[Congressional Record Volume 165, Number 99 (Thursday, June 13, 2019)]
[House]
[Pages H4637-H4640]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATIONS ACT, 2020

  The SPEAKER pro tempore. Pursuant to House Resolution 436 and rule 
XVIII, the Chair declares the House in the Committee of the Whole House 
on the state of the Union for the further consideration of the bill, 
H.R. 2740.
  The Chair appoints the gentlewoman from Texas (Mrs. Fletcher) to 
preside over the Committee of the Whole.

                              {time}  0955


                     In the Committee of the Whole

  Accordingly, the House resolved itself into the Committee of the 
Whole House on the state of the Union for the consideration of the bill 
(H.R. 2740) making appropriations for the Departments of Labor, Health 
and Human Services, and Education, and related agencies for the fiscal 
year ending September 30, 2020, and for other purposes, with Mrs. 
Fletcher in the chair.
  The Clerk read the title of the bill.
  The CHAIR. When the Committee of the Whole rose earlier today 
pursuant to House Resolution 431, further proceedings on amendment No. 
77 printed in House Report 116-109 offered by the gentlewoman from 
Pennsylvania (Ms. Houlahan) had been postponed.
  Pursuant to House Resolution 436, further amendments printed in part 
B of House Report 116-111 may be offered at any time during 
consideration of the bill for amendment, may be offered only by a 
Member designated in the report, shall be considered as read, shall be 
debatable for the time specified in the report equally divided and 
controlled by the proponent and an opponent, may be withdrawn by the 
proponent at any time before action thereon, shall not be subject to 
amendment except amendment described in section 4 of House Resolution 
431, and shall not be subject to a demand for division of the question.


                  Amendment No. 1 Offered by Mr. Pocan

  The CHAIR. It is now in order to consider amendment No. 1 printed in 
part B of House Report 116-111.
  Mr. POCAN. Madam Chairwoman, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:


[[Page H4638]]


  

       At the end of division A (before the short title), insert 
     the following:
       Sec. __.  None of the funds made available by this Act may 
     be used to convene an ethics advisory board authorized under 
     section 492A of the Public Health Service Act with regard to 
     research grant applications or current research projects in 
     the competitive renewal process that propose to use human 
     fetal tissue.

  The CHAIR. Pursuant to House Resolution 436, the gentleman from 
Wisconsin (Mr. Pocan) and a Member opposed each will control 5 minutes.
  The Chair recognizes the gentleman from Wisconsin.
  Mr. POCAN. Madam Chairwoman, I rise today to offer an amendment that 
ensures the Trump administration cannot block critical groundbreaking 
research solely because it utilizes human fetal tissue.
  I believe this new policy announced by HHS just last week is 
shortsighted and that Congress should make its voice heard on the 
issue. This amendment prohibits any funds in the bill being used to 
establish a sham ethics advisory board with regard to research products 
that use human fetal tissue.
  The June 5, HHS announcement bars NIH scientists from conducting any 
research using fetal tissue unless an additional ethics advisory board 
review of NIH grant applications for fetal tissue research occurs. This 
decision by President Trump is unnecessary since these grant 
applications are already subject to rigorous ethical review 
requirements.
  Currently, any federally funded research that uses fetal tissue must 
comply with oversight pursuant to the NIH Revitalization Act of 1993, 
which was enacted on a bipartisan basis. This framework requires 
informed consent and declarations pertaining to fetal tissue from all 
donors, physicians, and researchers involved.

