[Congressional Record (Bound Edition), Volume 146 (2000), Part 13]
[Senate]
[Pages 19358-19360]
[From the U.S. Government Publishing Office, www.gpo.gov]



THE CHILDREN'S PUBLIC HEALTH ACT OF 2000 AND THE YOUTH DRUG AND MENTAL 
                          HEALTH SERVICES ACT

  Mr. HATCH. Mr. President, I am delighted the Senate has now given 
final approval to an important bill that will go far toward improving 
our nation's public health infrastructure. I strongly support the 
Children's Public Health Act of 2000 and the Youth Drug and Mental 
Health Services Act (H.R. 4365). I hope this measure will soon pass the 
House as well.
  It is obvious that we owe our colleagues on the Health, Education, 
Labor, and Pensions Committee a debt of gratitude for their 
perseverance and dedication in developing this landmark legislation 
which contains a number of provisions of importance to my home state of 
Utah.
  The Children's Health Act of 2000 authorizes services that will 
ensure the health and well-being of future generations of America's 
young people, our most precious resources. I can think of no more 
important aim for legislation than to focus on our nation's future by 
providing for our children today.
  At the same time, through the Youth Drug and Mental Health Services 
Act, the bill will address serious drug abuse issues that affect our 
young people, including a reauthorization of the important programs of 
the Substance Abuse and Mental Health Services Administration, SAMHSA.
  The SAMSHA reauthorization legislation will improve this vital agency 
by providing greater flexibility for states and accountability based on 
performance, while at the same time placing critical focus on youth and 
adolescent substance abuse and mental health services. SAMHSA, formerly 
known as the Alcohol, Drug Abuse, and Mental Health Services 
Administration, ADAMHA, was created in 1992 by Public Law 102-321, the 
ADAMHA Reorganization Act. SAMHSA's purpose is to assist states in 
addressing the importance of reducing the incidence of substance abuse 
and mental illness by supporting programs for prevention and treatment.
  SAMHSA provides funds to states for alcohol and drug abuse prevention 
and treatment programs and activities, and mental health services 
through the Substance Abuse Prevention and Treatment, SAPT, and the 
Community Mental Health Services, CMHS, Block Grants. SAMHSA's block 
grants are a major portion of this nation's response to substance abuse 
and mental health service needs.
  As a proud supporter of H.R. 4365, I would like to highlight several 
provisions that are based on legislation I have introduced.
  First, this legislation reauthorizes the Traumatic Brain Injury Act, 
a law I authored in 1996. By incorporating my bill, S. 3081, H.R. 4365 
will extend authority for the critical Traumatic Brain Injury, TBI, 
programs from fiscal year 2001 through 2005.
  Each year, approximately two million Americans experience a traumatic 
brain injury; in Utah, 2000 individuals per year experience brain 
injuries. TBI is the leading cause of death and disability in young 
Americans, and the risk of a traumatic brain injury is highest among 
adolescents and young adults. Motor vehicle accidents, sports injuries, 
falls and violence are the major causes. These injuries occur without 
warning and often with devastating consequences. Brain injury can 
affect a person cognitively, physically and emotionally.
  Important provisions added to the Traumatic Brain Injury Act through 
this bill include extending the Center for Disease Control and 
Prevention's, CDC, grant authority so it may conduct research on ways 
to prevent traumatic brain injury. In addition, the legislation directs 
the CDC to provide information to increase public awareness on this 
serious health matter. The bill also calls on the National Institutes 
of Health, NIH, to conduct research on the rehabilitation of the 
cognitive, behavioral, and psycho-social difficulties associated with 
traumatic brain injuries.
  Finally, the measure requests the Health Resource Services 
Administration to provide and administer grants for projects that 
improve services for persons with a traumatic brain injury.
  I am grateful that the members of the HELP Committee were willing to 
include provisions from my legislation which reauthorizes this program. 
As a result, many more deserving individuals whose lives and families 
have been affected by a traumatic brain injury will now receive some 
type of assistance or help.
  Second, the Children's Health Act of 2000 also contains a bill that I 
authored, S. 3080, to address a troubling yet treatable malady--poor 
oral health in children.
  I have been concerned over reports from Utah and around the country 
about the poor oral health of our nation's children. A recent General 
Accounting Office report on dental disease calls tooth decay the most 
common chronic childhood disease and finds that it is most prevalent 
among low-income children.
  Eighty percent of untreated decayed teeth is found in roughly 25 
percent of children, mostly from low-income and other vulnerable 
groups. Decay left untreated leads to infection, pain, poor eating 
habits, and speech impediments.
  Compounding this problem is that there are few places for these 
children to receive care. Low provider reimbursement rates from state-
operated dental plans make it financially impossible for private 
practitioners to treat all the children in need. Today, there are a 
large number of children living in either the inner city or in rural 
areas who do not have a place to seek treatment. Our goal should be to 
provide access to dental care to children, regardless of where they 
live.
  Therefore, I am pleased to report that the ``Children's Public Health 
Act of 2000'' contains provisions to address this serious health 
concern. The legislation directs the Secretary of Health and Human 
Services to establish a program funding innovative oral health 
activities to improve the oral health of children under six years of 
age. The legislation will make these grants available to innovative 
programs at community health centers, dental training institutions, 
Indian Health Service facilities, and other community dental programs.
  Let's face it, dental disease in young children is a significant 
public health problem. And this legislation is the beginning of a 
coordinated, inter-agency strategy that will assist states and 
localities reduce this preventable problem.
  I am also pleased that we are considering the Youth Drug and Mental 
Health Services Act. This legislation addresses many important issues 
such as drug abuse and mental health services and how to treat these 
serious problems within our society.
  One issue that is highlighted in this bill is the prevention of teen 
suicide. This is an issue that is rapidly becoming a crisis not only in 
my State of Utah but throughout the entire country.
  Young people in the United States are taking their own lives at 
alarming rates. The trend of teen suicide is seeing suicide at younger 
ages, with the United States suicide rate for individuals under 15 
years of age increasing 121 percent from 1980 to 1992. Suicide is the 
third leading cause of death for young people aged 15 to 24, and the 
fourth leading cause of death for children between 10 and 14. In 1997 
study, 21 percent of the nation's high school students reported serious 
thoughts about attempting suicide, with 15.7 percent making a specific 
plan.
  Utah consistently ranks among the top ten states in the nation for 
suicide,

