[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

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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

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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

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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

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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.

____________________