[Congressional Record Volume 164, Number 164 (Wednesday, October 3, 2018)]
[Senate]
[Pages S6467-S6483]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  SUBSTANCE USE-DISORDER PREVENTION THAT PROMOTES OPIOID RECOVERY AND 
               TREATMENT FOR PATIENTS AND COMMUNITIES ACT

  The PRESIDING OFFICER. As if in legislative session, under the 
previous order, the Chair lays before the Senate the House message with 
respect to H.R. 6.
  The Presiding Officer laid before the Senate the following message 
from the House of Representatives:

       Resolved, That the House agree to the amendment of the 
     Senate to the bill (H.R. 6) entitled ``An Act to provide for 
     opioid use disorder prevention, recovery, and treatment, and 
     for other purposes,'' with an amendment.

                            Motion to Concur

  Mr. THUNE. As if in legislative session, I move to concur in the 
House amendment to the Senate amendment to H.R. 6 under the previous 
order.
  The PRESIDING OFFICER. The motion is pending.
  The Senator from South Dakota.


 =========================== NOTE =========================== 

  
  On page S6467, October 3, 2018, in the third column, the 
following appears: Resolved, That the House agree to the amendment 
of the Senate to the bill (H.R. 6) entitled ``An Act to provide 
for opioid use disorder prevention, recovery, and treatment, and 
for other purposes,'' with an amendment. The PRESIDING OFFICER. 
The Senator from South Dakota.
  
  The online Record has been corrected to read: Resolved, That the 
House agree to the amendment of the Senate to the bill (H.R. 6) 
entitled ``An Act to provide for opioid use disorder prevention, 
recovery, and treatment, and for other purposes,'' with an 
amendment. Motion to Concur Mr. THUNE. As if in legislative 
session, I move to concur in the House amendment to the Senate 
amendment to H.R. 6 under the previous order. The PRESIDING 
OFFICER. The motion is pending. The Senator from South Dakota.


 ========================= END NOTE ========================= 



                        FAA Reauthorization Act

  Mr. THUNE. Madam President, it is oftentimes easy to believe the news 
reporting on how the Senate is broken and bipartisanship is dead, but 
then you work with your colleagues--both Democrats and Republicans, 
from the House and the Senate--on something like the FAA 
Reauthorization Act, which we just passed, and you are reminded that we 
can still come together and get things done for the American people.
  The bill we just overwhelmingly passed and sent to the President's 
desk is the longest FAA reauthorization since the 1980s, and it will 
improve our aviation system for travelers, manufacturers, and 
innovators alike.
  The bill also reauthorizes the Transportation Security 
Administration, ensuring improved screening technologies and more 
explosive detection K-9s, additional focus on security and surface 
transportation to public areas, and new pathways to mitigate airport 
security delays for an overall better travel experience.
  It also reauthorizes the National Transportation Safety Board, 
providing key reforms to modernize and improve transparency in this 
important safety agency's investigations, recommendations, and Board 
member discussions. These important provisions are just the three-
quarters of the

[[Page S6468]]

bill in the jurisdiction of the Senate Commerce Committee, of which I 
have the privilege to serve as chairman.
  As chairman, I would like to personally thank the members of our 
committee for all of their hard work this Congress and especially 
Senator Nelson, the committee's ranking member; Senators Blunt and 
Cantwell, the chairman and ranking member of our Aviation Subcommittee; 
and Senators Fischer and Peters, the chairman and ranking member of our 
Surface Transportation Subcommittee.
  I would also like to acknowledge, on the House side, Chairman Shuster 
and Ranking Member DeFazio of the House Committee on Transportation and 
Infrastructure, Chairman McCaul and Ranking Member Thompson of the 
House Committee on Homeland Security and Governmental Affairs, and 
Chairman Smith and Ranking Member Johnson of the House Science 
Committee. They have been great partners, and I appreciate their 
efforts in helping to get this bill across the finish line.
  Finally, I would like to thank all of the staff from both Chambers 
who worked tirelessly, including many late nights and weekends, on this 
bill. Without their efforts, the final product would not have been such 
a success. While everyone on the team worked hard on this bill, on my 
staff I would like to especially thank Nick Rossi, Adrian Arnakis, Mike 
Reynolds, Simone Perez, Jackie Keshian, Missye Brickell, Fern Gibbons, 
Jason Smith, Andrew Neely, Isaiah Wonnenberg, Chance Costello, Alison 
Graab, Fredrick Hill, and Brianna Manzelli.
  On Senator Nelson's staff, thanks should go to Kim Lipsky, Mohsin 
Syed, Tom Chapman, Chris Day, Laurence Wildgoose, and Danny Blum.
  I would also ask unanimous consent to have printed in the Record the 
names of the staffers who are part of the committees in the House who 
played key roles in the legislation and, of course, the staff members 
from the committee Chairman Shuster chairs, the Transportation and 
Infrastructure Committee in the House, which was very instrumental in 
getting this bill across the floor in the House and ultimately over to 
us in the Senate and then the ranking member, as I mentioned, Peter 
DeFazio's staff.
  I ask unanimous consent to have printed in the Record the names of 
their staffs to whom we are grateful.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       Chairman Shuster's staff who should be thanked include: 
     Chris Vieson, Geoff Gosselin, Fred Miller, Holly Woodruff 
     Lyons, Naveen Rao, Hunter Presti, Cameron Humphrey, and 
     Hannah Matesic.
       From Ranking Member DeFazio's staff: Kathy Dedrick, Alex 
     Burkett, Rachel Carr, Michael Tien, and Luke Strimer.

  Mr. THUNE. Madam President, I also ask unanimous consent to have 
printed in the Record the names of Chairman McCaul's staff and Ranking 
Member Thompson's staff.
  Also, we are grateful to the staff of Chairman Smith, who chairs the 
House Science Committee. There was a good amount of science policy that 
was ultimately included in this legislation.
  Also, we are very grateful to Ranking Member Johnson's staff, Pam 
Whitney and Allen Li.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       From Chairman McCaul's staff: Brendan Shields, Kyle Klein, 
     Alex Rosen, Emily Trapani, and Forrest McConnell.
       From Ranking Member Thompson's staff: Hope Goins, Alex 
     Marston, and Rosalyn Cohen.
       From Chairman Smith's staff: Chris Wydler, Ashley Callen, 
     Mike Mineiro, and Sam Amber.

  Mr. THUNE. I am sure there will be people whom I have left off this 
list, and I apologize for that, but it just underscores the amount of 
collective effort that underpins our work.
  I could also easily expand that list to include those at the 
Department of Transportation and the Federal Aviation Administration 
who provided valuable assistance and technical expertise. We look 
forward, now that this bill has passed and headed to the President's 
desk for his signature, to working with them on its implementation.
  So again, I say thank you to my colleagues who supported this bill 
and all of those who were involved in bringing us to a conclusion. This 
is the culmination of many months of hard work, bipartisan negotiation. 
Frankly, it wasn't easy, and that is a great credit to the staff 
members I mentioned and to the individual members of our committee and 
the other committees who were so involved in seeing this get across the 
finish line.
  So I say thanks to the Members on the floor and the members of our 
committee.
  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Madam President, I would like to extend my 
congratulations to the Senator from South Dakota. This is a significant 
agreement on which he and Senator Nelson and others have worked very 
hard. I want to especially thank him for including in the bill 
something Senator Feinstein of California and I have worked on for 
several years; that is, the provision to ban the use of cell phones on 
airplanes. There is nothing worse than sitting next to someone on a 4-
hour flight who would make it his or her business of revealing all of 
the intimate details of their life to someone on a cell phone. This 
would take care of that.
  I would say to the Senator from South Dakota that sometimes I suggest 
to my friends in Tennessee that they look at Washington, DC, as a 
split-screen television. On the one side are tweets and Supreme Court 
contention and cable television and arguments, and on the other side we 
are getting quite a bit done, like the FAA bill, like the songwriters 
bill, like the appropriations bills that have kept us first in the 
world in supercomputing. Thanks to the leadership of Senator Blunt of 
Missouri and Senator Murray of Washington, we have, for the fourth 
consecutive year, included record funding for biomedical research. That 
doesn't capture as much attention as the other side of the TV screen, 
but it demonstrates that we are capable in this body of both vigorous 
contention on arguments, and we are also capable of doing the basic 
work of the Senate, which is to take big issues, see if we can come to 
some agreement about it, and come to a lasting conclusion, which the 
Senator was able to do, and I congratulate him for it.
  I want to speak for a few minutes about another example of that. We 
are in the midst of contentious disagreement about the Supreme Court, 
but at the same time we have an urgent, bipartisan consensus, of 
virtually unanimous agreement, to deal with the most urgent public 
health epidemic facing our country today in virtually every community; 
that is, the opioids crisis. Each one of us has stories about how the 
opioids epidemic is ravaging our hometowns and our home States.
  For example, at one of the several hearings we had in the Health 
Committee which I chair, a mother, Becky Savage, talked about her two 
sons whom she found in her basement after a graduation party one night, 
both dead. She was happy they were in their basement because instead of 
out driving around town, doing what teenagers might be doing, they were 
at home, but someone brought alcohol, someone brought opioid pills from 
the medicine cabinet in some home, and someone mixed those two 
together, producing two overdoses for two children who were not drug 
addicts, who were not alcoholics but who made a mistake.
  Another hearing involved visiting the Niswonger Children's Hospital 
in Johnson City, TN, where one-third of the babies born in the neonatal 
center there are born withdrawing from opioids because their mothers 
are addicted, and it takes them days or weeks more to get over that. We 
listened to two judges in Upper East Tennessee, two criminal court 
judges, State judges, who said that of 6,000 completed cases they heard 
last year, two-thirds of them had something to do with the opioid 
epidemic.
  There was the drug agent from Tennessee who was in my office who 
deals with meth and all sorts of drugs, and he described for me what 
had happened when they seized some fentanyl. Fentanyl is the white 
powder that is 50 times stronger than opioids--which comes from China, 
often in the mail--and which this bill we are about to talk about deals 
with. This drug agent, who is an experienced law enforcement officer, 
told me that just by opening a small plastic bag with a little of the 
white powder getting into the air, he was almost overcome and had to 
leave

[[Page S6469]]