[[Page 19359]]

and we continue to see increases in suicide rates among our youth. In 
Utah, suicide rates for ages 15 to 19 have increased almost 150 percent 
in the last 20 years. According to the CDC, Utah had the tenth highest 
suicide rate in the country during 1995-1996 and was 30 percent above 
the U.S. rate. This is one statistical measure on which I want to see 
my state at the bottom.
  Although numerous symptoms, diagnoses, traits, and characteristics 
have been investigated, no single fact or set of factors has ever come 
close to predicting suicide with any accuracy.
  I have worked on legislation that will help us determine the 
predictors of suicide among at risk and other youth. We need to 
understand what the barriers are that prevent youth from receiving 
treatment so that we can facilitate the development of model treatment 
programs and public education and awareness efforts. It also calls for 
a study designed to develop a profile of youths who are more likely to 
contemplate suicide and services available to them.
  This bill also contains provisions from S. 1428, the Methamphetamine 
Anti-Proliferation Act of 2000. I introduced this bill because of 
evidence that methamphetamine remains a threat to the entire country, 
and particularly to my state of Utah. Elements of this bill are also 
contained in S. 486 as it was reported by the Judiciary Committee.
  Throughout my travels in Utah, I have heard from state and local law 
enforcement officials, mayors, city councils, parents, and youth about 
the seriousness of the methamphetamine problem.
  Recently, I held two field hearings in Utah during which I heard 
directly from constituents whose lives had been affected by 
methamphetamine. I listened to a mother tell a heart-wrenching story of 
how her beloved daughter had become addicted to methamphetamine and how 
she feared for her daughter's life. She tearfully described her 
daughter as being two people, the person ``who has the values of our 
family, who is kind hearted and loving; and then there's our daughter 
who's the meth user, and they are completely opposite.''
  I also heard testimony from the wife of a methamphetamine addict. I 
heard how her husband's methamphetamine addiction destroyed their 
marriage and their financial security. Painfully, she explained how her 
husband put her and their infant son at risk when he decided to 
manufacture methamphetamine in their home. She had no choice but to 
report his activities to the police, a decision that undoubtedly will 
haunt her for the rest of her life.
  Methamphetamine use is an insidious virus sapping the strength and 
character of our country. We need to attack it. This bill contains the 
tools to help the people of Utah and the rest of the country fight this 
wicked drug.
  This bill bolsters the Drug Enforcement Agency's, DEA, ability to 
combat the manufacturing and trafficking of methamphetamine by 
authorizing the creation of satellite offices and the hiring of 
additional agents to assist State and local law enforcement officials. 
More than any other illicit drug, methamphetamine manufacturers and 
traffickers operate in small towns and rural areas. And, unfortunately, 
rural law enforcement agencies often are overwhelmed and in dire need 
of the DEA's expertise in conducting methamphetamine investigations.
  To address this problem, the bill authorizes the expansion of the 
number of DEA resident offices and posts-of-duty, which are smaller DEA 
offices often set up in small and rural cities that are overwhelmed by 
methamphetamine manufacturing and trafficking. There are also 
provisions to assist state and local officials in handling the 
dangerous toxic waste left behind by methamphetamine labs.
  To counter the dangers that manufacturing drugs like methamphetamine 
inflict on human life and on the environment, the bill imposes stiffer 
penalties on manufacturers of all illegal drugs when their actions 
create a substantial risk of harm to human life or to the environment. 
The inherent dangers of killing innocent bystanders and, at the same 
