June 13, 2019 - Issue: Vol. 165, No. 99 — Daily Edition116th Congress (2019 - 2020) - 1st Session
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DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2020; Congressional Record Vol. 165, No. 99
(House of Representatives - June 13, 2019)
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[Pages H4637-H4640] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov] DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2020 The SPEAKER pro tempore. Pursuant to House Resolution 436 and rule XVIII, the Chair declares the House in the Committee of the Whole House on the state of the Union for the further consideration of the bill, H.R. 2740. The Chair appoints the gentlewoman from Texas (Mrs. Fletcher) to preside over the Committee of the Whole. {time} 0955 In the Committee of the Whole Accordingly, the House resolved itself into the Committee of the Whole House on the state of the Union for the consideration of the bill (H.R. 2740) making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2020, and for other purposes, with Mrs. Fletcher in the chair. The Clerk read the title of the bill. The CHAIR. When the Committee of the Whole rose earlier today pursuant to House Resolution 431, further proceedings on amendment No. 77 printed in House Report 116-109 offered by the gentlewoman from Pennsylvania (Ms. Houlahan) had been postponed. Pursuant to House Resolution 436, further amendments printed in part B of House Report 116-111 may be offered at any time during consideration of the bill for amendment, may be offered only by a Member designated in the report, shall be considered as read, shall be debatable for the time specified in the report equally divided and controlled by the proponent and an opponent, may be withdrawn by the proponent at any time before action thereon, shall not be subject to amendment except amendment described in section 4 of House Resolution 431, and shall not be subject to a demand for division of the question. Amendment No. 1 Offered by Mr. Pocan The CHAIR. It is now in order to consider amendment No. 1 printed in part B of House Report 116-111. Mr. POCAN. Madam Chairwoman, I have an amendment at the desk. The CHAIR. The Clerk will designate the amendment. The text of the amendment is as follows: [[Page H4638]] At the end of division A (before the short title), insert the following: Sec. __. None of the funds made available by this Act may be used to convene an ethics advisory board authorized under section 492A of the Public Health Service Act with regard to research grant applications or current research projects in the competitive renewal process that propose to use human fetal tissue. The CHAIR. Pursuant to House Resolution 436, the gentleman from Wisconsin (Mr. Pocan) and a Member opposed each will control 5 minutes. The Chair recognizes the gentleman from Wisconsin. Mr. POCAN. Madam Chairwoman, I rise today to offer an amendment that ensures the Trump administration cannot block critical groundbreaking research solely because it utilizes human fetal tissue. I believe this new policy announced by HHS just last week is shortsighted and that Congress should make its voice heard on the issue. This amendment prohibits any funds in the bill being used to establish a sham ethics advisory board with regard to research products that use human fetal tissue. The June 5, HHS announcement bars NIH scientists from conducting any research using fetal tissue unless an additional ethics advisory board review of NIH grant applications for fetal tissue research occurs. This decision by President Trump is unnecessary since these grant applications are already subject to rigorous ethical review requirements. Currently, any federally funded research that uses fetal tissue must comply with oversight pursuant to the NIH Revitalization Act of 1993, which was enacted on a bipartisan basis. This framework requires informed consent and declarations pertaining to fetal tissue from all donors, physicians, and researchers involved. {time} 1000 Let's be clear. The Trump administration's decision is not about science or ethics. It is about politics. Fetal tissue research is not new. It has been supported by the NIH since the 1950s, and fetal tissue has been used to develop vaccines that have saved and improved the lives of billions of people around the world. Vaccines for diseases such as measles, mumps, rubella, chickenpox, whooping cough, tetanus, hepatitis A, and rabies were all created using fetal cell cultures. Researchers today are using fetal cells to develop vaccines against diseases that include Ebola, HIV, and dengue fever. Studies at UW-Madison in my district involving fetal tissue are trying to develop treatments for conditions that include blindness, Zika, developmental disorders, and diabetes. This is exactly the type of research that the Federal Government should be supporting, not defunding. I encourage my colleagues to ensure that we all continue to fund critical research on behalf of the American people and that we block last week's decision that threatens Federal funding of fetal tissue research. Madam Chair, I yield 1 minute to the gentlewoman from Connecticut (Ms. DeLauro), who is an amazing colleague. Ms. DeLAURO. Madam Chair, I rise in strong support of Congressman Pocan's