the room because it would cause him to pass out. That is the epidemic 
we are dealing with everywhere in America.
  Before I describe the bill, let me talk about two things that have to 
do with the bill. One is money and one is moonshot. People often say, 
when I describe our bill--which we called the Opioid Crisis Response 
Act but is now called by, I think, a better name, the SUPPORT for 
Patients and Communities Act--when I describe the bill, people ask: 
Where is the money? Well, the money is not in this bill. This is an 
authorization bill. We do money in other bills. We call them 
appropriations bills. The Congress and President Trump have both been 
attentive to the money.
  Since just March, including the appropriations bill passed in March 
and the appropriations bills approved by the Senate last week, we will 
have directed in the Congress $8.5 billion toward the opioid crisis--
everything from hundreds of millions for nonaddictive pain medicines to 
$1 billion for grants to States for more treatment--so $8.5 billion 
just this year. That is the money.
  Then, so far as the moonshot, some people say to me, ``Well, we need 
a moonshot for the opioids,'' and I wish we could have one. We probably 
need the energy, we probably need the money, and we probably need the 
resources and the determination it took in the 1960s for President 
Kennedy to say: Let's go to the Moon in a decade. Unfortunately, we 
can't do that from Washington, DC. This problem will not solve itself 
from here.
  We can't assign this task to an agency and say: Fix it in 10 years. 
That is why we call this bill the SUPPORT for Patients and Communities 
Act. The opioids epidemic is going to have to be solved in Ames, IA, 
and Nashville, TN, and Sacramento, CA, and communities all across this 
country by Governors who work with medical faculty to change the 
curriculum on how doctors learn about pain medicine; by States that, 
like Tennessee, have begun to limit the opioid prescriptions to 3 days 
at a time to try to avoid the 60-day, 60-pill bottle that someone might 
take home and use 15 pills and then have the rest taken by a teenager 
to a party, with a terrible result at the end; by the judges who deal 
with opioids and their criminal cases; and by the nurses and the 
treatment officials who try to help people with medication. All of this 
has to be solved community by community by community. We know that. We 
are not pretending that a single act here can fix the problem. We have 
had urgent bipartisan consensus on this. There have been contributions 
from 5 Senate committees, and 72 different Senators are reflected in 
this bill. That is why we have urgent bipartisan consensus, because we 
want to do everything we can do to provide tools to parents and 
patients and doctors and nurses and communities and Governors--anyone 
we can find--to deal with this crisis.
  Senator McConnell has called this opioid legislation ``landmark 
legislation,'' and I believe he is right. In our State, as in most 
States, more people are killed by opioid overdoses than by car 
crashes--in Tennessee, 1,776 last year. That is why the House passed 
this bill by 393 to 8 last Friday. That is why, after we vote on this 
bill today at 3:15, it will go directly to the President, and I am 
confident he will sign it quickly.
  With more than 70 different provisions, there is no way to talk about 
them all. Each one is important, but here are a few of the most 
important:
  Senator Portman's STOP Act. I talked about fentanyl--the white powder 
that is 50 times more powerful than opioids--coming by mail from China. 
FedEx and UPS can stop it, but the U.S. Postal Service can't. This 
gives the government the authority to stop that powder from coming in 
from China.
  Nonaddictive painkillers. The most common reason Americans see a 
doctor is because they hurt. They have pain. There are 100 million 
Americans with some pain, and there are 25 million Americans with 
chronic pain. They need help, and if opioids can't help over a long 
term, they need a nonaddictive pain medicine, which is why we have put 
in hundreds of millions of dollars and passed fast-tracked legislation 
to find that.
  Blister packs for opioids. States have begun to limit the doses of 
opioids that can be prescribed. We give to the Food and Drug 
Administration the authority to require manufactures to sell opioids in 
blister packs of three, five, or seven.
  Extend support for Medicaid patients. Again, Senator Portman worked 
hard on this one, as did others. This extends from 15 to 30 days the 
time for treatment for people with a substance use disorder, and it 
expands it to all those disorders.
  The TREAT Act. Senator Paul and Senator Markey have pushed this. It 
permanently allows more medical professionals to treat people in 
recovery to prevent relapse and overdose.
  The bill prevents doctor-shopping by improving State prescription 
drug monitoring programs, and it provides more behavioral and mental 
health providers and support for comprehensive opioid recovery 
centers--all three of the major techniques we know.
  It provides help for babies born in opioid withdrawal and for mothers 
with opioid use disorders and more early intervention with vulnerable 
children who have experienced trauma.
  As I said, there are more than 70 different proposals from Senators 
themselves, equally divided between Democrats and Republicans. That is 
why this bill, which is the most complex one, I suspect, I have ever 
worked on--I have worked on some complex ones, but it is as complex as 
any--it literally had to have the support of every single one of the 
Senators to move through this body once, to the House, and I suspect it 
will almost get it 100 percent again because of the urgency and the 
participation in this.
  I mentioned the $8.5 billion. Senator Blunt says there has been a 
1,300-percent increase in congressional funding to combat the opioid 
crisis over the last 4 years.
  Eight committees in the House. Five committees in the Senate. 
Seventy-two Senators. Senator Portman's STOP Act. Senators Paul and 
Markey's TREAT Act. Senator Rubio worked with us as we moved the Senate 
bill forward, and in the final version is his Eliminating Kickbacks in 
Recovery Act, which we were able to include in this final consensus 
legislation.
  I thank Senator McConnell, the majority leader, and Senator Schumer, 
the Democratic leader. They have lots to think about. They have many 
demands on them and their time. But they have made it possible through 
this whole process to make room for this because they understood the 
importance of it, and I thank them for that.
  I thank the chairmen and ranking members of the other Senate 
committees--Senators Hatch, Grassley, Thune, Crapo, Murray, Wyden, 
Feinstein, Nelson, Brown--and their staffs. It is not that easy for 
that many committees to put down their jurisdictional jealousies and 
work across committee jurisdictions to work together, but we had an 
urgent bipartisan consensus that we needed a result here.
  I thank Senator McConnell's staff, Scott Raab and John Abegg, as well 
as Senator Schumer's staff, Veronica Duron, for all of their work on 
the legislation. They expedited it when it needed to be expedited.
  I thank David Cleary on my staff and Evan Schatz on Senator Murray's 
staff. They are the chiefs on those issues. When they work together and 
Senator Murray and I work together, we often can get a lot done.
  On my staff, I especially want to thank Grace Stuntz, who was the 
policewoman on all of this, working with the various committees here 
and the various committees in the House, and her team: Andy Vogt, 
Melissa Pfaff, Margaret Coulter, Curtis Vann, Tyler Shrive, Brett 
Meeks, and Jen Boyer. They did a tremendous amount of work. I also 
thank Lindsey Seidman, Bobby McMillin, Jake Baker, Jordan Hynes, Liz 
Wolgemuth, Taylor Haulsee, Ashton Davies, Elizabeth Gibson, Christina 
Mandreucci, Evan Dixon, and William Heartsill.
  On Senator Murray's staff, I thank John Righter, Nick Bath, Andi 
Fristedt, Laurel Sakai, Colin Goldfinch, Madeleine Pannell, Allie 
Kimmel, Katherine McClelland, Lori Achman, Sheri Lou Santos, and Remy 
Brim.
  We worked closely with the House of Representatives. I called both 
Representative Walden and Representative Brady and talked with them 
before we went ahead with this, and they

[[Page S6470]]

worked seamlessly with us for the last several months. The chairmen and 
ranking members of the House who made contributions included 
Representatives Walden, Brady, Goodlatte, Foxx, Shuster, Pallone, Neal, 
Conyers, Scott, DeFazio, and their staffs.
  Lastly, I would like to thank the staff of the Senate and House 
Legislative Counsel. They helped us write the bill. With all of the 
changes and all the Senators and all the provisions, they did a 
spectacular job. The staff of the administration provided technical 
assistance along the way, as well as the staff of the Congressional 
Budget Office. They worked literally around the clock. They worked on 
weekends to make it possible for us to get through the House and to now 
get through the Senate and down Pennsylvania Avenue to the President of 
the United States. This wouldn't be here without them.
  This is a landmark piece of legislation. This legislation, with more 
than 70 contributions from U.S. Senators--really equally divided 
between both parties--and $8.5 billion of funding since March, is an 
important step toward dealing with the most serious public health 
epidemic in any of our communities. The Supreme Court debate is 
important, but in hundreds of thousands of families and literally every 
community across this country, this is more important. This is more 
important, and this legislation will help.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Washington.


                        FAA Reauthorization Act

  Ms. CANTWELL. Madam President, I come to the floor to follow my 
colleagues, Senators Thune and Nelson and to thank them for the FAA 
bill which we just passed and which is on its way to the President's 
desk. I so appreciated working with the chairman and ranking member and 
my colleague on the subcommittee, Senator Blunt, on this FAA 
reauthorization bill.
  As mentioned by the chairman, this is the first long-term 
reauthorization in decades, and it represents a 5-year investment in 
critical infrastructure that our airports need all throughout the 
United States.
  It represents for us in the Pacific Northwest hundreds of millions of 
dollars of investments in our airports that help us continue to grow 
our economic and regional economies. Everybody in the State of 
Washington knows that we are bursting at the seams when it comes to our 
airports and that we need more capacity--particularly at Seattle-Tacoma 
International Airport, where we saw an increase of nearly 2 million 
passengers. It has been one of the fastest growing airports in the 
Nation for the last 5 years. This long-term infrastructure bill will 
provide hundreds of millions of dollars for airport investments in our 
State and will help us meet that growth and demand.
  This bill is also a major down payment on security and efficiency to 
help us handle that growth and the impact to our economy and to our 
transportation systems. That is one of the reasons this bill has 
provisions to bring more K-9 units to airports throughout the United 
States, including the State of Washington. The K-9 units have been 
vital to helping us cut nearly in half the time it takes to get 
passengers through the airport screening process, and I believe they 
are a tremendous deterrent, and they make sure that our airports are 
safe and secure from those who may want to do harm. The fact that we 
are improving the ability of these K-9 units to be supported by local 
airports is one of the great aspects of this bill as well.
  We also want to note that our airport infrastructure across the State 
includes a lot of contract towers; that is, airports that help us with 
regional transportation, private transportation, and a diverse range of 
operations. Yet these airports are often in the shadows of larger 
airports, whether that is Felts Field in Spokane or Walla Walla 
Airport. Making sure that these contract tower airports receive support 
and funding so they can continue to help our aviation sector and the 
flying public is a great aspect of this bill.
  Also, many of my colleagues have talked about the other improvements 
to safety and security. We are continuing to make a down payment on 
next-generation technology; that is, our air traffic control system. I 
can't say enough about how important it is for us to continue to move 
forward on the NextGen aviation system. It helps us fly more 
efficiently. It saves on fuel costs. It helps our system operate more 
efficiently. The bill's innovation also takes a next step forward on 
unmanned aerial vehicles.
  I again thank our colleagues--particularly Senator Thune and Senator 
Nelson--for their great work on this, and my colleague Senator Blunt. 
Making aviation investments is critical to continuing to grow an 
aviation economy in the United States. It is also just as critical to 
growing economies around the State because air transportation helps 
them attract and keep businesses in the area. While we have Sea-Tac 
bursting at the seams, we have other regional airports that are still 
trying to grow, and giving them this infrastructure investment will 
help in the future.
  I again thank our colleagues. I am glad we are moving forward on the 
first long-term aviation infrastructure investment in decades. Some of 
us here may remember the last bill, on which I think we had something 
like 23 extensions over many, many years before we finally got a bill. 
So this represents the first time in many decades that we now have a 5-
year picture that we can look at and see the investment for aviation 
moving forward.
  I thank my colleagues and will continue to work with them on other 
aspects of aviation improvement for the future.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Tillis). The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. DONNELLY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                            Opioid Epidemic

  Mr. DONNELLY. Mr. President, I come to the floor today to discuss the 
opioid abuse epidemic, which has taken the lives of too many Hoosiers, 
harming families and communities across my State and our country. This 
is a public health crisis. It is a complex problem, and addressing it 
will require all of us to work together in a bipartisan way at the 
Federal, State, and local levels.
  I am very pleased that the House and the Senate have worked together 
over many months to write this bipartisan legislation, the SUPPORT for 
Patients and Communities Act. This bill provides important new tools to 
combat the opioid epidemic and to work to ensure that those providing 
prevention, treatment, and recovery services in our communities have 
the resources necessary to help those in need of assistance. I am also 
proud that this legislation contains several bipartisan bills I helped 
lead over the past year.
  For Hoosiers in Northern Indiana, one particular provision in this 
legislation is particularly significant. On July 26, 2017, Dr. Todd 
Graham was senselessly murdered in South Bend after refusing to 
prescribe an opioid to a patient. To honor Dr. Graham's memory, I 
helped to introduce the bipartisan Dr. Todd Graham Pain Management 
Improvement Act with my friend and fellow Hoosier Senator Todd Young. 
This bill directs the Department of Health and Human Services to study 
Medicare's payment and coverage policies for nonopioid pain treatments. 
It could also help to increase access to nonopioid treatments and 
prevent future patients from developing an addiction. It would never 
have been possible without the leadership and courage of Julie Graham 
and the Graham family.
  Another way of increasing access to nonopioid pain treatments is to 
encourage the development of new nonopioid pain treatments. I helped to 
introduce two bipartisan bills to achieve that goal. These bills would 
require the FDA to clarify how nonopioid pain treatments can qualify 
for expedited approval and to clarify how it will assess treatments 
that reduce the need for opioids. Provisions based on both of these two 
bills are included in this legislation so we can get closer to helping 
treat pain without the risk of addiction.
  On another front, as we work to provide health professionals with new 
treatment options, we must also make sure that there are enough health 
professionals to provide substance abuse

[[Page S6471]]

disorder treatment in communities that need them. There are far too 
many areas in my State of Indiana and across America that lack access 
to meaningful addiction treatment and the trained professionals to 
provide it.
  Earlier this year, I worked with Senators Lisa Murkowski and Maggie 
Hassan to address this issue by introducing the bipartisan Substance 
Use Disorder Workforce Loan Repayment Act. This bill provides up to 
$250,000 in student loan forgiveness for trained addiction treatment 
providers who will work in areas with a shortage of mental health 
professionals or an above-average overdose death rate. This new 
initiative helps to recruit more providers to work in addiction 
medicine and to serve in areas that most need their services. I am very 
proud to report that the Donnelly-Murkowski-Hassan bill was included in 
this larger legislative package.

  Drug overdoses killed more than 72,000 Americans in 2017, including 
nearly 30,000 from opioid overdose. In Indiana, 1,840 Hoosiers were 
lost to overdoses just last year alone. That is heartbreaking, as each 
person is someone's loved one and someone's family member.
  We have a lot of work to do, and I will not rest until we reduce this 
overdose rate, because one overdose is one too many. The SUPPORT for 
Patients and Communities Act will provide critical resources to 
communities across Indiana and across America.
  I look forward to seeing this legislation passed here in the Senate 
and then signed into law by the President. I look forward to continuing 
to work with my colleagues on both sides of the aisle to address this 
epidemic.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mrs. CAPITO. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                            Opioid Epidemic