                              {time}  1000

  Let's be clear. The Trump administration's decision is not about 
science or ethics. It is about politics.
  Fetal tissue research is not new. It has been supported by the NIH 
since the 1950s, and fetal tissue has been used to develop vaccines 
that have saved and improved the lives of billions of people around the 
world.
  Vaccines for diseases such as measles, mumps, rubella, chickenpox, 
whooping cough, tetanus, hepatitis A, and rabies were all created using 
fetal cell cultures. Researchers today are using fetal cells to develop 
vaccines against diseases that include Ebola, HIV, and dengue fever. 
Studies at UW-Madison in my district involving fetal tissue are trying 
to develop treatments for conditions that include blindness, Zika, 
developmental disorders, and diabetes.
  This is exactly the type of research that the Federal Government 
should be supporting, not defunding.
  I encourage my colleagues to ensure that we all continue to fund 
critical research on behalf of the American people and that we block 
last week's decision that threatens Federal funding of fetal tissue 
research.
  Madam Chair, I yield 1 minute to the gentlewoman from Connecticut 
(Ms. DeLauro), who is an amazing colleague.
  Ms. DeLAURO. Madam Chair, I rise in strong support of Congressman 
Pocan's amendment.
  The administration's decision to forgo promising research to develop 
treatments and cures for diseases such as HIV, ALS, and Parkinson's, 
once again, is putting extreme personal ideology ahead of public 
health.
  Researchers have used fetal tissue in research for decades to develop 
vaccines and cures for diseases such as polio and measles. The research 
has saved millions of lives. That is what we are about, saving lives.
  Research involving fetal tissue today is conducted subject to strict 
guidelines that have lasted through both Democratic and Republican 
administrations. This antiscience decision will stall medical research 
in its tracks, reduce hope for those suffering from debilitating 
diseases, and harm the ability of American scientists to continue to 
lead global efforts on biomedical research.
  The Trump administration has said that the Department of Health and 
Human Services conducted an audit and scientific review of fetal tissue 
research that led to this decision. Quite frankly, they refuse to make 
the results of that review available to the Congress.
  There is simply no scientific or ethical basis for the proposed 
restrictions on this vital research. It is misguided. It is a dangerous 
policy. It should be reversed.
  Madam Chair, I support the gentleman's amendment.
  Mr. HARRIS. Madam Chair, I rise in opposition to the amendment.
  The CHAIR. The gentleman from Maryland is recognized for 5 minutes.
  Mr. HARRIS. Madam Chair, let's get a handle on exactly what this 
amendment does. This amendment says that we are going to take one of 
the most controversial areas of research--controversial regarding the 
ethics of the research--and we are going to say the Federal Government 
can't determine whether it is ethical.
  Madam Chair, we have a construct for this. This construct was 
developed by Mr. Waxman two decades ago in a piece of statute signed by 
President Clinton that said that when you submit research for funding 
to the HHS Department, and it is a topic around which there are ethical 
questions--and there are ethical questions--that the Secretary can 
choose to seat a panel, not a sham panel, but a panel that consists of 
attorneys, ethicists, practicing physicians, theologians, and 
scientists with substantial accomplishments in biomedical and 
behavioral research.
  That doesn't sound too sham to me. It is a panel that is going to 
review it because, Madam Chair, without that, the only review this gets 
with regard to, for instance, an institutional review board is at the 
institution that stands to gain the funding when the project is funded. 
It is because of that conflict of interest that the Congress 
thoughtfully said, in statute, that we ought to have a mechanism to 
consider the ethics.
  Madam Chair, we are going to hear about all kinds of things done with 
fetal tissue. Yes, they were done decades and decades ago. Those 
vaccines were done on cell lines that have been around for a long time.
  Can there be some research that might benefit from fetal tissue? 
Sure, there can be. But we should always make the determination of 
whether it is ethical.
  How can we stand in good conscience and say that we are going to 
take, on the basis of ethics, one of the most controversial areas of 
research and wall it off and say that the Federal Government can't 
consider ethics? Oh, my gosh, that is a step way too far.
  Madam Chair, I reserve the balance of my time.
  Mr. POCAN. Madam Chair, may I inquire how much time I have remaining.
  The CHAIR. The gentleman from Wisconsin has 1\1/2\ minutes remaining.
  Mr. POCAN. Apparently, Madam Chair, the other side of the aisle would 
like to debate political science rather than medical science today. I 
understand that. It is always great to make your base happy rather than 
healthy. But there is a big difference when it comes to the issue of 
fetal tissue.
  We have had this debate before in committee. This isn't new. What is 
new are the cures that are coming out of the use of fetal tissue not 
just at UW-Madison but across the country.
  The President's action shows how far removed not just the debate is 
that we just heard, which is more about politics than science, but over 
half the people who are on this new board don't even have to be 
scientists, when we already have the proper oversight in place to make 
sure that this is ethical research.
  I get it. You have to make your base happy, especially in the era of 
Donald Trump. But the bottom line is, you are hurting your constituents 
by trying to place politics over medical science. That is just a really 
bad idea.