amendment. The administration's decision to forgo promising research to develop treatments and cures for diseases such as HIV, ALS, and Parkinson's, once again, is putting extreme personal ideology ahead of public health. Researchers have used fetal tissue in research for decades to develop vaccines and cures for diseases such as polio and measles. The research has saved millions of lives. That is what we are about, saving lives. Research involving fetal tissue today is conducted subject to strict guidelines that have lasted through both Democratic and Republican administrations. This antiscience decision will stall medical research in its tracks, reduce hope for those suffering from debilitating diseases, and harm the ability of American scientists to continue to lead global efforts on biomedical research. The Trump administration has said that the Department of Health and Human Services conducted an audit and scientific review of fetal tissue research that led to this decision. Quite frankly, they refuse to make the results of that review available to the Congress. There is simply no scientific or ethical basis for the proposed restrictions on this vital research. It is misguided. It is a dangerous policy. It should be reversed. Madam Chair, I support the gentleman's amendment. Mr. HARRIS. Madam Chair, I rise in opposition to the amendment. The CHAIR. The gentleman from Maryland is recognized for 5 minutes. Mr. HARRIS. Madam Chair, let's get a handle on exactly what this amendment does. This amendment says that we are going to take one of the most controversial areas of research--controversial regarding the ethics of the research--and we are going to say the Federal Government can't determine whether it is ethical. Madam Chair, we have a construct for this. This construct was developed by Mr. Waxman two decades ago in a piece of statute signed by President Clinton that said that when you submit research for funding to the HHS Department, and it is a topic around which there are ethical questions--and there are ethical questions--that the Secretary can choose to seat a panel, not a sham panel, but a panel that consists of attorneys, ethicists, practicing physicians, theologians, and scientists with substantial accomplishments in biomedical and behavioral research. That doesn't sound too sham to me. It is a panel that is going to review it because, Madam Chair, without that, the only review this gets with regard to, for instance, an institutional review board is at the institution that stands to gain the funding when the project is funded. It is because of that conflict of interest that the Congress thoughtfully said, in statute, that we ought to have a mechanism to consider the ethics. Madam Chair, we are going to hear about all kinds of things done with fetal tissue. Yes, they were done decades and decades ago. Those vaccines were done on cell lines that have been around for a long time. Can there be some research that might benefit from fetal tissue? Sure, there can be. But we should always make the determination of whether it is ethical. How can we stand in good conscience and say that we are going to take, on the basis of ethics, one of the most controversial areas of research and wall it off and say that the Federal Government can't consider ethics? Oh, my gosh, that is a step way too far. Madam Chair, I reserve the balance of my time. Mr. POCAN. Madam Chair, may I inquire how much time I have remaining. The CHAIR. The gentleman from Wisconsin has 1\1/2\ minutes remaining. Mr. POCAN. Apparently, Madam Chair, the other side of the aisle would like to debate political science rather than medical science today. I understand that. It is always great to make your base happy rather than healthy. But there is a big difference when it comes to the issue of fetal tissue. We have had this debate before in committee. This isn't new. What is new are the cures that are coming out of the use of fetal tissue not just at UW-Madison but across the country. The President's action shows how far removed not just the debate is that we just heard, which is more about politics than science, but over half the people who are on this new board don't even have to be scientists, when we already have the proper oversight in place to make sure that this is ethical research. I get it. You have to make your base happy, especially in the era of Donald Trump. But the bottom line is, you are hurting your constituents by trying to place politics over medical science. That is just a really bad idea. Parliamentary Inquiry Mr. HARRIS. Parliamentary inquiry. The CHAIR. The gentleman from Maryland will state his parliamentary inquiry. Mr. HARRIS. Madam Chair, are comments supposed to be addressed to the Chair? The CHAIR. Members are reminded to direct their remarks to the Chair. Mr. POCAN. Which I was doing, Madam Chair, and I appreciate that. So, again, if you want to be a scientist who doesn't believe in science, that is fine. That means you are a politician. I would like to think that those of us who are going to deal with those [[Page H4639]] areas that involve science, even if we are politicians, focus on the science aspects, and I am going to do just that. That is why this amendment is important to make sure we have lifesaving research. Madam Chair, I urge support, and I yield