  Mrs. CAPITO. Mr. President, today I rise to strongly support the 
passage of the SUPPORT for Patients and Communities Act, the SUPPORT 
Act. Actually, I think that is a great title, the SUPPORT Act.
  The SUPPORT Act combines the work of the House of Representatives 
with the Senate's Opioid Crisis Response Act, which we recently passed 
with overwhelming bipartisan support.
  As we anticipate voting on this groundbreaking legislation soon and 
sending it to the President's desk, I wanted to highlight some of the 
provisions I think are most critical, many of which I worked on with my 
colleagues on the other side of the aisle to move forward.
  The SUPPORT Act successfully builds on the work Congress began with 
the passage of the Comprehensive Addiction and Recovery Act back in 
July of 2016, and it is a critical next step in our fight against an 
epidemic that continues to devastate families and communities across 
this country, especially in my home State of West Virginia.
  This legislation reflects what we have learned in the past few years 
since we passed CARA. West Virginia has been struggling so much with 
the opioid crisis; we have been struggling longer and harder than many 
of our other States. This is not something we are particularly proud 
of, but it is a reality with which we live, and we really face the 
challenge.
  This crisis has shaped our ongoing response to the epidemic, as well 
as my contributions to the bill. In West Virginia, we understand 
better, I think, some of the causes of the crisis and how we can deal 
with them. We have discovered what is working in our State, and we have 
learned that the ripple effects go far beyond those struggling with 
addiction. It affects families and children and communities.
  When thinking about next steps for fighting the opioid epidemic, one 
of the first things I realized was that the formula for State funding 
was not providing adequate resources to the hardest hit States--States 
like West Virginia. I joined with my colleague Senator Shaheen from New 
Hampshire--her State also has been devastated by this epidemic--to help 
change that formula.
  I am pleased that this bill reauthorizes the State grants in a way 
that ensures that States like ours--small States with very large 
problems--will begin to receive more resources and those resources that 
we desperately need.
  Something else we quickly realized in West Virginia was that we 
didn't have the treatment facilities or the trained workforce to 
adequately support individuals seeking treatment. To address these 
needs, I worked with my colleague Senator Hassan from New Hampshire to 
create a grant program establishing comprehensive opioid recovery 
centers, or CORKs, in the most affected areas, and I worked on 
provisions that will help increase and better prepare our healthcare 
workers.
  We also realized, sadly, that there will always be bad actors who 
attempt to take advantage of those in crisis. I have talked to friends 
of mine whose young adult children are in the throes of addiction and 
will literally pay anything--anything--to get the help they feel their 
loved one deserves, making them particularly vulnerable, I think, to 
bad actors and to folks who might take advantage of that. So we 
introduced the Opioid Addiction Recovery Fraud Prevention Act with 
Senator Cortez Masto from Nevada. This measure will hold fraudulent 
substance abuse treatment programs and recovery centers accountable by 
empowering the FTC to bring enforcement actions against them.
  Another issue I hear about often is the need among employers for 
potential employees who are able to pass a drug test. Our economy is 
booming, our workforce is expanding, but we are having difficulty in 
some areas finding enough employees who can actually pass a drug test. 
It is not unusual; I will hear that 10 people get tested, and only 2 
will pass.
  We also have the need for recovering addicts to be able to find that 
pathway back to employment. To address both of these needs, this 
legislation authorizes grants that will align job training and 
treatment services, including several provisions from the CARA Act that 
I sponsored with Senator Brown from Ohio.
  As to the causes of the crisis, there are many, but there are two 
areas that come up again and again.
  First is the need to reduce the number of prescriptions for opioids. 
To get at the root of the problem, Senator Feinstein and I introduced 
the Using Data to Prevent Opioid Diversion Act. Our bill, which is now 
a part of the SUPPORT Act, provides drug manufacturers and distributors 
with data to identify pharmacies that are suspiciously ordering 
prescription opioids, and it grants law enforcement the authority to 
hold them accountable, as they should be, if they fail to use this data 
to identify, report, and stop suspicious orders.
  Had something like this been on the books before, we may have been 
able to stop--and I want you to hear this statistic--the 780 million 
oxycodone and hydrocodone pills that were distributed to pharmacies in 
my State alone--my 1.8 million population State, between the years of 
2007 and 2012, 780 million pills, including the nearly 9 million pills 
that were distributed between 2007 and 2008 to a single pharmacy in 
Kermit, WV, where the population is 392.
  The second issue that comes up often is the need to reduce the amount 
of synthetic opioids like fentanyl, which is killing--killing--people. 
It is 100 times more potent than heroin.
  The STOP Act will help prevent the shipment of synthetic opioids into 
the United States through the international mail system, where the vast 
amount of these originate. This measure, which Senator Portman led and 
I joined with him to introduce, imposes tough new requirements for our 
U.S. Postal Service and Customs and Border Protection. By better 
targeting illegal packages, we can keep those dangerous drugs from 
ending up on our streets and in our local communities.
  West Virginia has a more mature opioid epidemic, which has helped us 
to learn what is working and what is not working. One great example of 
something that is working is our Quick Response Teams, or QRTs, which 
has been piloted in Huntington, WV. Based on

[[Page S6472]]

similar programs around the country, a QRT is a three-pronged effort by 
medical professionals, mental health agencies, and law enforcement. 
These teams contact individuals who overdose within 72 hours of their 
overdose to help get them into treatment programs. In other words, 
let's not have them just go to the emergency room, stop the overdose, 
and have them walk back out with no followup.
  Given the success of the QRTs in our State, I worked with Senator 
Murphy to include a grant program in the SUPPORT Act that will allow 
communities across the country to implement similar programs.
  When it comes to what is not working, over the last year or so, I 
began to hear from hospice staff who, due to a DEA rule--I seriously 
didn't understand this rule--were not allowed to destroy unused 
medication unless authorized by State law.
  A lot of times in hospice, particularly elderly people in hospice--or 
anybody who is in a great deal of pain--have medications on the shelf, 
and if they are left to the disposal of a family member, you could see 
how they are ripe for falling into the wrong hands of a grieving family 
member or possibly somebody in and out of the home who has an addiction 
issue. I worked with Senator Collins to ensure that the SUPPORT Act 
includes language that would allow hospice employees to dispose of 
those controlled substances.
  Another example of a policy that is not working is a 40-year-old 
regulation related to substance use disorder privacy records. This came 
to my attention following a terrible tragedy for my fellow West 
Virginian, Jessie Grubb, which was caused by confusion and 
misinformation.
  Jessie was a daughter, a great sister, an athlete, and someone who 
was recovering from addiction. Following surgery from a running injury, 
despite her family's and her own best efforts to make clear that she 
was not to be prescribed opioids, she was discharged from the hospital 
with a prescription for 50 oxycodone pills. Jessie overdosed on those 
pills. She was 30 years old.
  Following her tragic death, Senator Manchin and I introduced Jessie's 
Law. Jessie's Law makes it easier for doctors to know if a patient has 
a history of opioid abuse. It requires HHS to develop best practices 
for prominently displaying this information in electronic health 
records when requested by the patient so that they can see them right 
there as they are discharging the patient.
  Although Jessie's Law passed the Senate in August, it had not passed 
the House, and I am glad to see it in the SUPPORT Act.
  Still, while this may help avert future tragedies, many in the 
addiction community have encouraged further action to assure that 
providers can safely and effectively coordinate high-quality treatments 
for patients with substance abuse disorder. To meet those needs, 
Senator Manchin and I introduced the Protecting Jessie Grubb's Legacy 
Act. Part 2 is not in the SUPPORT Act, and we will continue to work on 
this Legacy Act to make sure that this important policy change happens.
  Something we have seen in West Virginia are the ripple effects of the 
opioid epidemic. These are the children, the families. An unbelievably 
increasing number of children are being raised by their grandparents, 
raised by their great-grandparents, or are in foster care. It is 
putting a major strain on our social services but also on the 
individual child who, through no fault of their own, has ping-ponged 
from house to house in very emotional kinds of ways.
  There are more babies receiving neonatal care, and I have worked with 
my colleagues to make sure the CRIB Act, which I worked on with Senator 
Brown as well--this measure clarifies a State's ability, under 
Medicaid, to provide care for infants with neonatal abstinence syndrome 
in residential pediatric recovery centers like Lily's Place, which we 
have in Huntington, WV. The First Lady actually visited Lily's Place, 
and we would welcome her to come back.
  We also reauthorized the Residential Treatment for Pregnant and 
Postpartum Women, a grant program I worked with my former colleague 
Senator Ayotte to include in CARA. This provides new resources to 
identify, prevent, and mitigate the effects of trauma related to the 
opioid epidemic on infants, children, and their families.
  If nothing is done for this generation and the ripple effect on 
children, I fear we are at real risk of losing not just one generation 
to opioids but the next generation as well. Fortunately, there are lots 
of things that are being done. I will mention one: the Martinsburg 
Initiative in West Virginia, which is a combination among Shepherd 
University, the Martinsburg Police Department, and Berkeley County 
Schools, as well as the Boys & Girls Clubs of the Eastern Panhandle 
working together, based on a CDC study which shows that when children 
have adverse childhood experiences, such as exposure to drugs and 
alcohol, it can have a major impact on their physical and mental 
development. When we started CARA 2 years ago, it was a good start, and 
the SUPPORT Act is a great next step. A lot of this has to do with 
funding. The Defense-Labor conference report that the President signed 
into law last week includes $3.8 billion for the opioid epidemic--an 
increase of $250 million. With this year's funding, funding for related 
programs has increased by more than $3.5 billion over 4 years. Clearly, 
we have a commitment to this as a body, as all of us working together.

  I would like to applaud the efforts of all the committees involved 
and especially the dedication of the HELP Committee--Chairman Alexander 
and his staff and those who have worked together. I look forward to 
continuing to work with my colleagues on ongoing and emerging problems 
in this space. Methamphetamine is something that is way on the rise and 
taking over, unfortunately, from heroin, which is just a terrific 
tragedy.
  There is no one silver bullet when it comes to the opioid epidemic, 
but one thing is certain: I and we will keep fighting against those who 
are bringing deadly drugs into our communities. We will fight for those 
struggling with addiction and seeking treatment. We will fight for the 
children who are caught in the middle, and we will fight for every 
other person who is affected by this crisis.
  I am going to keep fighting for States like mine. Even in the darkest 
hours in West Virginia with this crisis, we have continued to move 
forward to a better place. Overdoses are down in Huntington, WV, by 41 
percent because of our community efforts toward a brighter, drug-free 
future. That is what we are all fighting for.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Ms. KLOBUCHAR. Mr. President, I join my colleague from West Virginia 
and thank her for her leadership on this work.
  The continuing problem of opioid abuse--the epidemic that has swept 
our Nation--has struck at the heart of my State, like West Virginia. In 
my State, there were 694 deaths from opioids and other drug overdoses 
in 2017. That is more than the number of people who died from car 
crashes and homicides combined in the State of Minnesota.
  No matter where I go, I hear heartbreaking stories. It is not just 
beloved superstars like Prince whom we have lost in Minnesota; it is 
teenagers in Duluth and young people in our farmland, 12-year-olds.
  One story I heard from some people at a small town gathering was 
about 12-year-olds being courted by drug pushers. The drug pushers tell 
them to go home to their parents' medicine cabinet. They are given a 
list of stuff to look for and are told: If you bring one of those 
bottles of pills with those names on it, we will give you a beer. That 
is happening in my State.
  There is the story of Shelly Elkington's daughter, Casey Jo, who was 
a champion swimmer who hoped to study nursing like her mom, but in 
2008, she was diagnosed with Crohn's disease. After painful 
complications, Casey Jo received her first prescription opioid for pain 
relief.
  As many of you know, about four out of five heroin users got their 
start on prescription drugs. The very pills that are supposed to ease 
someone's pain end up getting them hooked or, worse yet, getting them 
killed. That is what happened to Casey Jo. She died of an illegal drug 
overdose, but she first became addicted because of that painkiller she 
took that day. That is what

[[Page S6473]]

