all of 
their options--all of their options--in a neutral, nondirective, and 
factual manner, including adoption. For some women, adoption services 
and counseling may be the best option. But we must ensure that every 
woman has access to all options and is allowed to make the choice that 
is best for her and her family.
  Unfortunately, this bill represents yet another missed opportunity to 
get serious about reproductive health and preventing unintended 
pregnancy in this country. This amendment uses funding from other 
programs in the Children and Families Services account that are 
critical to the well-being of children, women, and families as an 
offset for this new program. Funding for Head Start, the Domestic 
Violence Hotline, programs that help serve and protect runaway and 
homeless youth, among others, are at risk.
  Madam Chair, I oppose the amendment, and I reserve the balance of my 
time.
  Mr. KELLY of Pennsylvania. Mr. Chairman, I thank the gentlewoman. I 
do share her concern. That is why we are asking for $5 million of the 
$39.1 million be used to give expectant mothers the opportunity to 
learn fully and make a decision based on what they want to do. It is 
about education. It is about making them fully aware.

[[Page H7291]]

  But this is about adoption. This is not about anything else. This is 
not about taking anything away from anybody. This is about giving them 
the opportunity to understand the options that they do have in an 
unplanned pregnancy.
  Mr. Chairman, I reserve the balance of my time.
  Ms. LEE. Mr. Chair, as I close, while this amendment focuses on 
adoption services, we cannot ignore what is missing from this bill and 
from this process, and that is an opportunity to vote on the amendment 
to fund Title X Family Planning. We must restore funding for family 
planning services; invest in a comprehensive approach that prioritizes 
health promotion, education, services, and care; and an approach that 
includes sex education programs, better access to birth control, and 
reproductive health services.
  I am extremely concerned about the cut that this amendment imposes on 
the Children and Families account at HHS. I oppose this amendment. This 
is cutting funds from Head Start, Runaway and Homeless Youth grants, 
and the Community Services Block Grant, among other critical programs.
  Mr. Chairman, I yield back the balance of my time.
  Mr. KELLY of Pennsylvania. Mr. Chairman, I appreciate the 
gentlewoman's comments. What this is really about is 2 million couples 
willing to adopt children in the United States. It is hard for me to 
stand here today and say that it would be a much different world if 
people were really given the opportunity to understand what their 
options are and be able to fulfill the wishes of over 2 million couples 
in the United States who are looking to adopt a child. I think that is 
incredibly important, and I don't understand why we couldn't look at 
something like that and say this is about adoption. That is all it is 
about.
  Now, this is fully endorsed, by the way, by the National Council for 
Adoption.
  At this time, I would also offer my condolences to Ms. DeLauro for 
the loss of her mother. She is a fine lady, and I am sure that, no 
matter what, she will look back on the years she spent with her mother 
and cherish every one of those.
  Mr. Chairman, I yield back the balance of my time.
  The Acting CHAIR (Mr. Mitchell). The question is on the amendment 
offered by the gentleman from Pennsylvania (Mr. Kelly).
  The amendment was agreed to.
  Mr. COLE. Mr. Chairman, I move that the Committee do now rise.
  The motion was agreed to.
  Accordingly, the Committee rose; and the Speaker pro tempore (Mr. 
Simpson) having assumed the chair, Mr. Mitchell, Acting Chair of the 
Committee of the Whole House on the state of the Union, reported that 
that Committee, having had under consideration the bill (H.R. 3354) 
making appropriations for the Department of the Interior, environment, 
and related agencies for the fiscal year ending September 30, 2018, and 
for other purposes, had come to no resolution thereon.

                          ____________________