Suicide Prevention Lifeline Improvement Act of 2021

Mr. Speaker, pursuant to House Resolution 1191, I call up the bill (H.R. 7666) to amend the Public Health Service Act to reauthorize certain programs relating to mental health and substance use disorders, and for other purposes, and ask for its immediate consideration in the House.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and add extraneous material on H.R. 7666.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today in support of H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act of 2022, and I thank Ranking Member Rodgers for working with me these past few months to develop this comprehensive legislation that will help address the mental health and substance use disorder crisis facing millions of Americans.

This bill is needed today more than ever. Americans report rising anxiety and depression and increased use of alcohol, opiates, and other substances. One in five adults are battling a mental illness. Suicide is now the second leading cause of death for children ages 10 to 14, and earlier this year the Centers for Disease Control and Prevention released a report finding that 4 in 10 high school students said they felt persistently sad or hopeless during the COVID-19 pandemic. The opioid crisis also continues to devastate families and communities all around the Nation. 108,000 people lost their lives due to drug overdoses just last year alone.

The Restoring Hope for Mental Health and Well-Being Act will help restore hope for millions of Americans. The bill strengthens and expands more than 30 critical programs that collectively support mental health care and substance use disorder prevention, care, treatment, and recovery support services in communities across the Nation.

As the Nation prepares for the launch of the 988 National Suicide Prevention Lifeline dialing code next month, H.R. 7666 provides key crisis response efforts, establishing the Substance Abuse and Mental Health Services Behavioral Health Crisis Coordination Office and requiring the development of crisis response best practices. The legislation also continues investments in critical mental health and substance use services block grant funding to States, territories, and Tribes.

The Restoring Hope Act includes crucial provisions to meet the challenges of the Nation's opioid epidemic, expanding and ensuring timely patient access to lifesaving treatment for opioid use disorders through the elimination of barriers to treatment. It includes Representative Tonko's MAT Act, which eliminates the X-waiver, a burdensome registration requirement that establishes arbitrary caps on the number of patients a provider can treat for opioid use disorder using buprenorphine.

This bill also establishes a one-time, 8-hour training requirement on treating and identifying substance use disorders that providers must complete

before their first registration or renewal of a license to dispense controlled substances.

H.R. 7666 also helps bolster the behavioral health workforce capacity and training. It also increases access to mental health and substance use disorder care and coverage by applying the mental health parity law to State and local government workers, such as teachers and frontline workers.

The legislation also supports the mental health of children and young people. It continues investment in the integration of behavioral health into pediatric primary care through Pediatric Mental Health Access Grants and enhances research at the National Institutes of Health on the cognitive, physical, and socioemotional impacts of modern technology and multimedia on infants, children, and adolescents.

I can't stress enough that this is an epidemic that focuses a lot on children and adolescents. Older youth need help with suicide prevention and other mental health support and substance use disorder services. Students in higher education need that help, and they get it through a program called the Garrett Lee Smith Memorial Act.

The bill also ensures that State Medicaid programs have resources to implement and strengthen school-based mental health services while preserving the continuity of coverage for justice-involved youth. These important provisions will increase children's access to care.

Mr. Speaker, the scope and reach of this bipartisan legislation--and I stress that. This was reported out of the Energy and Commerce Committee unanimously, Mr. Speaker. It is truly bipartisan. It is going to help to support the mental health and well-being of millions of Americans, their families, and communities for years to come.

I thank Members on both sides of the aisle, not only Ranking Member Rodgers, but the subcommittee leadership as well, both Democrat and Republican.

The reason that we try to do this on a bipartisan level and get everybody's support is because we have a good chance of passing this in the Senate, which is also acting on similar legislation. We are hopeful that as a result of a large vote today, that will spur the Senate into action, and we can actually get this bill signed into law.

Mr. Speaker, I urge my colleagues to support the bill, and I reserve the balance of my time.

House of Representatives,

Committee on the Judiciary,

Washington, DC, June 10, 2022.

Hon. Frank Pallone, Jr.,

Chairman, Committee on Energy and Commerce, House of

Representatives, Washington, DC.

Dear Chairman Pallone: This letter is to advise you that

the Committee on the Judiciary has now had an opportunity to

review the provisions in H.R. 7666, the ``Restoring Hope for

Mental Health and Well-Being Act of 2022,'' that fall within

our Rule X jurisdiction. I appreciate your consulting with us

on those provisions. The Judiciary Committee has no objection

to your including them in the bill for consideration on the

House floor, and to expedite that consideration is willing to

forgo action on H.R. 7666, with the understanding that we do

not thereby waive any future jurisdictional claim over those

provisions or their subject matters.