is happening to too many families in Minnesota and across the country.
  Here in the Senate, we have made some progress on the epidemic. Last 
Congress, I led a bill with three other Senators--Senators Rob Portman 
of Ohio, Sheldon Whitehouse of Rhode Island, and Kelly Ayotte of New 
Hampshire. It is called the Comprehensive Addiction and Recovery Act, 
known as CARA, and it was signed into law. It encourages States and 
communities to pursue several strategies, including increasing the 
availability of naloxone to save lives in overdose situations.
  Later in 2016, this Senate and this Congress made $1 billion in 
funding available for treatment and prevention with the passage of the 
21st Century Cures Act. I got to be at the bill-signing with President 
Obama and Vice President Biden.
  Earlier this year, we made an additional $3.3 billion available as 
part of the government funding bill.
  That is all progress, but we still have a lot of work to do. We are 
taking important steps forward by passing this legislation today, which 
includes more than 70 provisions to take on addiction. We have worked 
with the administration, we have worked with the House, and we see this 
as a bipartisan priority.
  One of the major pieces that are in this legislation is based on the 
STOP Act that I introduced with Senator Portman to help stop dangerous 
synthetic drugs from entering our country in the first place.
  We know this is a serious problem. Powerful synthetic drugs like 
fentanyl, which is up to 100 times more potent than morphine, keep 
coming in from China. In my State, there were 172 deaths involving 
synthetic opioids last year. That is a 74-percent increase from the 
year before. More than 90 percent of those deaths involved fentanyl.
  That is the reason I joined with Senator Portman to introduce 
legislation to close the loophole that allows substances like fentanyl 
to be shipped into our country in the mail using the U.S. Postal 
Service. That is what the traffickers are doing. They are sending these 
drugs in the mail to our country from China and from other places.
  Under current law, the U.S. Postal Service doesn't require advance 
electronic data for packages entering the country. That makes it easier 
on the traffickers and harder for our law enforcement officers to 
locate packages that contain illicit drugs. Our commonsense legislation 
requires that these shipments provide this data to make it easier for 
our Customs agents to detect packages containing synthetic drugs and 
stop them from being shipped to communities across the country.
  The way I look at it is this: If Target--a hometown company in 
Minnesota--can find a pair of shoes in Hawaii from a simple SKU number, 
I would think we would be able to stop traffickers and criminals from 
sending in incredibly dangerous drugs that literally can kill people 
with an amount basically the size of a pinch of salt, that we would be 
able to stop them from bringing this into the country in U.S. Postal 
Service packages. That is just wrong.
  With 318 million international packages having entered our country 
without advance electronic data last year, it is clear that we must do 
more. I look forward to this measure being signed into law as part of 
this package.
  Another provision in this legislation is a provision called the SALTS 
Act that I authored with Senator Graham. It passed the Judiciary 
Committee in May. Our bill will help to crack down on criminals who 
sell and distribute analogue synthetic drugs. Senator Graham and I have 
been trying to pass this for a long period of time, and I am glad this 
is finally getting done.
  The issue of synthetic drugs hit home for me when, a few years ago, a 
19-year-old from Blaine, MN, died after overdosing on a drug called 2C-
E. Back then, I introduced a bill to outlaw 2C-E and eight similar 
substances, and it was signed into law as part of a broader bill. I 
remember we worked on that with Senators Graham, Grassley, Schumer, and 
others, and we combined the bill and were able to get those listed on 
the illegal drug list. But that is not enough because we are seeing 
that new synthetic drugs are constantly coming into the market. 
Criminals are adjusting the chemical composition of these drugs, so as 
we get one listed, they just change it a little bit so that it is no 
longer contained on the list because it has a different chemical 
composition. But it is still an illegal drug manufactured for the 
purpose of getting people hooked.
  The bill Senator Graham and I have crafted will make it easier for 
law enforcement to prosecute the criminals who traffic what are called 
analogue drugs--similar drugs where compositions have been changed 
enough to make it so that they are not on the list. The bill addresses 
a loophole in current law that allows drug dealers to skirt the law by 
labeling these drugs as ``not intended for human consumption'' when 
they are placing people in danger every day. They slap that label on 
and say ``See, we didn't mean that to be illegal,'' and they change the 
composition so it is not illegal on the list.
  What our bill does as part of this opioid package is it allows for 
the consideration of factors to help to make clear that these dangerous 
substances really are intended for human consumption no matter what 
label they slap on them, such as the substance's marketing, labeling, 
or the difference between its price and the price at which the 
substance that it is represented as--like candy or bath salts--is 
normally sold. That is a good clue that it is not just candy or bath 
salts.
  Since I first introduced this bill, the Drug Enforcement 
Administration has taken action to emergency schedule fentanyl 
analogues on a temporary basis. But we know that criminals are 
continuing to come up with new analogue drugs, and this measure will 
help us to meet those threats.
  The last provision in this bill that I want to talk about is based on 
legislation that Senator Rubio and I introduced, and that is the 
Eliminating Kickbacks in Recovery Act. Our bill targets unscrupulous 
actors who prey on patients seeking treatment to exploit their health 
insurance by making it illegal to provide or receive kickbacks for 
referring patients to recovery homes and treatment facilities. These 
kickbacks are already illegal under Federal healthcare plans like 
Medicare, but there is no Federal law to prohibit them in private 
health insurance plans. When people are struggling with addiction, 
their focus should be on getting well, not on worrying whether 
treatment facilities are trying to take advantage of them to make more 
money. It is simply outrageous. Our bill will crack down on healthcare 
facilities or providers who try to game the system to take advantage of 
these vulnerable patients.
  Those are three provisions I have worked on that are in this bill, 
but, as we know, there is a lot of other good work that has been done 
in this bill. In the end, the way I look at this is that our first goal 
is to stop people from getting addicted in the first place. That means 
doing all we can to stop this fentanyl, carfentanil, and all the 
illegal drugs from coming in. That means providing education in our 
schools so kids understand what is happening and how dangerous these 
drugs are. That means working with our doctors and healthcare providers 
so they are not overprescribing opioids. We now know that four out of 
five heroin users got their start on legal prescription drugs. We want 
to put limits--and that is going on all over the country with 
Republican and Democratic Governors--and we must do more here.
  The second piece of this is making sure we have treatment available 
for people who are addicted. There are all kinds of work being done on 
treatment, from SUBOXONE, to the work that is being done in the medical 
device industry as they look at potential ways to get people off of 
these drugs, to traditional treatment methods. We have to be openminded 
to all possibilities to get people off of these drugs because once 
addiction occurs, they are very hard drugs to kick. That means we are 
going to have to put in resources to combat that.
  I personally support Senator Manchin's bill, the LifeBOAT Act, which 
is a commonsense approach that allows a one-penny additional fee on 
each milligram of active opioid in these drugs so that that money can 
be used to pay for treatment. We should be using those kinds of 
innovative ideas at the Federal and State level.
  The last point is to go after the bad guys, the people who are trying 
to get people hooked on these drugs. That is

[[Page S6474]]

where two of the bills I just discussed--the analogue bill with Senator 
Graham and the bill that Senator Portman introduced with me, the STOP 
Act, which requires the Postal Service to track these packages--it is a 
combined effort.
  There is a law enforcement piece of this, but we cannot forget that 
at its core, we want to stop this cycle where people are getting 
addicted. And when they do get addicted, when that happens, we have to 
get them the treatment they deserve.
  I used to be a prosecutor in the criminal justice system, and I 
always said that we wanted to run our office as efficiently as 
possible. We wanted to use business techniques in how we ran an office. 
But there was one important way that we were not like a business: We 
didn't want to see repeat customers. We didn't want to see people 
cycling in and out of the criminal justice system. The best way we can 
ensure that doesn't happen is by making sure that people get the 
treatment they need so that they can go on to lead happy, productive 
lives.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. MERKLEY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                     Nomination of Brett Kavanaugh

  Mr. MERKLEY. Mr. President, the most important words of our 
Constitution are the first three, ``We the People.'' This describes the 
entire purpose of our Constitution, which is to create a government 
responsive to the people and to produce laws that reflect the will of 
the people. It requires a close adherence to the vision embodied in the 
Constitution, including the advice and consent vision in the 
Constitution.
  We know that the Founders of our country struggled with how to 
appoint people to high positions in the executive branch and in our 
courts. It was Alexander Hamilton who laid out the deliberations. He 
said: If a body or an assembly has that power, there will be a lot of 
horse trading back and forth, and we will not get the best people 
suited to the positions in the executive branch and in the courts. So 
the responsibility should rest with one person. That is how the 
nominating power came to be vested with the President.
  The Founders also discussed the fact that a single person can go off 
track. The President might have favoritism toward people from his or 
her home State. The President might favor people who, in turn, had done 
favors for him or her and so forth.
  They said that the way to avoid this is to have the Senate be a check 
upon the President, and that ``would tend to greatly prevent the 
appointment of unfit characters.'' That is how Alexander Hamilton 
summed it up.
  Our responsibility is to review the record of individuals and make 
sure that no one is appointed who is of unfit character. That 
separation of powers has been honored over the centuries with the 
President nominating and then the Senate reviewing the entire record of 
the individual to honor its responsibility to figure out if this 
individual is fit or if this individual is unfit.
  But now we have something we have never seen before, which is that 
the President's team has intervened in a massive way to block a 
thorough review of the nominee's record. There are three parts of this 
intervention. The first was to weigh in with Senate leadership and say: 
Don't request anything about his 3 years as Staff Secretary. There was 
a conspiracy then between the President's team and a few Senators to 
prevent the entire body from being able to review Nominee Kavanaugh's 
record.
  That is unacceptable because each and every one of us has that 
responsibility. Each and every one of us takes the oath of office. This 
isn't just a responsibility that exists for one or two people who refer 
to themselves by title like majority leader or chairman of the 
Judiciary Committee. This is a responsibility that every one of us has, 
and that responsibility has been violated with this violation of the 
separation of powers.
  The second thing the President did was to proceed to appoint an 
individual to use the stamp ``Presidential privilege,'' meaning 
executive privilege, to deny access to the Senate of some 100,000 
documents when the individual served in the capacity of a lawyer on the 
team of White House Counsel. In this case, the Senate did request the 
records. This is solely the exercise of the President and perhaps, 
therefore, it is the clearest example of the violation of the 
separation of powers.
  We have from the individual himself the statement: ``The White House 
. . . has directed that we not provide these documents.'' That is 
referring directly to the documents on which William Burck marked 
``Presidential privilege''--100,000 documents.
  Why are these documents important? Well, we know from the more 
limited ones we have received that it addresses his actions and his 
opinions on a host of important topics.
  The documents reveal, for example, that while he said he wasn't 
involved in the discussions around certain nominations, we know that, 
at least in a modest way, he was, from the documents we have. But we 
don't have the bulk of the documents to explain the whole story.
  He said he wasn't involved with the discussions regarding the use of 
torture, but we have a limited glimpse from the documents we did get 
that he was involved in those discussions. The remaining documents 
probably have a much more expanded vision of his involvement.
  He said he wasn't involved in the receipt of stolen documents that 
regard nomination discussions--documents stolen from the Senate 
Democrats--and yet we find out from the existing documents that we have 
that he was and that these were received directly by him.
  Here we are with this limited glimpse of three cases in which he 
misrepresented the story. We certainly didn't get the full story. What 
is in the 100,000 documents that were censored that we never got?
  We have never been in this situation before where a President 
deliberately obstructed the review of the nominee's record in this vast 
procedure. Did the President's team go through them carefully and say: 
Oh, well, because of the sensitivity of XYZ, therefore, we are going to 
block documents ABC, and therefore create an index explaining that. No, 
they did not. We have a whole-scale blockage of key parts of the 
record.
  There is more than that. There is also the President's role in 
marking documents ``committee confidential.'' Here is the challenge. We 
have a responsibility--a constitutional responsibility--that has been 
violated. That is why today I filed a motion to compel the President to 
provide those 100,000 documents marked ``Presidential privilege'' to us 
in the Senate, so we can review them and do our responsibility under 
the Constitution.
  Let me switch topics. I have heard Senators here say: Well, we 
certainly couldn't vote for this individual if he lied to the committee 
in his testimony. That certainly would mean he was unsuited to serve. 
Yet we have numerous instances in which he has lied to the committee, 
and he is unsuited to serve.
  At a minimum, the President should withdraw this nominee. It is 
certainly an enormous dark mark on the integrity of the Court to take 
someone who misled the Senate--Democrats and Republicans--about 
numerous topics. In just those three issues I mentioned, we had 
deception. On issues related to whether he received stolen documents, 
he did. He said he didn't.
  Was he involved in the proceedings for certain nominees? He said he 
wasn't, but he was.
  Was he involved in the conversations over torture? He said he wasn't, 
but he was.
  That is just with the limited information we have.
  Then we have the hearing in which he said that his friends who were 
at the gathering with Dr. Ford refuted her story. That is a straight-
out lie. Not one of them refuted her story. They said they didn't 
remember. They said they didn't know. They certainly didn't refute it. 
That is a lie.
  He said she wasn't in the same social circle, but we know she was. 
She dated his good friend.
  When he was asked about certain things like ``boofing'' and ``Devil's 
Triangle,'' he lied to the committee about

[[Page S6475]]

what those terms meant and what all his friends knew they meant. They 
meant things I will not discuss here, but he wasn't honest with the 
committee. The list then goes on and on.