                         Parliamentary Inquiry

  Mr. HARRIS. Parliamentary inquiry.
  The CHAIR. The gentleman from Maryland will state his parliamentary 
inquiry.
  Mr. HARRIS. Madam Chair, are comments supposed to be addressed to the 
Chair?
  The CHAIR. Members are reminded to direct their remarks to the Chair.
  Mr. POCAN. Which I was doing, Madam Chair, and I appreciate that.
  So, again, if you want to be a scientist who doesn't believe in 
science, that is fine. That means you are a politician. I would like to 
think that those of us who are going to deal with those

[[Page H4639]]

areas that involve science, even if we are politicians, focus on the 
science aspects, and I am going to do just that. That is why this 
amendment is important to make sure we have lifesaving research.
  Madam Chair, I urge support, and I yield back the balance of my time.
  Mr. HARRIS. Madam Chair, may I inquire as to how much time remains.
  The CHAIR. The gentleman from Maryland has 2 \1/2\ minutes remaining.
  Mr. HARRIS. Madam Chair, before I came to Congress, I was a medical 
scientist. I actually held NIH grants. So, Madam Chair, I find it a 
little unusual that someone would criticize my opinion on medical 
science and dismiss it. But we live in a strange world. That is why the 
American people look at Congress and wonder what is going on.
  The fact of the matter is that it is not a Trump administration 
policy that issues where ethics are involved should go to a committee 
convened to consider that.
  Madam Chair, I have had things go before IRBs, institutional review 
boards, at institutions. It is a good first step, and the peer-review 
process at NIH is probably a good second step. But for some issues like 
fetal tissue research, where we saw fetal tissue marketed--brains, $800 
plus tax--we think it is not at all unreasonable that the Federal 
Government, before spending a dime of taxpayer money--because, 
remember, the President's policy does nothing about funding it. It just 
says taxpayer dollars shouldn't be used unless we have considered the 
ethics.
  My gosh, there is nothing wrong with that. The fact of the matter is 
that Americans don't want their tax dollars spent on things that are 
unethical, and this is the way that we can determine whether it is 
ethical.
  Again, this has not been set up by the Trump administration. This is 
Mr. Waxman, who will never be confused with a Republican, and signed by 
President Clinton.
  I will remind the gentleman that this issue has been discussed in 
committee for a few years. The committee has come down on both sides of 
it because this is a controversial issue, and controversial issues are 
best left to the experts just like this ethics committee statute 
states.
  Madam Chair, I yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from Wisconsin (Mr. Pocan).
  The question was taken; and the Chair announced that the ayes 
appeared to have it.
  Mr. HICE of Georgia. Madam Chair, I demand a recorded vote.
  The CHAIR. Pursuant to clause 6 of rule XVIII, further proceedings on 
the amendment offered by the gentleman from Wisconsin will be 
postponed.


                Amendment No. 2 Offered by Mr. Pascrell

  The CHAIR. It is now in order to consider amendment No. 2 printed in 
part B of House Report 116-111.
  Mr. PASCRELL. Madam Chair, I have an amendment at the desk.
  The CHAIR. The Clerk will designate the amendment.
  The text of the amendment is as follows:
       Page 68, line 9, before the period insert the following: 
     ``Provided further, That of the amount made available under 
     this heading and not reserved by the preceding provisos, 
     $10,000,000 shall be made available to carry out section 7091 
     of the SUPPORT for Patients and Communities Act (Public Law 
     115-271)''.