In the event a House-Senate conference on this or similar

legislation is convened, the Judiciary Committee reserves the

right to request an appropriate number of conferees to

address any concerns with these or similar provisions that

may arise in conference.

Please place this letter into the Congressional Record

during consideration of the measure on the House floor. Thank

you for the cooperative spirit in which you have worked

regarding this matter and others between our committees.

Sincerely,

Jerrold Nadler,

Chairman.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Illinois (Ms. Schakowsky), who chairs our Subcommittee on Consumer Protection and Commerce.

Mr. Speaker, I yield 2 minutes to the gentleman from Maryland (Mr. Sarbanes), who has been involved with these health and behavioral issues for a long time.

Mr. Speaker, I yield 2 minutes to the gentleman from New York (Mr. Tonko), who chairs our Environment and Climate Change Subcommittee.

Mr. Speaker, I yield 2 minutes to the gentleman from Arizona (Mr. O'Halleran), a member of the Committee on Energy and Commerce.

Mr. Speaker, I yield 2 minutes to the gentlewoman from New Hampshire (Ms. Kuster), a member of the Energy and Commerce Committee.

Mr. Speaker, I yield 1 minute to the gentleman from Maryland (Mr. Hoyer), the House majority leader.

Mr. Speaker, I yield 2 minutes to the gentlewoman from

Washington (Ms. Schrier), a member of the Energy and Commerce Committee.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Michigan (Mrs. Dingell), a member of the committee.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Texas (Mrs. Fletcher), who is also a member of the Energy and Commerce Committee.

Mr. Speaker, I yield 1 minute to the gentleman from Oregon (Mr. Blumenauer).

Mr. Speaker, I yield 1 minute to the gentleman from Virginia (Mr. Beyer).

Mr. Speaker, I yield 2 minutes to the gentlewoman from Texas (Ms. Jackson Lee).

Madam Speaker, I just wanted to stress that H.R. 7666 includes programs focused on supporting youth mental health.

I thank the gentlewoman for her leadership on this issue. In fact, H.R. 7666 includes programs focused on supporting youth mental health including due to such traumatic events that were mentioned by the gentlewoman.

The SAMHSA Garrett Lee Smith State/Tribal Youth Suicide Prevention and Early Intervention Program, for instance, and HRSA's Pediatric Mental Health Care Access program, which helps integrate behavioral health into pediatric primary care, extends resources to support Project AWARE, building student, families, and school behavioral health resiliency. Further, the bill provides support to complement SAMHSA's launch of the new 988 National Suicide Prevention Lifeline dialing code next month that will expand access to crisis care support through call, text, or chat functions for millions of Americans.

Madam Speaker, I yield an additional 1 minute to the gentlewoman from Texas (Ms. Jackson Lee).

Let me just add, I am pleased to work with the gentlewoman from Texas on this critical matter.

I thank her for her support in ensuring children and families have access to the mental health support and services they need to lead healthy and hopeful lives.

Madam Speaker, I yield an additional 30 seconds to the gentlewoman from Texas.

Madam Speaker, I yield 1 minute to the gentleman from California (Mr. Levin).

Madam Speaker, I yield 1 minute to the gentleman from Rhode Island (Mr. Cicilline).

Madam Speaker, I have no additional speakers. I am prepared to close. I reserve the balance of my time.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield myself the balance of my time.

Let me just reiterate what the ranking member said. This was really a bipartisan bill. I thank Mrs. Rodgers, Mr. Guthrie, Ms. Anna Eshoo, and all the staff that worked so hard on this legislation.

It is important that we have as big a vote as possible because this bill has a real chance of passing the Senate and getting to the President's desk and will really address the mental health and substance abuse concerns that we have and the crisis that we have. So I urge everyone to vote ``yes.''

Madam Speaker, I yield back the balance of my time.

Madam Speaker, pursuant to House Resolution No. 1191, I rise to offer amendments en bloc No. 1.

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, I rise in support of the eight mental health amendments under this en bloc consideration. Collectively, these amendments further strengthen the bipartisan nature of the underlying comprehensive bill, the Restoring Hope for Mental Health and Well-Being Act of 2022.

I thank my colleagues for their leadership and contributions to furthering the health of the American people and wish to speak in strong support of their adoption into H.R. 7666.

Many of these amendments, Madam Speaker, include provisions from bills that previously passed the House this Congress on suspension that the Senate has yet to act upon.

I am pleased that we have the opportunity to, once again, emphasize their importance by including them in this crucial legislative package.