  He said he was not aware of the story until he read it in The New 
Yorker magazine. It turns out that it was not true when, in fact, he 
intervened to try to sabotage that story before it was ever printed 
because he knew about it beforehand.
  Colleagues, look, there are times when we may have an individual who 
suits one's judicial philosophy but who is totally unsuited to serve on 
the Court. Stand up for this institution. Stand up for the Senate. It 
has been unable to carry out its responsibility under the Constitution 
of reviewing this man's whole record. Stand up for the integrity of the 
committee process and the fact that we don't put people on the Court 
who lie to this body. Stand up for the vision of the United States of 
America--the vision of a ``we the people'' nation, not of a government 
by and for the powerful. Yet that is exactly what his decisions stand 
for. Stand up for the vision of a President and a republic instead of 
for the vision of a King and a kingdom, which is what his view of 
Presidential power turns into--a President above and beyond the law.
  Colleagues, do your job. That means we do not vote until we have the 
documents and review his entire record, and when we vote, if he is 
still the nominee, we reject him because he lied, because he 
demonstrated intense partisanship, because he is angry under stress, 
because he threatened retaliation, because he is unsuited to serve on 
any court, let alone the Supreme Court of the United States of America.
  The PRESIDING OFFICER (Mr. Cotton). The Senator from Missouri.
  Mr. BLUNT. Mr. President, my colleague just talked about standing up 
for the Senate, about standing up for the values that traditionally 
have been our values. One of those principal values has been ``innocent 
until proven guilty.'' What we have seen happen here in the last week 
is something that did not need to happen, certainly, in the way it has 
happened.
  The hearing, the hours of questions, the picking apart of those 
answers at leisure--we have seen all of that. Do you know what would 
have happened if we had followed this process the right way? It is hard 
to do when a significant majority of the committee says that it is 
against the nominee before he has the hearing and when several Senators 
say they are against the nominee before he is even nominated, no matter 
who the nominee will be.
  There would have been a normal background check that would have 
occurred if the information that had been available to the committee--
to the Democrats and their staffs--had been turned over at the time. 
How would they have handled that? How would those in the FBI have 
handled that on July 30 or August 30 or on any other date? They would 
have handled that by going and talking to the people involved. Dr. Ford 
and Judge Kavanaugh would have been interviewed by the FBI. The people 
they would have mentioned with whom the FBI should also talk would have 
been interviewed by the FBI, and that would have been put in the file. 
The material could have been presented to the committee as it should 
have been.
  In Judge Kavanaugh's private hearing, they were willing to talk about 
baseball tickets. They could have pursued this in the private hearing: 
Here is what is in this file. What do you have to say about that?
  Dr. Ford, as she said she had wanted to be, would have been kept 
anonymous in that process. There would have been no reason--unless the 
committee would have decided to do what somebody on that committee 
did--to have used her name and for this to have become a major public 
confrontation. This could have been handled in another way. Her letter 
and her personal trauma could have been handled in a way that they were 
not. In fact, it couldn't have been handled more poorly or politically 
by some in the minority or by their staffs than it was.
  Only after the original hearings had ended, only after it was obvious 
that Judge Kavanaugh--in my view, it was obvious--had the votes to be 
confirmed, then, suddenly, were these unverifiable charges made public 
by the Democrats on the committee and by their staffs.
  I work hard in the Senate to find agreement with my colleagues of 
both parties. I have been the principal Republican cosponsor on 
legislation with all but four of the Democrats in the Senate. I do my 
best to find the areas we can agree on. In fact, with regard to this 
FAA bill today, Senator Cantwell and I chair that subcommittee, while 
Senator Thune and Senator Nelson chair the full committee. There is 
this and appropriations. There are a lot of things that have happened 
this year that haven't happened for a while, and it is because we have 
reached out to try to work together.
  What we have with this nomination is a new principle. I find the 
``guilty until proven innocent'' conduct by some of our colleagues to 
be totally unacceptable. It is not who we are. It cannot become the new 
standard. I heard somebody say at a meeting this week: Well, if these 
charges are out there, this person will always be impacted when there 
is a case before the Court that might possibly involve those charges. 
That cannot be how we pursue the future. We cannot pursue the future by 
thinking: If you are charged with something, you will be, from that 
point on, somehow unable to do the job that you are eminently qualified 
for.
  We have a person here who has 300 court of appeals opinions on the 
most challenging court of appeals in the country--more than a dozen of 
those accepted almost word for word by the Supreme Court. There is 
plenty to determine judicial temperament. There is plenty to determine 
whether the judge can do what the judge is supposed to do.
  Unless later today, somehow, we see something, which is highly 
unlikely based on all of the things that are already out there, I 
intend to vote for Judge Kavanaugh. I don't think he would have said he 
categorically and unequivocally didn't do this--or anything like it 
regarding the specific charge--if he had. It was not necessary. You 
wouldn't have to say that about conduct over three decades ago. You 
could say all kinds of other things, but here is a lawyer whose legal 
capacity has never been challenged. He would not have had to make that 
unequivocal statement if there had been any reason to be concerned 
about that statement.
  He said he didn't do it. All who were mentioned and who were asked if 
they saw it happen say they didn't see it. I believe something 
traumatic did happen to Dr. Ford. I don't believe it involved Judge 
Kavanaugh. With the obvious, specific three-decades-later memory of the 
person involved--with that exception--you could actually believe that 
both of them are telling the truth.
  I joined Judge Kavanaugh's daughter in praying for Dr. Ford and her 
family. I also think we should all pray for Judge Kavanaugh and his 
family.
  This is an issue that has gotten totally out of hand. It is an issue 
that has gone well beyond the bounds of what we believe in our country. 
It is an issue that we can't let begin to determine the future way we 
do these things. You cannot have guilty until proven innocent. You 
cannot have innocent until nominated as the standard for the country. 
We cannot let this go forward that way.
  Some relationships here--and they are important ones to me and 
others--are going to take a little while to restore, but we will have 
to restore them. There aren't enough of us to walk away from each other 
and say: We cannot possibly move forward in working with you. I intend 
to continue to work with my colleagues, but I also intend to continue 
to stand up for the fundamental values of fairness that this country 
has always held most dear. We need to do that this week with this 
nomination as well.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. BARRASSO. Mr. President, I rise, as well, to speak about the 
nomination of Judge Brett Kavanaugh to serve on the U.S. Supreme Court. 
He was nominated on July 9--86 days ago today.
  Even before he was nominated, a number of Members of this body stood 
and said they would oppose the nomination to the Supreme Court with 
their not even knowing who he or she might be. After the name came out 
that evening, other Members of the Senate

[[Page S6476]]

said they opposed him. Chuck Schumer, the Democrat minority leader, 
said he would oppose the nomination with everything he had. It used to 
be that we could just disregard language like this as empty rhetoric--
not anymore. Now we know exactly what the Democrats had in mind from 
the very start. We have seen the kind of smear campaign they had 
planned from the very beginning.
  What I have heard from people at home, in Wyoming, is that they 
didn't think things could get any lower in Washington, DC, until they 
saw this. The Democrats have done everything under the Sun to delay 
Judge Kavanaugh's nomination and to tarnish his reputation. It began 
with misrepresenting Judge Kavanaugh's sterling judicial record. Well, 
that didn't work.
  Then they unfairly complained that they didn't have enough documents 
by Judge Kavanaugh. When that didn't work, they shifted to surprise 
attacks on his character.
  The only thing they have accomplished is to set a new low for how the 
Democrats treat people in Washington, DC.
  There is a way we do things in the Senate to make sure we can fairly 
and fully investigate nominees for important jobs. What we have seen is 
that the Democrats have absolutely rejected this bipartisan tradition. 
They hid information for more than 2 months. Then, after Judge 
Kavanaugh had gone through 4 days of confirmation hearings, the 
Democrats leaked that information to the press--information that they 
had been sitting on and hiding from the American people, hiding from 
the Republicans on the committee, hiding from the judge himself.
  This isn't the first time we have seen the Democrats try to change 
the rules when it comes to judicial nominees. The Democrats really do 
have a double standard. They do it time and again. They want one set of 
rules for when there is a Democratic President and then a totally 
different set of rules for when there is a Republican President.
  The Democrats have had for years something known as the Biden rule, 
which was named after then-Senator Biden and then-Vice President Joe 
Biden. This Biden rule says you shouldn't confirm a Supreme Court 
nominee once a Presidential election is in full swing. The Democrats 
wanted that rule in place when George Bush was President. Once 
President Obama was in office, the Democrats wanted to pretend they had 
never said it, never heard of it, and that it no longer applied. They 
wanted a totally different set of rules for considering nominees for a 
Democratic President than those for a Republican President.
  Then they had what we saw here in the Senate as the Reid nuclear 
option. That is when the Democrats decided and voted overwhelmingly to 
get rid of the filibuster for confirming judges and other nominees. The 
Democrats set the rule when they were in the majority, when there was a 
Democrat in the White House, and they wanted to confirm people who were 
nominated by President Obama. As soon as a Republican got into the 
White House, the Democrats who voted to change the rule now complained 
when the rule they changed was applied to them. The Democrats have a 
double standard.
  Now what we see is the Schumer rule. The Democrats took the normal 
process for how we review nominees, and they threw it out the window. 
The Democrats' new rule is this: Defeat the nominee no matter what. The 
Democrats are willing to do whatever it takes to delay, disrupt, 
intimidate, and obstruct this Republican nominee. The Democrats haven't 
just thrown out the standards for how we do our work here; they have 
absolutely trampled on common human decency.
  It was bad enough when Democrats were just trying to delay things. 
They demanded reams of paperwork. Well, Senators have been given access 
to 500,000 pages of records--one-half million pages of records--from 
the judge's time as a judge and throughout his career in public 
service. That is triple the amount of information they have ever gotten 
about any other Supreme Court nominee.
  After Judge Kavanaugh's confirmation hearings, he responded to nearly 
1,300 written questions from Senators. Those are more questions than we 
have had for every other Supreme Court nominee in history, combined--
combined.
  Judge Kavanaugh has served on the circuit court in the District of 
Columbia--the second highest court in the land--for 12 years. He has 
written opinions in 300 cases. If anyone wants to know how he will act 
as a judge, they should look at how he has already acted as a judge for 
the past dozen years. These are the documents that matter. These are 
the ones that tell you how he approaches being a judge.
  People can look at the 13 cases where the Supreme Court adopted Judge 
Kavanaugh's reasoning. That is how much respect other judges and 
Justices have for his careful and compelling decisions.
  Washington Democrats don't seem to care about any of this. Democrats 
got the documents they asked for so they just changed their demands.
  You can see how transparent Democrats have been by looking at what 
they said last week. As late as last Friday morning, Democrats were 
saying we should pause for a week. That is what Senator Schumer, 
Senator Feinstein, and other members of the Judiciary Committee said. 
They said: Let's pause for 1 week.
  As soon as Republicans said we would do that, the Democrats said that 
is not good enough. They said it doesn't matter what happens in that 
week, they are still voting no. For them, it was never about finding 
the truth. For many, it was never even about the name of the nominee 
because they came out opposing him before his name was even placed in 
nomination by the President.
  This has always been about the far-left wing of the Democratic Party 
doing--as they have described it--whatever it takes to push their 
talking points.
  It is now all about the politics of personal destruction. They don't 
seem to care much about what they do and how they damage the people 
involved. They don't care about the damage they are doing to the Senate 
and the damage they are doing to the Supreme Court.
  The American people deserve better than this. It is time for the 
Democrats to end their charade before they do more harm to the Senate, 
to the Supreme Court, and to the United States of America.
  Thank you.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. PERDUE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                     Nomination of Brett Kavanaugh

  Mr. PERDUE. Mr. President, this has the potential of being a historic 
week in America. The last 10 days have been very troubling to me as a 
U.S. Senator, as an individual citizen, husband, father, son.
  I am very troubled today by the extreme measures we see being made 
right now about a case my colleagues across the aisle are trying to 
make. I am outraged, actually. After a personal incident that involved 
my wife and me this week, we have seen firsthand the length to which 
Members of the other side of the aisle will go to distract us away from 
the truth.
  This body, the U.S. Senate, has become nothing more than a bully 
pulpit for someone's special cause, when it should be a deliberative 
body. We should be finding the truth.
  My Democratic colleagues claim they want to work together with 
Republicans. They talk all the time about working in a bipartisan way. 
Yet, when we get into the heat of the battle, nothing could be further 
from the truth.
  This is bigger than confirming Judge Kavanaugh to the U.S. Supreme 
Court. This is about civility in our country. People have died 
supporting our Constitution and fighting for the freedoms we have in 
this country: innocent until proven guilty, for goodness' sake. When 
that is not convenient with an argument you are trying to make, it gets 
trashed. That is what we have seen this week in this body.
  This is about the common discourse in America. Whoever said we always 
have to agree? We don't. But whoever

[[Page S6477]]

said you have to hate someone if you disagree with them?
  Senate Democrats have made it clear, they are willing to say or do 
anything to stop the President's agenda which, by the way, is working. 
We are growing this economy at twice the rate we achieved under 
President Obama. We have over 331 nominees today waiting to be 
confirmed--the first time in history this has ever been done to this 
degree.
  One of my Democratic colleagues called Judge Kavanaugh ``your worst 
nightmare.'' Another called him ``a nominee who wants to pave the path 
of tyranny.'' Yet another said: This Supreme Court confirmation would 
mean ``the destruction of the Constitution.'' Seriously? That is 
irresponsible for somebody in this body. She said that before Judge 
Kavanaugh was even announced as a nominee. Worst of all, another one of 
my Democratic colleagues said anyone who supports Judge Kavanaugh's 
confirmation is ``complicit in the evil.'' I just don't understand 
that.
  Really? Senate Democrats want to be reasonable and work together? 
Seriously? This rhetoric sounds anything but reasonable to me. In fact, 
I believe my Democratic colleagues have gone one tick too far this 
time. When paid activists who support you attack my wife, you have gone 
too far. The American people will know that on both sides. That didn't 
start outside this body; it actually started in here. You are inciting 
this disrespect of our law.
  One of my Democratic colleagues in this body has encouraged people to 
``get in the face of some Congresspeople.'' Really? How does that move 
the cause of justice forward? The House minority leader wants to see 
``uprisings all over the country.'' Seriously?
  Another Member of the House said--and I am quoting the entire quote 
here.

       They're not going to be able to go to a restaurant--

  Talking about Republicans--

       they're not going to be able to stop at a gas station, 
     they're not going to be able to shop at a department store. 
     The people are going to turn on them. They're going to 
     protest. They're going to absolutely harass them until they 
     decide that they're going to tell the president, no I can't 
     hang with you.

  The same Member of the House also said:

       If you see anybody from that cabinet in a restaurant, in a 
     department store, at a gasoline station . . . you get out and 
     create a crowd, and you push back on them and you tell them 
     they're not welcome.