time, contaminating the environment during the methamphetamine 
manufacturing process warrant a punitive penalty that will deter some 
from engaging in the activity.
  Finally, the bill increases penalties for manufacturing and 
trafficking the drug amphetamine, a lesser-known, but no-less dangerous 
drug than methamphetamine. Other than for a slight difference in 
potency, amphetamine is manufactured, sold, and used in the same manner 
as methamphetamine. Moreover, amphetamine labs pose the same dangers as 
methamphetamine labs. Not surprisingly, every law enforcement officer 
with whom I have spoken agreed that the penalties for amphetamine 
should be the same as those for methamphetamine. For these reasons, the 
bill equalizes the punishment for manufacturing and trafficking the two 
drugs.
  While we know that vigorous law enforcement measures are necessary to 
combat the methamphetamine scourge, we also recognize that we must act 
to prevent our youth from ever starting down the path of drug abuse. We 
also must find ways to treat those who have become trapped in 
addiction. For these reasons, the bill contains several significant 
prevention and treatment provisions.
  The comprehensive nature of this bill attacks the methamphetamine 
problem on several fronts. It bolsters our law enforcement efforts to 
crack down on traffickers, provides treatment and prevention funding 
for our schools and communities, and authorizes much needed resources 
for cleaning-up the toxic pollutants left behind by methamphetamine lab 
operators.
  I have been working for over a year with colleagues on both sides of 
the aisle and in both Houses of Congress to pass this important 
legislation. It is important to highlight that, as part of this 
process, there have been changes to the bill made in response to 
legitimate complaints raised by my colleagues and constituents. For 
example, provisions relating to search warrants and the Internet have 
been deleted because of these concerns.
  Overall, this bill represents a bipartisan effort that will result in 
real progress in our continuing battle against the scourge of 
methamphetamine.
  Yet another important anti-drug abuse provision in this bill we are 
adopting today is the Drug Addiction Treatment Act, or the DATA bill. 
With the bipartisan cosponsorship of Senators Levin, Biden and 
Moynihan, I introduced S. 324 last year, and I am pleased that this 
bill has been inserted in H.R. 4365.
  In 1999, as part of the comprehensive methamphetamine bill, S. 486, 
the DATA bill was reported by the Judiciary Committee and adopted by 
the full Senate. The DATA bill also was included in the anti-drug 
provisions that were adopted as part of the bankruptcy reform 
legislation, S. 625, that passed the Senate last year. I hope the third 
Senate passage is indeed the charm.
  The goal of the DATA provisions is simple but it is important: The 
DATA bill attempts to make drug treatment more available and more 
effective to those who need it.
  This legislation focuses on increasing the availability and 
effectiveness of drug treatment. The purpose of the Drug Addiction 
Treatment Act is to allow qualified physicians, as determined by the 
Department of Health and Human Services, to prescribe schedule III, IV 
and V anti-addiction medications in physicians' offices without an 
additional Drug Enforcement Administration, DEA, registration if 
certain conditions are met.
  These conditions include certification by participating physicians 
that they are licensed under state law and have the training and 
experience to treat opium addicts and they will not treat more than 30 
in an office setting unless the Secretary of Health and Human Services 
adjusts this number.
  The DATA provisions allow the Secretary, as appropriate, to add to 
these conditions and allow the Attorney General to terminate a 
physician's DEA registration if these conditions are violated. This 
program will continue after three years only if the Secretary and 
Attorney General determine that this new type of decentralized 
treatment should not continue.