back the balance of my time. Mr. HARRIS. Madam Chair, may I inquire as to how much time remains. The CHAIR. The gentleman from Maryland has 2 \1/2\ minutes remaining. Mr. HARRIS. Madam Chair, before I came to Congress, I was a medical scientist. I actually held NIH grants. So, Madam Chair, I find it a little unusual that someone would criticize my opinion on medical science and dismiss it. But we live in a strange world. That is why the American people look at Congress and wonder what is going on. The fact of the matter is that it is not a Trump administration policy that issues where ethics are involved should go to a committee convened to consider that. Madam Chair, I have had things go before IRBs, institutional review boards, at institutions. It is a good first step, and the peer-review process at NIH is probably a good second step. But for some issues like fetal tissue research, where we saw fetal tissue marketed--brains, $800 plus tax--we think it is not at all unreasonable that the Federal Government, before spending a dime of taxpayer money--because, remember, the President's policy does nothing about funding it. It just says taxpayer dollars shouldn't be used unless we have considered the ethics. My gosh, there is nothing wrong with that. The fact of the matter is that Americans don't want their tax dollars spent on things that are unethical, and this is the way that we can determine whether it is ethical. Again, this has not been set up by the Trump administration. This is Mr. Waxman, who will never be confused with a Republican, and signed by President Clinton. I will remind the gentleman that this issue has been discussed in committee for a few years. The committee has come down on both sides of it because this is a controversial issue, and controversial issues are best left to the experts just like this ethics committee statute states. Madam Chair, I yield back the balance of my time. The CHAIR. The question is on the amendment offered by the gentleman from Wisconsin (Mr. Pocan). The question was taken; and the Chair announced that the ayes appeared to have it. Mr. HICE of Georgia. Madam Chair, I demand a recorded vote. The CHAIR. Pursuant to clause 6 of rule XVIII, further proceedings on the amendment offered by the gentleman from Wisconsin will be postponed. Amendment No. 2 Offered by Mr. Pascrell The CHAIR. It is now in order to consider amendment No. 2 printed in part B of House Report 116-111. Mr. PASCRELL. Madam Chair, I have an amendment at the desk. The CHAIR. The Clerk will designate the amendment. The text of the amendment is as follows: Page 68, line 9, before the period insert the following: ``Provided further, That of the amount made available under this heading and not reserved by the preceding provisos, $10,000,000 shall be made available to carry out section 7091 of the SUPPORT for Patients and Communities Act (Public Law 115-271)''. The CHAIR. Pursuant to House Resolution 436, the gentleman from New Jersey (Mr. Pascrell) and a Member opposed each will control 5 minutes. The Chair recognizes the gentleman from New Jersey. Mr. PASCRELL. First, Madam Chair, I commend Chairwoman DeLauro, the gentlewoman from Connecticut, and Ranking Member Cole for their work on this bill and accommodating a bipartisan amendment. I thank my colleagues, Congressman David McKinley, Congresswoman Diana DeGette, and Congressman Scott Tipton, for working together with me on this quest for the past 2 years. The Alternatives to Opioids in the Emergency Department program, or ALTO, was first piloted by Dr. Mark Rosenberg, a doctor at St. Joseph's emergency department in my hometown of Paterson--one T--New Jersey, and hospitals in Colorado as well. ALTO tests alternative pain management protocols to limit the use of opioids in emergency departments. ALTO programs can serve as a new preventive blueprint for hospitals and healthcare providers across America. As our health providers grapple with ways to combat the opioid epidemic wracking every community in our Nation, they have been working and achieving results to prevent unnecessary use of opioids. To build on these successful programs, we introduced H.R. 5197, the Alternatives to Opioids in the Emergency Department Act, last Congress. To help tackle the opioid crisis and limit the use of opioids in emergency departments, this bill authorized a $10 million grant program to fund demonstration programs to test alternative pain management protocols. Thanks to the Energy and Commerce Committee, our bill was signed into law as part of H.R. 6, the SUPPORT for Patients and Communities Act. This bipartisan Pascrell-McKinley-DeGette-Tipton amendment No. 2 would provide the full authorized funding for the Alternatives to Opioids program. Our amendment has the support of the American College of Emergency Physicians. Madam Chair, I include in the Record their letter. American College of Emergency Physicians, June 11, 2019. Hon. Bill Pascrell, Jr., Washington, DC. Dear Congressman Pascrell: On behalf of the American College of Emergency Physicians (ACEP) and our 38,000 members, thank you for your steadfast commitment to address the nation's opioid epidemic, especially your continued efforts to promote your Alternatives to Opioids (ALTO) in the Emergency Department Act that was successfully included in the