  This is America, but these are the tactics of the Brown Shirts in 
Germany in the 1930s--unacceptable, totally irresponsible. This is 
outrageous and unacceptable behavior for anyone but much less a Member 
of this body, a Member of Congress, and a Member of the U.S. Senate. 
You have crossed a line. Inciting dangerous behavior is not something 
we should be about in this body.
  Now, when it comes to Judge Kavanaugh, America was built on a bedrock 
principle that we were trying to instill in America as opposed to what 
we lived with under different rule in Europe, and that is this: The 
presumption of innocence is sacred. An individual here is innocent 
until proven guilty. That is part of what makes our country so 
exceptional.
  Unfortunately, Senate Democrats have become so far removed from 
getting to the truth that they will stop at nothing to delay this 
Supreme Court confirmation. That is all this week is about. It is 
another delay.
  Any objective observer would agree that Chairman Grassley afforded 
both Dr. Ford and Judge Kavanaugh an equal opportunity to speak before 
the U.S. Senate Judiciary Committee and to the American people. As a 
matter of fact, any war on women this week and in this sad story here 
has been perpetrated on Dr. Ford by Senate Democrats. She wanted this 
to be confidential, and this body could have done that. They could have 
done all the investigation confidentially without dragging her name 
through the media--or Judge Kavanaugh's.
  Some people on the Democratic side of the Senate want America to 
believe this is just a simple case of he said, she said, and it comes 
down to whom do you believe. It is a lot more than that. It is not only 
he said, she said, but it is ``they said.''
  The accuser in this case named three people who she said would 
corroborate her story. Not only did they not corroborate her story, 
they actually corroborated his story.
  Senate Democrats were not satisfied even with that. They weren't 
satisfied that when the letter was leaked to the press--it wasn't given 
to the committee--but when it was leaked to the press some 6 weeks 
after it was received by Senate Democrats--6 weeks--an investigation 
was started immediately by the Judiciary Committee. Oh, but wait. 
Senate Democrats chose not to participate. How is that for looking for 
the truth? Instead, what they did is they waited until we had a hearing 
and then said: Oh, we need another FBI investigation that we knew would 
be totally redundant with what had just been done by Federal 
investigators employed by the Senate Judiciary Committee, but we went 
ahead and agreed as a committee to do just what you wanted; that is, to 
allow a full and open FBI investigation into this, which is nothing 
more than redundant with what had just been done in the prior couple of 
weeks.
  Judge Kavanaugh has had six--six--FBI investigations. This is the 
seventh formal FBI investigation. Not only that, the minute the 
committee saw Dr. Ford's letter, it immediately, as I said, went into 
detail with these outside Federal investigators, without the help of 
Senate Democrats who are members of that committee. As a matter of 
fact, when the ranking member of the Senate Judiciary Committee met 
with Judge Kavanaugh a few weeks ago, she had been in possession of 
this letter from Dr. Ford for several weeks, and her staff had already 
recommended an attorney to Dr. Ford, but in that meeting with Judge 
Kavanaugh--the first meeting between the ranking member and Judge 
Kavanaugh--she didn't mention the letter one time. That is in the 
testimony. She held on to Dr. Ford's letter for 6 weeks before it was 
leaked to the press.
  Again, it is clear this is all a well-orchestrated effort to cause 
delay and push this decision, hopefully--in their minds--past the 
election. Shame on any Member of this body, Republican or Democratic, 
that puts self-interests and political interests before their 
constitutional responsibility.
  The committee has voted favorably to move Judge Brett Kavanaugh's 
nomination forward. That means it comes to this floor. It is time to 
take a full vote before this body, before the U.S. Senate.
  We hope in the next few hours, the next day, to have this FBI report 
and to put this sad saga to bed. It is time to put partisan politics 
and delays behind us. It is time to confirm Judge Brett Kavanaugh to 
the U.S. Supreme Court.
  I want to say one more thing. It is time for this body to reread 
their oath of office, to uphold and defend the Constitution of the 
United States, to make sure that what we say in this body is the best 
and the very best America has to offer, to move our concerns forward.
  Thank you.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.


                SUPPORT for Patients and Communities Act

  Mr. PORTMAN. Mr. President, today the U.S. Senate is going to vote on 
legislation that is representative of years of work that has been done 
to help address the opioid crisis. That vote will occur in about half 
an hour.
  This is historic legislation. It is legislation that was put together 
by the House and Senate, on a bipartisan basis, to answer some of the 
pleas and calls from our communities back home--pleas from people 
asking: Can't you do more to help us reverse the tide of this opioid 
epidemic?
  I would like to start by thanking and commending Senator Lamar 
Alexander for putting together this legislation, taking the work from 
five different committees of Congress--the HELP Committee, Judiciary, 
Finance, Banking, the Commerce Committee--putting those different 
legislative projects together, along with projects that had come over 
from the House. Seventy Members of this body have contributed to this 
legislation.
  This legislation is important because although Congress acted a 
couple years ago, unfortunately, the problem has gotten worse, not 
better, and we have learned more. The last major legislation we passed 
on opioid legislation was about 2 years ago. By the way, during those 2 
years, I am told I have been

[[Page S6478]]

on this floor 56 times talking about this issue. I have been talking 
about how the legislation we passed is working or not working, talking 
about stories from back home, talking about the need to implement the 
legislation we passed in a more expeditious way because of this 
problem, talking about the urgency, and talking about having the 
necessary funding.
  Here is the good news: We have increased funding dramatically. The 
two bills we passed in 2016 are beginning to work. One is called the 
Comprehensive Addiction and Recovery Act that I coauthored with Senator 
Whitehouse; the other is called the Cures legislation. Both of them 
helped. CARA has grants that go directly to nonprofits, to programs 
that work that are evidence-based, to help with prevention and 
education, treatment, and longer term recovery, and to help our first 
responders.
  The second one, the Cures legislation, gives grants that are going 
directly to the States from the Federal Government and then back to the 
programs States think work best for them. These funds, which are 
unprecedented, along with these two laws, are helping. They are helping 
to make the Federal Government a better partner with State and local 
government and with nonprofits to combat this crisis.
  I have been all over my State to see how these programs are working, 
and I have spoken on the floor a lot about the people I have met who 
have been helped. I have spoken about some of the cases of hope--cases 
where somebody who stepped forward to take advantage of one of these 
programs and found the treatment that worked for him or her.
  I have also talked about the need for us to do more. That is why 
earlier this year--again on a bipartisan basis--we introduced CARA 
2.0--the Comprehensive Addiction Recovery Act 2.0--to learn from what 
we are seeing back home, what is working or not working with the first 
legislation and to move it forward.
  The legislation we are about to vote on this afternoon includes a 
number of provisions of CARA 2.0, and I appreciate that. Again, I thank 
my colleagues for including those and the leadership for bringing this 
to the floor.
  It also, though, includes some other legislation I think is really 
important. Unfortunately, again, we have to do it. Seventy-two 
thousand--that is the number of Americans who died from opioid and 
other drug overdoses last year. In 1 year, more people have died from 
opioid and other drug overdoses than in the entire Vietnam war.
  Opioids was the No. 1 cause of death. Within opioids, the No. 1 cause 
of death was fentanyl, the synthetic form of opioids. Even though we 
have made progress with the legislation I am talking about, we have 
this record level of overdose deaths in my home State and in our 
country. I believe one reason for that is that despite doing a better 
job on prevention and treatment and longer term recovery, we have had 
this influx of a new deadly drug. This is the fentanyl influx. It comes 
mostly from China. It comes mostly through our Postal Service. It is 
the No. 1 killer right now in my State and probably the No. 1 killer in 
the country in terms of drugs.
  In Ohio, there has been a 4,000-percent increase in the last 5 years 
in fentanyl overdoses and deaths. It is inexpensive. It is cheap. It is 
deadly. It is 50 times more powerful than heroin; a few specs can kill 
you. Because it is synthetic, there seems to be a limitless supply. We 
need to push back.
  One thing this legislation before us today does is it says we are 
going to stop having our Postal Service be the conduit for this poison 
coming into our communities. It is about time. The legislation is very 
simple. It says this loophole where you can send this deadly poison 
through the mail system is going to be closed because we are going to 
say that now the post office has to provide law enforcement the 
information, in advance, electronically, that all the other private 
carriers already have to provide.
  We spent 2 years investigating this. One thing we found in our 
Permanent Subcommittee on Investigations was the dealers--the 
traffickers--were saying: If you send it through the Postal Service, 
delivery is guaranteed because they don't have the screening at the 
Postal Service.
  The STOP Act is important. It will serve as a tourniquet, stemming 
the flow of this deadly poison that has led to record-level overdose 
deaths and endangers anyone--including first responders and mail 
carriers--who comes in contact with it. This is important because it 
pushes back on the supply, but that is not all we have to do.
  We have to do a better job in terms of getting people into treatment 
to be able to overcome their addiction. This legislation we are about 
to vote on does that as well. It includes a bipartisan proposal I 
introduced with a group of colleagues to expand Americans' access to 
treatment by lifting what is called the IMD, or Institutions for Mental 
Disease, exclusion.
  This is how it works. It is an outdated policy. It is a vestige of a 
policy from years ago to try to discourage institutional care, which 
was well-meaning at the time. But this is what it does today: It says 
that in a residential treatment setting--and some of them are doing a 
great job--you are limited to 16 beds if you want Medicaid 
reimbursement.
  One of the most heartbreaking things I do as a Senator is talk to 
families, parents, and loved ones of people who overdosed and died 
after they wanted to get into treatment but were turned away and told 
there was no more room for them. I have talked to a father and a mother 
whose daughter went to treatment. Finally, she was ready. They turned 
her away because there wasn't room. In the 2 weeks while she was on the 
waiting list, what happened? She used heroin, she overdosed, and she 
died. She was ready, but they weren't ready for her. This legislation 
will help prevent that and will allow more people who are ready to 
overcome their addiction get into a treatment center and get a form of 
medication-assisted treatment that is right for them.
  Significantly, the final version that we will vote on today, agreed 
to by the House and Senate, is an improvement from the House-passed 
legislation because it now is covering any kind of substance abuse, not 
just opioids, not just cocaine, not just crystal meth, not just alcohol 
but any kind of substance abuse. That is very important. All of them 
are problems in our communities. Crystal meth has increased in a lot of 
areas of Ohio, even as we have made progress against opioids, as an 
example.
  This legislation will also ensure that once people get into 
treatment, it is up to the high standards and the standards of best 
care that we all want. It includes several provisions I have been 
working on to do just that. One is national quality standards and best 
practices for recovery housing, so people who are transitioning out of 
treatment and into longer term recovery have high-quality housing 
options that eliminate the gaps that so often occur in recovery.
  It also helps young people struggling with addiction by authorizing 
support programs in high schools and colleges--we have some great 
examples of this in Ohio, spreading around the country--to focus on 
people who are already addicted but also to act as further 
encouragement for people who want to come and learn more about this for 
prevention and education.
  It will help provide resources and care for some of the most 
vulnerable affected by this crisis. There is $60 million in this 
legislation for a plan of care for babies who are born dependent on 
drugs. These babies have what is called neonatal abstinence syndrome 
because their mom was addicted and was using while they were in the 
womb. They come out needing to go through withdrawal themselves. They 
need more help. We don't know what the impact is going to be longer 
term, but we know our hospitals across the country are being filled 
with innocent babies who need our help.
  It has the CRIB Act included in this legislation, a bipartisan bill I 
coauthored that will help newborns suffering from addiction recover in 
the best setting possible for them and allows, again, reimbursement for 
great organizations, such as Brigid's Path back home in Dayton, OH, 
where people come and provide care to kids whose parents are addicted. 
They aren't in foster care yet, but they need this care and transition 
to be able to ensure their longer term success.
  Finally, it reauthorizes some really important programs: drug courts,

[[Page S6479]]

which are working to get people who are incarcerated into treatment; 
drug-free community prevention grants, which are helping to push back 
in our high schools and middle schools and even elementary schools; 
high-intensity drug trafficking areas, HIDTA grants, which focus on the 
Federal Government working more with State and local government on drug 
interdiction.
  This opioid epidemic has gripped my State of Ohio. We are among the 
States hardest hit. But every State in this Chamber has been hit, and 
it is personal. It is personal for all of us because we have all heard 
the stories.
  On Monday, before I came here to vote in this Chamber, I went to the 
funeral of a young man whose family I have known my entire life. His 
mom, whom I have known since I was born, was heartbroken, talking about 
his opioid addiction and talking about everything they tried to do to 
get over this. We talked about it as a disease, which it is. This young 
man's life was cut way too short. I shared in their heartbreak, 
mourning his beautiful life cut short by addiction.
  I am tired of reading about tragedies like this in the news, hearing 
about it from friends and families, and watching the devastation caused 
by opioids across my State. We need to do more to turn this tide, and I 
believe this legislation will help.
  In the midst of this opioid epidemic, we have to do more to cut off 
the supply of these deadly drugs. That is done here. We need to do more 
to close the gaps that occur in treatment. That is part of this. We 
need to do more to catch those who fall through the cracks and help 
those gripped by addiction get into treatment, get over their 
addiction, and get on to lives of meaning and purpose--a life with 
purpose.
  To those I represent who are struggling with addiction, to those who 
have friends or loved ones who have struggled or continue to struggle 
with addiction, and to the millions of people in communities across 
this country who have been crippled by this crisis, this legislation is 
a turning point and a glimmer of hope. It is a glimmer of hope at the 
end of a dark tunnel. It will not solve all of the problems. 
Ultimately, those are going to come from our communities, from our 
families, from within our own hearts. But this legislation will help by 
allowing law enforcement to stop the flow of these deadly drugs, 
allowing people ready to turn their lives around to get treatment and 
support, and allowing our communities to begin to heal.

  I urge all of my colleagues to support this legislation this 
afternoon.
  I yield back my time.
  The PRESIDING OFFICER. The Senator from Vermont.