[[Page 19360]]

  This bill would also allow the Secretary and Attorney General to 
discontinue the program earlier than three years if, upon consideration 
of the specified factors, they determine that early termination is 
advisable.
  Nothing in the waiver policy called for in my bill is intended to 
change the rules pertaining to methadone clinics or other facilities or 
practitioners that conduct drug treatment services under the dual 
registration system imposed by current law. And nothing in this bill is 
intended to diminish the existing authority of DEA to enforce 
rigorously the provisions of the Controlled Substances Act. Doctors and 
health care providers should be free to practice the art of medicine 
but they may never violate the terms of the Controlled Substances Act.
  In drafting the waiver provisions of the bill, the Drug Enforcement 
Agency, the Food and Drug Administration, and the National Institute on 
Drug Abuse were all consulted. Secretary Shalala has provided her 
leadership in this area. As well, this initiative is consistent with 
the announcement of the Director of the Office of National Drug Control 
Policy, General Barry McCaffrey, of the Administration's intent to work 
to decentralize methadone treatment.
  In 1995, the Institute of Medicine of the National Academy of 
Sciences issued a report, ``Development of Medications for Opiate and 
Cocaine Addictions: Issues for the Government and Private Sector.'' The 
study called for ``(d)eveloping flexible, alternative means of 
controlling the dispensing of anti-addiction narcotic medications that 
would avoid the `methadone model' of individually approved treatment 
centers.''
  The Drug Addiction Treatment Act--DATA--is exactly the kind of policy 
initiative that experts have called for in America's multifaceted 
response to the drug abuse epidemic. I recognize that the DATA 
legislation is just one mechanism to attack this problem, and I plan to 
work with my colleagues in the Congress to devise additional strategies 
to reduce both the supply and demand for drugs.
  These provisions promote a policy that dramatically improves these 
lives because it helps those who abuse drugs change their lives and 
become productive members of society. We have work to do on heroin 
addiction. For example, a 1997 report by the Utah State Division of 
Substance Abuse, ``Substance Abuse and Need for Treatment Among 
Juvenile Arrestees in Utah'' cites literature reporting heroin-using 
offenders committed 15 times more robberies, 20 times more burglaries, 
and 10 times more thefts than offenders who do not use drugs. We must 
stop heroin abuse in Salt Lake City and in all of our nation's cities 
and communities.
  In my own state of Utah, I am sorry to report, according to a 1997 
survey by the State Division of Substance Abuse, about one in ten 
Utahns used illicit drug in a given survey month. That number is simply 
too high; although I cannot imagine that my colleagues would not be 
similarly alarmed if they looked at data from their own states. We must 
prevent and persuade our citizens from using drugs and we must help 
provide effective treatments and systems of treatments for those who 
succumb to drug abuse.
  I hope that the success of this system will create incentives for the 
private sector to continue to develop new medications for the treatment 
of drug addiction, and I hope that qualified doctors will use the new 
system and that general practice physicians will take the time and 
effort to qualify to use this new law to help their addicted patients. 
I am proud to have worked with the Administration and my colleagues on 
a bipartisan basis in adopting the DATA provisions and creating this 
new approach that undoubtedly will improve the ability for many to 
obtain successful drug abuse treatment.
  In closing, I also want to commend the many staff persons who have 
worked so hard on this bill. These include Dave Larson, Anne Phelps, 
Jackie Parker, Marcia Lee, Kathleen McGowan, Leah Belaire, David 
Russell, Pattie DeLoatche and Bruce Artim in the Senate and Marc Wheat 
and John Ford in the House.
  I strongly support this legislation and urge my colleagues in the 
House to pass it as quickly as possible. It is a bill that will raise 
awareness on children's health issues and, at the same time, assist 
those who have specific needs with regard to alcohol abuse, drug abuse 
and mental health issues. It is a good consensus product and is worthy 
of our support.

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