  The CHAIR. Pursuant to House Resolution 436, the gentleman from New 
Jersey (Mr. Pascrell) and a Member opposed each will control 5 minutes.
  The Chair recognizes the gentleman from New Jersey.
  Mr. PASCRELL. First, Madam Chair, I commend Chairwoman DeLauro, the 
gentlewoman from Connecticut, and Ranking Member Cole for their work on 
this bill and accommodating a bipartisan amendment. I thank my 
colleagues, Congressman David McKinley, Congresswoman Diana DeGette, 
and Congressman Scott Tipton, for working together with me on this 
quest for the past 2 years.
  The Alternatives to Opioids in the Emergency Department program, or 
ALTO, was first piloted by Dr. Mark Rosenberg, a doctor at St. Joseph's 
emergency department in my hometown of Paterson--one T--New Jersey, and 
hospitals in Colorado as well. ALTO tests alternative pain management 
protocols to limit the use of opioids in emergency departments.
  ALTO programs can serve as a new preventive blueprint for hospitals 
and healthcare providers across America. As our health providers 
grapple with ways to combat the opioid epidemic wracking every 
community in our Nation, they have been working and achieving results 
to prevent unnecessary use of opioids.
  To build on these successful programs, we introduced H.R. 5197, the 
Alternatives to Opioids in the Emergency Department Act, last Congress. 
To help tackle the opioid crisis and limit the use of opioids in 
emergency departments, this bill authorized a $10 million grant program 
to fund demonstration programs to test alternative pain management 
protocols. Thanks to the Energy and Commerce Committee, our bill was 
signed into law as part of H.R. 6, the SUPPORT for Patients and 
Communities Act.
  This bipartisan Pascrell-McKinley-DeGette-Tipton amendment No. 2 
would provide the full authorized funding for the Alternatives to 
Opioids program. Our amendment has the support of the American College 
of Emergency Physicians.
  Madam Chair, I include in the Record their letter.

                                               American College of


                                         Emergency Physicians,

                                                    June 11, 2019.
     Hon. Bill Pascrell, Jr.,
     Washington, DC.
       Dear Congressman Pascrell: On behalf of the American 
     College of Emergency Physicians (ACEP) and our 38,000 
     members, thank you for your steadfast commitment to address 
     the nation's opioid epidemic, especially your continued 
     efforts to promote your Alternatives to Opioids (ALTO) in the 
     Emergency Department Act that was successfully included in 
     the SUPPORT for Patients and Communities Act (P.L. 115-271) 
     last year. ACEP was proud to work with you to secure 
     enactment of this important law that will help expand access 
     to appropriate options to treat a patient's pain without 
     opioids.
       ALTO is based on a very simple premise that the best way to 
     avoid opioid misuse and addiction is to never start a patient 
     on opioids. ALTO protocols use specific nonaddicting drugs 
     and therapies that target receptor sites and enzymes that 
     mediate the pain. As you well know, within two years of 
     implementing the ALTO program at a hospital in New Jersey, 
     there was an 82 percent reduction in opioid prescriptions. 
     More recently, 10 hospitals in Colorado established a similar 
     program and saw a decrease in opioid use of 36 percent in 
     just the first six months.
       ACEP was deeply grateful for your efforts last year to 
     secure this program's authorization as part of the SUPPORT 
     Act, and we continue to support your efforts to secure 
     appropriated funding for this critical program. Thank you 
     again for your leadership on this issue, and please know that 
     ACEP stands ready to assist you in this effort.
           Sincerely,
                                     Vidor E. Friedman, MD, FACEP,
                                                   ACEP President.