                     Nomination of Brett Kavanaugh

  Mr. SANDERS. Mr. President, one out of four women in this country has 
been a victim of sexual assault. This is an epidemic, and it tells me--
and I think the vast majority of the American people--that we need a 
culture change in the way boys and men respond to women.
  Last night, the President of the United States--instead of 
understanding that we have to change our culture, instead of 
understanding that we have to make it easier for women who have been 
victims of sexual assault to come forward and tell their stories--got 
up on a podium in Mississippi and mocked Dr. Ford, made fun of her.
  Here is a woman who has come forward to do what she thought was right 
as an American citizen, understanding from day one that she would be 
attacked by political opponents. The result of her having come forward 
was that she has received death threats; she has been separated from 
her children; and she has had Nazis protesting outside her house. That 
is what she has gone through, and the President's response to her 
courage is to mock her, to make fun of her.
  What kind of message does that send to women and men all over this 
country--women who are struggling to determine whether, when they come 
forward, they will be laughed at, they will be rejected?
  The President of the United States should lead this country in 
changing that type of culture, making it easier for women to come 
forward and tell their stories, making it clear to boys and men that in 
this country, that type of behavior is unacceptable. Yet we had a 
leader of our country, a President of the United States, mocking this 
woman.
  I hope that every Member of this Chamber, regardless of their 
feelings about Kavanaugh, would come forward and express disgust and 
outrage at the behavior of President Trump with regard to Dr. Ford.
  A number of my Republican colleagues have come forward and said: You 
know, at the very beginning of this process, well before the 
allegations of sexual assault or the veracity of Mr. Kavanaugh, there 
were people coming forward, saying they were opposed to the nomination. 
I plead guilty. I was one of those people. I announced my opposition to 
Judge Kavanaugh probably a day after Trump made that nomination.
  Let me tell you exactly why I came out early against Judge Kavanaugh. 
The reason is that for years now there has been a hard right 5-to-4 
majority on the Supreme Court who have time and again made rulings that 
represented the wealthy and the powerful, rulings against the interests 
of working families, women, the environment, children, and the poor. 
Based on the statements that Kavanaugh has made over the years and 
based on his judicial rulings, I had no doubt that, if seated, 
Kavanaugh would become part of that hard-right majority. I should tell 
you now, based on the last hearing that took place before the Judiciary 
Committee where we saw Mr. Kavanaugh's politics come out, my initial 
judgment turned out to be exactly right.
  If he is seated, he will be part of the hard right--a hard right that 
ruled on Citizens United that billionaires in America have the right to 
undermine our democracy and spend as much money as they want to elect 
candidates who represent the wealthy and the powerful. I fear that if 
Kavanaugh is on the Supreme Court, he will take Citizens United even 
further.
  We have a hard right on the Supreme Court by a 5-to-4 vote that 
gutted the Voting Rights Act--an act designed to protect minorities 
from discrimination in terms of their ability to vote. Literally the 
day after that decision came down, there were Republican Governors and 
attorneys general all over this country working overtime, shamefully, 
cowardly, to make it harder for poor people, people of color, and young 
people to vote. I have no doubt that if Mr. Kavanaugh is seated, he 
will be part of that hard-right philosophy. So I apologize to nobody 
for, within 1 day of that nomination, saying that I was opposed to it. 
That is my view.
  Obviously, many of my Republican colleagues, maybe some Democrats, 
did not reach that conclusion. However, in the past 3 months and 
especially in the past few weeks, we have heard credible accusations of 
sexual assault by several women. These are charges that must be 
thoroughly and seriously investigated by the FBI.
  If confirmed, Judge Kavanaugh will have a lifetime seat on the 
Supreme Court--a lifetime seat. Yet we have the Republican leader and 
other Members saying: We have to rush this process along. We have to 
give the FBI just a few days in order to complete their investigation 
because, my goodness, we have to fill that empty seat on the Supreme 
Court. How hypocritical is that?
  Let me remind my colleagues that less than 2\1/2\ short years ago, 
following the death of Justice Scalia, my Republican colleagues simply 
refused to even consider President Obama's nomination of Merrick 
Garland for a seat on the Supreme Court, and they left that seat open 
for 10 months until they got a Republican President. If you could wait 
for 10 months to fill that empty seat, I think you can wait a few weeks 
more for us to do a thorough investigation of the allegations against 
Judge Kavanaugh.

  We are dealing with not only Judge Kavanaugh's rightwing political 
philosophy; we are dealing with not only the serious allegations of 
sexual assault, which have to be thoroughly investigated; we are 
dealing with another very important issue, and that is the issue of 
veracity, whether Judge Kavanaugh was honest and truthful in terms of 
his responses to questions asked of him recently and years before when 
he came before the Judiciary Committee. I have heard colleagues say--I 
think rightfully--that regardless of philosophy, if somebody lies to a

[[Page S6480]]

U.S. Senate committee, that person should not be seated.
  What we need right now, not in a few days' period, is a thorough 
investigation not only of the charges, the allegations of sexual 
assault, but also issues of whether Judge Kavanaugh has been honest 
when he has come before the Judiciary Committee.
  Let me give a few examples of what I mean--things that need to be 
explored. In his previous testimony before the committee, Judge 
Kavanaugh was asked more than 100 times whether he knew about files 
stolen by Republican staffers from Judiciary Committee Democratic 
staffers. He said he didn't know anything about it when he was in the 
Bush White House. Yet emails released as part of these hearings show 
these files were regularly shared with Kavanaugh while he was on the 
Bush White House staff. In fact, one of the emails had the subject line 
``spying.'' Was Judge Kavanaugh telling the truth, or was he lying? We 
have to determine that.
  In 2006, Judge Kavanaugh told Congress he didn't know anything about 
the NSA warrantless wiretapping program prior to it being reported by 
the New York Times. This year, an email revealed that while at the 
White House, he might have been involved in some conversations about 
this program. Was Judge Kavanaugh telling the truth in his response to 
the committee?
  In 2004, Judge Kavanaugh testified that the nomination of William 
Pryor to the 11th Circuit Court ``was not one that I worked on 
personally''--again, when he was in the Bush White House. Documents now 
contradict that statement.
  Newly released documents also call into question whether Judge 
Kavanaugh was truthful that the nomination of Charles Pickering ``was 
not one of the judicial nominees that I was primarily handling.'' Was 
he telling the truth?
  If he was not telling the truth on these issues, does that tell us 
something about the character of this man who wants to take a seat on 
the Supreme Court?
  In 2006, Judge Kavanaugh testified: ``I was not involved and am not 
involved in the questions about the rules governing detention of 
combatants.'' New evidence released as part of these confirmation 
hearings contradicts that assertion.
  Those are issues not dealing with the allegations of sexual assault. 
In terms of the recent allegations, Judge Kavanaugh repeatedly told the 
committee that he never drank to the point where he didn't remember 
something. He also denied ever becoming aggressive when he drinks. This 
is not an issue of whether somebody drinks. Millions of people drink. 
This is an issue of whether he was being honest in his responses. As 
you know, there have been a number of reports from those people Judge 
Kavanaugh attended high school with and attended college and law school 
with that contradict his assertion about his drinking habits. Judge 
Kavanaugh himself, in a 2001 email, referenced ``growing aggressive'' 
during a weekend vacation but that he ``didn't remember.'' Again, the 
issue here is not drinking; the issue is veracity. Was he telling the 
truth?
  On another issue, Judge Kavanaugh testified that he treated women 
``as friends and equals'' and with ``dignity and respect.'' Numerous 
entries in his school yearbook would seem to suggest otherwise. Was 
Judge Kavanaugh's statements to the committee truthful? Again, whether 
you like his philosophy or you don't, it is important for us to 
ascertain the veracity of his testimony.
  Judge Kavanaugh claimed that he and Dr. Ford ``did not travel in the 
same social circles.'' Dr. Ford said that she dated Chris Garrett, 
referenced as a friend in his yearbook. In fact, she testified that 
Garrett introduced her to Kavanaugh.
  Kavanaugh claimed numerous times in response to Dr. Ford's 
allegations that ``all four witnesses say it didn't happen'' and that 
witnesses ``refuted'' Dr. Ford's story. Yet one of the witnesses simply 
said she didn't remember the party in question that took place decades 
ago but that, in fact, she believes Dr. Ford.
  Kavanaugh testified that he had ``no connections'' to Yale, when, in 
fact, he was a legacy student whose grandfather attended the school.
  Kavanaugh claimed that he had no idea his mentor and good friend Alex 
Kozinski was sexually harassing his clerks and creating a hostile work 
environment, but Kozinski's behavior was such an open secret that some 
law schools were warning potential applicants to stay away from 
Kozinski. Kavanaugh claims he was not on Kozinski's infamous email list 
but refused to even search his emails to double-check. Was Judge 
Kavanaugh telling the truth about his relationship with Judge Kozinski?
  These are very serious issues. Millions of Americans are deeply 
involved and concerned about these issues--issues not only about 
philosophy, issues about sexual harassment of women, issues about 
veracity. This is a question we have to get to the bottom of. We do not 
need artificial time limitations. Let's do it right, before we cast a 
vote on Judge Kavanaugh.
  I yield the floor.
  Mr. DURBIN. Mr. President, today I wish to engage in a colloquy with 
Senator Portman to speak about section 5052 of H.R. 6, the SUPPORT for 
Patients and Communities Act.
  Section 5052 of H.R. 6 takes a long-overdue step of lifting the 
``Institutions for Mental Disease,'' or IMD, exclusion for individuals 
with a diagnosis of substance use disorder. For more than half a 
century, this arcane provision has restricted access to care for 
patients struggling with addiction by prohibiting Medicaid from 
reimbursing for residential substance abuse treatment in facilities 
with more than 16 beds.
  Sixteen beds? That might suffice in some parts of the country, but 
certainly not in many Illinois communities suffering from the opioid 
epidemic. I have visited facilities down in Carbondale, IL, where they 
told me they have hundreds of people waiting for treatment and a 12-
week wait for an open bed. We don't restrict cancer or diabetes or 
heart disease patients to only receiving care in certain-sized 
facilities, and we should not do the same for substance use disorders.
  In the face of the Nation's worst ever drug overdose epidemic, this 
Federal law has prohibited treatment centers from expanding services to 
accommodate the growing demand for recovery services and blocking an 
entire class of high-quality providers from providing care. It is 
unacceptable.
  For years, I have worked in a bipartisan manner to lift this IMD 
exclusion. I have led bipartisan groups of Senators in writing to the 
Centers for Medicare and Medicaid Services, CMS, urging them to provide 
flexibility from this treatment barrier and also worked to ensure 
Illinois's section 1115 Medicaid waiver includes authority to partially 
waive the IMD exclusion.
  I have also worked on legislation for multiple years to lift the IMD 
exclusion for individuals with a diagnosis of substance use disorder. I 
first reintroduced the Medicaid CARE Act in a prior Congress and then 
last year teamed up with Senators Portman, Brown, King, and others to 
reintroduce the legislation, which lifted the bed cap from 16 beds to 
40 beds and allowed for up to 60 days of residential treatment if it 
was deemed medically necessary. Later, we joined to introduce the 
Improving CARE Act, which removed the bed cap altogether, allowed for 
inpatient stays for up to 90 days, and introduced measures to ensure 
that patients would have access to all necessary treatments, in the 
highest quality facilities, with a plan for successful transitions to 
outpatient and community-based care.
  Section 5052 of the SUPPORT for Patients and Communities Act took 
much of our proposal from the Improving CARE Act, including ensuring 
that we lift the IMD exclusion for individuals with all diagnoses of 
substance use disorder and improving the array of patient treatment 
options when seeking care. This work will have an incredible impact on 
improving access to care in my State and nationwide, and I would like 
to thank all of our bipartisan colleagues who helped to secure this 
important language to break down the IMD exclusion.
  Unfortunately, section 5052 does not include a policy that matters a 
lot to me and my colleagues: directly allowing for eligible individuals 
seeking

[[Page S6481]]