SUPPORT for Patients and Communities Act (P.L. 115-271) last year. ACEP was proud to work with you to secure enactment of this important law that will help expand access to appropriate options to treat a patient's pain without opioids. ALTO is based on a very simple premise that the best way to avoid opioid misuse and addiction is to never start a patient on opioids. ALTO protocols use specific nonaddicting drugs and therapies that target receptor sites and enzymes that mediate the pain. As you well know, within two years of implementing the ALTO program at a hospital in New Jersey, there was an 82 percent reduction in opioid prescriptions. More recently, 10 hospitals in Colorado established a similar program and saw a decrease in opioid use of 36 percent in just the first six months. ACEP was deeply grateful for your efforts last year to secure this program's authorization as part of the SUPPORT Act, and we continue to support your efforts to secure appropriated funding for this critical program. Thank you again for your leadership on this issue, and please know that ACEP stands ready to assist you in this effort. Sincerely, Vidor E. Friedman, MD, FACEP, ACEP President. Mr. PASCRELL. Madam Chair, let's give our ERs the resources to help save some more lives. I respectfully ask the House to support my amendment so that we may fully fund the ALTO program. Madam Chair, I reserve the balance of my time. Mr. HARRIS. Madam Chair, even though I don't oppose the amendment, I rise in opposition. The CHAIR. Without objection, the gentleman from Maryland is recognized for 5 minutes. There was no objection. Mr. HARRIS. Madam Chair, I reserve the balance of my time. Mr. PASCRELL. Madam Chair, I yield such time as she may consume to the distinguished gentlewoman from Connecticut (Ms. DeLauro). Ms. DeLAURO. Madam Chair, I thank the gentleman from Paterson with one T. Madam Chair, I rise in support of this bipartisan amendment, and let me reiterate ``bipartisan amendment.'' This amendment provides $10 million for a new program at the Substance Abuse and Mental Health Services Administration for a newly authorized demonstration program for hospitals and emergency departments to develop, implement, or study alternatives to opioids for pain management. As our Nation continues to combat the opioid epidemic, this effort would provide the opportunity to study and develop best practice pain management strategies that involve nonaddictive medical products and other types of treatments provided in our emergency rooms. Madam Chair, I urge my colleagues to support this bipartisan amendment. [[Page H4640]] Mr. HARRIS. Madam Chair, I thank the gentleman from New Jersey for this. This is a real problem that we have. As a physician, I will tell you, we haven't gotten this right yet. Again, I am an anesthesiologist, and I have been taking care of patients for 30 years, three decades. What we still find is that we have people who prescribe narcotics and opioids. We know, by the way, Madam Chair, that if someone is given a 10-day supply of opioids for an outpatient operation, there is a 10 percent chance that they will be addicted 1 year afterward. Yesterday, my son had an outpatient operation, and he got a prescription for 50 opioid pills. I am sitting there thinking, oh my God, is there an alternative? We were taught for years that if you go to the emergency room and you have a broken bone, you are going to get sent out with a narcotic prescription. Then they did a study that shows that alternating Tylenol with ibuprofen, acetaminophen with ibuprofen, is just as good as the narcotic. {time} 1015 My God, for decades, we have been giving people narcotics, unaware that we were committing a certain number of them to a terrible life. And I appreciate the gentleman's passion about it, because we had good news in Maryland yesterday, for the first time, the number of deaths from overdoses went down. But the number of overdoses continues to increase. We got better at preventing the deaths. Now we have to get better at preventing the addiction and treating the addiction. Madam Chair, this amendment goes a long way toward that. I reserve the balance of my time Mr. PASCRELL. Madam Chair, I thank my colleagues for the support. I urge the passage of the amendment, and I yield back the balance of my time. Mr. HARRIS. Madam Chair, I yield back the balance of my time. The CHAIR. The question is on the amendment offered by the gentleman from New Jersey (Mr. Pascrell). The question was taken; and the Chair announced that the ayes appeared to have it. Mr. HICE of Georgia. Madam Chair, I demand a recorded vote. The CHAIR. Pursuant to clause 6 of rule XVIII, further proceedings on the amendment offered by the gentleman from New Jersey will be postponed. Ms. DeLAURO. Madam Chair, I move that the Committee do now rise. The motion was agreed to. Accordingly, the Committee rose; and the Speaker pro tempore (Mr. Pascrell) having assumed the chair, Mrs. Fletcher, Chair of the Committee of the Whole House on the state of the Union, reported that that Committee, having had under consideration the bill (H.R. 2740) making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2020, and for other purposes, had come to no resolution thereon. ____________________
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