  Mr. PASCRELL. Madam Chair, let's give our ERs the resources to help 
save some more lives. I respectfully ask the House to support my 
amendment so that we may fully fund the ALTO program.
  Madam Chair, I reserve the balance of my time.
  Mr. HARRIS. Madam Chair, even though I don't oppose the amendment, I 
rise in opposition.
  The CHAIR. Without objection, the gentleman from Maryland is 
recognized for 5 minutes.
  There was no objection.
  Mr. HARRIS. Madam Chair, I reserve the balance of my time.
  Mr. PASCRELL. Madam Chair, I yield such time as she may consume to 
the distinguished gentlewoman from Connecticut (Ms. DeLauro).
  Ms. DeLAURO. Madam Chair, I thank the gentleman from Paterson with 
one T.
  Madam Chair, I rise in support of this bipartisan amendment, and let 
me reiterate ``bipartisan amendment.''
  This amendment provides $10 million for a new program at the 
Substance Abuse and Mental Health Services Administration for a newly 
authorized demonstration program for hospitals and emergency 
departments to develop, implement, or study alternatives to opioids for 
pain management.
  As our Nation continues to combat the opioid epidemic, this effort 
would provide the opportunity to study and develop best practice pain 
management strategies that involve nonaddictive medical products and 
other types of treatments provided in our emergency rooms.
  Madam Chair, I urge my colleagues to support this bipartisan 
amendment.

[[Page H4640]]

  

  Mr. HARRIS. Madam Chair, I thank the gentleman from New Jersey for 
this. This is a real problem that we have. As a physician, I will tell 
you, we haven't gotten this right yet.
  Again, I am an anesthesiologist, and I have been taking care of 
patients for 30 years, three decades. What we still find is that we 
have people who prescribe narcotics and opioids.
  We know, by the way, Madam Chair, that if someone is given a 10-day 
supply of opioids for an outpatient operation, there is a 10 percent 
chance that they will be addicted 1 year afterward.
  Yesterday, my son had an outpatient operation, and he got a 
prescription for 50 opioid pills. I am sitting there thinking, oh my 
God, is there an alternative?
  We were taught for years that if you go to the emergency room and you 
have a broken bone, you are going to get sent out with a narcotic 
prescription. Then they did a study that shows that alternating Tylenol 
with ibuprofen, acetaminophen with ibuprofen, is just as good as the 
narcotic.

                              {time}  1015

  My God, for decades, we have been giving people narcotics, unaware 
that we were committing a certain number of them to a terrible life.
  And I appreciate the gentleman's passion about it, because we had 
good news in Maryland yesterday, for the first time, the number of 
deaths from overdoses went down. But the number of overdoses continues 
to increase.
  We got better at preventing the deaths. Now we have to get better at 
preventing the addiction and treating the addiction.
  Madam Chair, this amendment goes a long way toward that.
  I reserve the balance of my time
  Mr. PASCRELL. Madam Chair, I thank my colleagues for the support. I 
urge the passage of the amendment, and I yield back the balance of my 
time.
  Mr. HARRIS. Madam Chair, I yield back the balance of my time.
  The CHAIR. The question is on the amendment offered by the gentleman 
from New Jersey (Mr. Pascrell).
  The question was taken; and the Chair announced that the ayes 
appeared to have it.
  Mr. HICE of Georgia. Madam Chair, I demand a recorded vote.
  The CHAIR. Pursuant to clause 6 of rule XVIII, further proceedings on 
the amendment offered by the gentleman from New Jersey will be 
postponed.
  Ms. DeLAURO. Madam Chair, I move that the Committee do now rise.
  The motion was agreed to.
  Accordingly, the Committee rose; and the Speaker pro tempore (Mr. 
Pascrell) having assumed the chair, Mrs. Fletcher, Chair of the 
Committee of the Whole House on the state of the Union, reported that 
that Committee, having had under consideration the bill (H.R. 2740) 
making appropriations for the Departments of Labor, Health and Human 
Services, and Education, and related agencies for the fiscal year 
ending September 30, 2020, and for other purposes, had come to no 
resolution thereon.

                          ____________________