such care to stay up to 90 days in a facility for treatment. Inpatient 
and residential stays for substance use disorder treatment should by no 
means be indefinite, and I believe that individuals should seek 
outpatient treatment as quickly as possible so that they can return to 
their homes and communities. However, section 5052 raises the statutory 
length of stay for only 30 days, which in many cases is insufficient 
for individuals that need more intensive treatment for their substance 
use disorder.
  I know Senator Portman is going to discuss this further, but section 
5052 includes language defining eligibility under this new authority to 
include Medicaid enrollees enrolled under a State plan or a waiver of 
such plan. Given that Illinois and other States do have Medicaid 1115 
waivers to provide substance use disorder treatment in IMDs, I want to 
affirm that this new statutory authority for 30 days of care can be 
woven seamlessly together with separate State waivers to maximize the 
length of stay for patients to include additional days under a waiver.
  Mr. PORTMAN. Mr. President, I agree with Senator Durbin. First, I 
would like to also voice my appreciation for the hard work that our 
colleagues in both the House and Senate put into the SUPPORT for 
Patients and Communities Act. Lifting the IMD exclusion for all 
individuals with substance use disorder was no easy feat and took 
decades to accomplish, and I believe that this is a testament to all 
that we can achieve when we work together to solve our Nation's 
problems in a bipartisan way.
  With that said, I would like to echo Senator Durbin's concerns 
regarding the limitation of stays for just 30 days. Each individual 
seeking treatment for substance abuse is unique and so are their 
treatment needs. That is why my colleagues and I included a 90-day 
limit to stays in our Improving CARE Act; 90 days would both 
successfully accommodate a full range of patient needs, while also 
ensuring that there is a time limit on inpatient stays so that patients 
and providers can work together in a timely manner to successfully 
transition the patient into outpatient care.
  Section 5052 recognizes this by taking language from our Improving 
CARE Act that requires participating, inpatient facilities to offer at 
least two forms of medication-assisted treatment because we recognized 
that everyone's treatment needs are different and there is not one 
single treatment or length of stay in an inpatient facility that is 
right for everyone. In many instances, 60 or even 90-day treatment 
programs may be necessary for an individual to succeed, and this is why 
we included a 90-day stay limit in the Improving CARE Act.
  However, it should be noted that section 5052 does include additional 
language that I hope might rectify this issue. We included in our 
Improving CARE Act clarifying language that notes that nothing in the 
policy will supersede the existing ``Medicaid and CHIP Managed Care 
Final Rule'' that was finalized by the Centers for Medicare and 
Medicaid Services on April 25, 2016. That rule allows for Medicaid-
managed care plans to offer inpatient, substance abuse treatment for up 
to 15 days at a time.
  Thus, it is important for us to clarify that as the architects of 
these provisions that Medicaid managed care plans do in fact have the 
authority to blend the 30-day stay limit that is authorized under 
section 5052 of the SUPPORT for Patients and Communities Act and the 
15-day stay limit from the Managed Care Final Rule. Under this 
construct, Medicaid managed care plans will have the flexibility to 
offer inpatient, substance abuse treatment for up to 45 days.
  My home State of Ohio relies heavily on Medicaid managed care and 
currently enrolls nearly 90 percent of all Medicaid beneficiaries into 
Medicaid managed care plans. While I am disappointed that we could not 
find the means to offer our constituents up to 90 days of care, I am 
grateful that many in my State will be able to have a bit of additional 
flexibility to extend their stays and get the treatment that they need.
  Mr. DURBIN. Mr. President, I would like to reiterate my appreciation 
to Senators Portman, Brown, Cardin, King, and others and echo what 
Senator Portman said about flexibility to elongate lengths of stay as 
medically necessary for patients, beyond the 30 days under this new 
statutory authority. Earlier this year, Illinois obtained a Medicaid 
1115 waiver to address behavioral healthcare in the State, which 
allowed for a partial waiver of the IMD exclusion to allow for Medicaid 
beneficiaries in my State to receive up to 30 days of treatment in 
these IMD facilities. That was good news.
  Nonetheless, I expect that section 5052 of the SUPPORT for Patients 
and Communities Act will still be able to help residents of Illinois 
and those in other States with 1115 waivers, because, similar to the 
authority that Senator Portman noted that Medicaid managed care plans 
have, States will be able to pair this new authority under section 5052 
with the existing authorities under State waivers. Thus, Medicaid 
enrollees in Illinois will be able to combine the 30-day stay under our 
waiver with the 30 days under this new authority, thus giving my 
constituents the opportunity to receive up to 60 days of inpatient, 
substance use disorder treatment a year. That is an important new step 
forward, and I look forward to working with our State and CMS to fully 
implement this policy for States to coordinate waivers and statutory 
authority for longer lengths of stay.
  This is by no means a uniform policy for each of the States, and I 
hope that we can come together again to lengthen these stay limits.
  Mr. PORTMAN. Mr. President, I agree with Senator Durbin. While the 
policy in H.R. 6 is limited and does explicitly limit inpatient, 
substance abuse treatment stays to just 30 days, there are in fact 
opportunities for individuals with either Medicaid managed care or for 
individuals living in states with 1115 waivers that expanded this type 
of coverage to receive longer stays if necessary.
  Mr. DURBIN. Mr. President, I agree with Senator Portman on stitching 
together this new statutory authority with existing managed care and 
waiver authorities to elongate patients' lengths of stay, as medically 
appropriate. I would once again like to thank all of my colleagues, 
including Chairman Hatch, Ranking Member Wyden, Chairman Alexander, and 
Ranking Member Murray, for their help in getting this important policy 
across the finish line.
  Mr. WYDEN. Mr. President, when it comes to Medicaid, there is no 
question the program is front and center in the fight against the 
opioid epidemic. Medicaid is the single largest payer of substance use 
disorder services in the Nation, paying for a third of all medication-
assisted treatment across the country and covering millions of 
Americans currently suffering; yet gaps in the system still exist.
  The SUPPORT for Patients and Communities Act includes a number of 
policies that will help fill some of these gaps both within Medicaid 
and across the healthcare system. One such provision focuses on 
providing States with additional flexibility around Medicaid's so-
called IMD exclusion related to inpatient and residential treatment. I 
view this provision as one piece of a larger approach focused on 
ensuring patients have access to the care and services they need across 
the entire continuum of care. It includes early prevention, access to 
critical outpatient and community-based services, residential and 
inpatient care when needed, and essential step-down care so individuals 
can successfully transition back into the community.
  However, I want to take a moment to note my concern about this 
particular provision that will leave gaps for young adults seeking care 
and treatment. Specifically, I am particularly worried about young 
adults who may not be able to access quality residential substance use 
disorder treatment services in the same settings as older individuals. 
Under the Medicaid statute, the IMD exclusion applies to all 
individuals under the age of 65 with limited exceptions for individuals 
under age 21 for inpatient psychiatric hospital services. As a result, 
I am concerned that, because the provision in this bill only applies to 
those age 21 and older, younger adults below the age of 21 may not have 
access to the full array of residential substance use disorder 
treatment options, settings that may be closer to home, closer to 
support networks, and that more appropriately serve their needs.

[[Page S6482]]

  I am hopeful that my colleagues across the aisle will work with me to 
address this and other yet to be addressed gaps in our healthcare 
system to better meet the needs of the millions of Americans, young and 
old, suffering from the scourge that is the opioid epidemic.
  The PRESIDING OFFICER (Mr. Toomey). The Senator from Washington.


                SUPPORT for Patients and Communities Act

  Mrs. MURRAY. Mr. President, earlier this year, I heard from an 
elementary school principal in Washington State about how the opioid 
crisis was hurting the kids in his school. Students at his school were 
having trouble focusing in class as they dealt with the trauma of a 
family member's substance use at home. Some of his teachers were having 
trouble understanding how best to help those students with their 
trauma.
  I also heard from the staff at a hospital about how they deliver many 
babies to mothers struggling with opioid addiction. Many are born with 
neonatal abstinence syndrome, battling with symptoms of withdrawal.
  I have heard from countless other families across my home State of 
Washington about how the opioid crisis has impacted their loved ones.
  Our communities have been crying out for action to address the root 
causes and ripple effects of the opioid crisis that have caused so much 
heartbreak for so many people. Today, we are making an important step 
to answer that call.
  The legislation we are passing today includes a wide set of policy 
solutions from both sides of the aisle to help tackle this problem from 
many different angles. Many people helped craft this legislation and 
offered their own valuable insights, ideas, and solutions, and I am 
grateful to all of them.
  I especially want to thank the committee leaders in both Chambers who 
did so much to bring this together: Senators Wyden, Feinstein, 
Alexander, Hatch, and Grassley in the Senate, and Congressmen Pallone, 
Neal, Nadler, Walden, Brady, and Goodlatte in the House.
  I am grateful to Leader Schumer and Leader McConnell and several 
others who were particularly helpful in this process.
  I thank Senators Heitkamp, Donnelly, Markey, Hassan, Casey, Manchin, 
McCaskill, Baldwin, Nelson, Kaine, and so many more. And of course I 
thank my staff and the many other members of the staff who worked on 
this as well.
  The bill we all crafted together is a meaningful, bipartisan 
compromise. It is not what I would have written on my own, and it is 
not what other colleagues would have written on their own, but it is a 
collection of impactful, commonsense solutions where we were able to 
find common ground--ideas that respond to the root causes and the 
ripple effects our communities are facing.
  It includes support for State efforts to improve plans for safe care 
for children born to mothers battling substance use disorders, like 
those at the hospital I visited. It ensures that the Health Department 
is implementing strategies already identified to protect moms and 
babies from the effects of opioid substance abuse.
  It includes provisions to develop a task force and grants to help 
support trauma-informed care programs and increase access to mental 
health care for children and families in their communities, including 
at schools like the one the principal told me about, and provisions to 
build on critical public health activities to prevent opioid misuse 
from occurring in the first place.
  It includes provisions to address the economic and workforce impacts 
of the opioid crisis, such as support for training to help the nearly 1 
million people out of work due to opioid use disorder to gain and 
retain employment, as well as provisions to strengthen our behavioral 
workforce so patients and families can access the treatment they need.
  It continues meaningful grants that help States address the most 
pressing problems associated with substance use disorders in their 
communities and makes those grants more flexible and available to our 
Tribal communities who are suffering deeply with the impact of 
substance use disorders.
  It expands access to treatment services by making more providers 
eligible to prescribe medication-assisted treatment.
  It includes provisions to help the Food and Drug Administration 
address the crisis as well, such as giving it new authority over 
packaging and disposal of opioids, as well as many other steps to help 
those on the frontlines of this epidemic.
  I am glad we can include so many voices in this discussion and that 
it led to a bill that offers so many ideas to address the different 
angles of this crisis. I look forward to seeing this bill become law so 
it can start helping our families and communities as we work to reach 
everyone impacted by this nationwide fight against opioid use disorder.
  This is an important bill, and it is an impactful step forward. It is 
not a final step by any means. The opioid crisis is ongoing, and our 
efforts to address it must be as well. I am going to keep listening to 
people in Washington State about what they need to respond to this 
question and working with my colleagues in Washington, DC, to provide 
the resources and solutions that will help make a difference.
  I urge my colleagues to support this important legislation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee.
  Mr. ALEXANDER. Mr. President, I wish to say to the Senator from 
Washington that I fully subscribe to her remarks. She is the ranking 
Democrat on the HELP Committee, and we work together to produce 
results. I like it when we can, and I think the American people do as 
well.
  I had a chance to come to the floor earlier this afternoon to thank 
Senator Murray and her staff and the other Senators and their staffs 
and the large number of people who made this bill possible, so I will 
not repeat all that.
  I would like to say, I think it is worthwhile to stop and say that at 
the time of a contentious debate about the Supreme Court, the U.S. 
Senate has found something that is equally important and really more 
important to hundreds of families across this country, maybe thousands, 
in virtually every community because the opioid epidemic is our most 
severe public health epidemic, and we have worked together, and we 
literally have unanimously agreed on this bill in the Senate, all 100 
of us--well, maybe not all 100 but almost all 100 of us. At least all 
100 of us agreed to let it go forward, and almost all 100 of us will 
vote for it.
  The House of Representatives was nearly as unanimous. We have a 
bipartisan sense of urgency to deal with this. Senator McConnell has 
called it landmark legislation.
  It is not the first step the Senate and the House have taken. There 
was the CARA Act, Comprehensive Addiction and Recovery Act. There was 
the 21st Century Cures Act, which Senator Murray and I worked on and 
presented to the Congress and which Senator McConnell called the most 
important piece of legislation in the last Congress.
  There are the appropriations bills, which have produced this year 
$8.5 billion for the opioid crisis when you combine the money 
appropriated in March and the money that is being approved this month.
  Then there are the provisions of this act. More than 70 Senators have 
made contributions to it. Senator Murray listed many of them: Senator 
Portman's STOP Act to stop fentanyl from coming through the mail; the 
Holy Grail, in my opinion, nonaddictive painkillers.
  Mr. President, I ask unanimous consent for an extra 60 seconds to 
finish my remarks.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ALEXANDER. Authority for the FDA to require manufacturers to sell 
smaller doses of opioids; extending treatment for Medicaid patients 
from 15 to 30 days in covering all substances; the TREAT Act, Senator 
Markey, Senator Paul worked hard on this.
  I want to especially thank Senator McConnell and Senator Schumer for 
creating the environment so we could put together the work of five 
different committees in the Senate and eight different committees in 
the House of Representatives. That rarely happens. It takes a good deal 
of restraint and good will, and the reason for it is because of this 
bipartisan urgency to deal

[[Page S6483]]

with this problem. This is not a moonshot from Washington. It is 
everything, though, we could think of to do; more than 70 different 
proposals to support patients and support communities as they continue 
to fight our No. 1 public health epidemic.
  I yield the floor.
  The PRESIDING OFFICER. Under the previous order, the question is on 
agreeing to the motion to concur.
  Mr. ISAKSON. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The clerk will call the roll.
  The assistant bill clerk called the roll.
  Mr. CORNYN. The following Senator is necessarily absent: the Senator 
from Texas (Mr. Cruz).
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 98, nays 1, as follows:

                      [Rollcall Vote No. 221 Leg.]

                                YEAS--98

     Alexander
     Baldwin
     Barrasso
     Bennet
     Blumenthal
     Blunt
     Booker
     Boozman
     Brown
     Burr
     Cantwell
     Capito
     Cardin
     Carper
     Casey
     Cassidy
     Collins
     Coons
     Corker
     Cornyn
     Cortez Masto
     Cotton
     Crapo
     Daines
     Donnelly
     Duckworth
     Durbin
     Enzi
     Ernst
     Feinstein
     Fischer
     Flake
     Gardner
     Gillibrand
     Graham
     Grassley
     Harris
     Hassan
     Hatch
     Heinrich
     Heitkamp
     Heller
     Hirono
     Hoeven
     Hyde-Smith
     Inhofe
     Isakson
     Johnson
     Jones
     Kaine
     Kennedy
     King
     Klobuchar
     Kyl
     Lankford
     Leahy
     Manchin
     Markey
     McCaskill
     McConnell
     Menendez
     Merkley
     Moran
     Murkowski
     Murphy
     Murray
     Nelson
     Paul
     Perdue
     Peters
     Portman
     Reed
     Risch
     Roberts
     Rounds
     Rubio
     Sanders
     Sasse
     Schatz
     Schumer
     Scott
     Shaheen
     Shelby
     Smith
     Stabenow
     Sullivan
     Tester
     Thune
     Tillis
     Toomey
     Udall
     Van Hollen
     Warner
     Warren
     Whitehouse
     Wicker
     Wyden
     Young

                                NAYS--1

       
     Lee
       

                             NOT VOTING--1

       
     Cruz
       
  The motion is agreed to.

                          ____________________