The amendment offered by Congressman Bera and Congressman Fitzpatrick is just such an amendment. Like the bill it reflects, the HERO Act, which passed the House last year, it will improve data collection and services to ensure our first responders and public safety officers receive the mental health care services they need.

Additionally, Congresswoman Napolitano and Congressman Katko submitted an amendment which extends and revises SAMHSA's Project AWARE program providing school-based mental health services, including screening, treatment, and outreach programs, provisions that likewise passed the House last year in H.R. 721, the Mental Health Services for Students Act of 2021.

Representatives Katko and Napolitano were also joined by Congressmen Beyer, Raskin, Cardenas, and Fitzpatrick in offering an additional amendment that includes provisions from H.R. 2981, the Suicide Prevention Lifeline Improvement Act of 2021, which also passed the House last year.

The amendment extends funding for SAMHSA's Lifeline--crucial in this Nation's moment of mental health crisis, supporting crisis care response and support as we prepare for the launch of the new 988 dialing code next month.

I appreciate the additional focus on the particular needs of certain communities in our country that several amendments add to the underlying bill.

I thank Representatives Reschenthaler, Morelle, Wild, and Dean for their amendment requiring a study to determine the true cost of untreated serious mental illness on families, healthcare systems, public housing, and law enforcement in America.

In addition, we certainly cannot do enough to support the men and women who have valiantly served our Nation in the Armed Forces.

I thank Congressman Joyce for his amendment that requires the Department of Defense to carry out a 2-year pilot program aimed at preventing suicides amongst Active-Duty members of the Armed Forces.

I also appreciate and support the amendment submitted by Congressman Feenstra requiring the new Behavioral Health Crisis Coordinating Office established within SAMHSA by H.R. 7666, to provide technical assistance and support to the Veterans Crisis Line.

Further, Madam Speaker, I support the mental health and well-being of those who are pregnant or postpartum. The amendment offered by Congresswoman Moore makes important improvements to the Maternal Mental Health Hotline authorization to ensure those implementing the hotline consult with appropriate State, local, and Tribal public officials and those working with low-income people.

I am particularly pleased that H.R. 7666 would establish a new authorization for a Maternal Mental Health Hotline, and I appreciate Representative Moore's amendment that will serve to improve the underlying legislation.

Finally, Madam Speaker, while we know children in this country are facing a mental health crisis, unfortunately, we know that all too many also experience other chronic health challenges.

I am grateful to Representative Pressley for her amendment requiring the Secretary of Health and Human Services conduct a study on the rates and risks of suicidal behaviors among youth with chronic illnesses and to provide Congress with recommendations for ways to provide early intervention, best practices, and strategies to address disparities.

I am pleased to support these amendments and encourage my colleagues to do the same.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield 4 minutes to the gentlewoman from Massachusetts (Ms. Pressley), who has one of the important amendments included in this en bloc.

Madam Speaker, I have no additional speakers, and I yield back the balance of my time.

Madam Speaker, pursuant to House Resolution 1191, I rise to offer amendments en bloc No. 2.

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, I rise in support of this en bloc amendment. This package includes bipartisan bills and policies that will increase access to substance use disorder prevention, treatment, and recovery support services.

The amendment introduced by Representatives Rodney Davis, Bilirakis, O'Halleran, Wagner, and Kuster reflects H.R. 2355, the Opioid Prescription Verification Act of 2021, which has previously passed the House. The amendment, like the bill it is drawn from, encourages the use of e-prescribing for opioids and incentivizes States to maintain and utilize prescription drug monitoring programs.

Likewise, the amendment offered by Representatives Andy Kim and Davids also reflects a previously House-passed bill, H.R. 2364, the Synthetic Opioid Danger Awareness Act. Their amendment requires the Department of Health and Human Services to conduct a public education campaign about synthetic opioids, including fentanyl and its analogues, and disseminate information about synthetic opioids to healthcare providers.

Continuing the theme of bipartisanship, Representatives McKinley and Dingell introduced an amendment that amends the Controlled Substances Act to clarify the process for registrants to exercise due diligence upon discovering a suspicious order. Like the prior amendments, this, too, is drawn from a prior House-passed bill, H.R. 768, the Block, Report, And Suspend Suspicious Shipments Act of 2021.

Further, the amendment offered by Representatives Trone, Armstrong, and Sherrill also draws from a prior House-passed bill extending a critical authorization for the State Opioid Response grants and Tribal Opioid Response grants for 5 years.

Another amendment introduced by Representatives Dean, Spartz, Scanlon, and Fitzpatrick reflects H.R. 5950, the Improving Patient Access to Care and Treatment Act. This amendment increases the time from 14 to 60 days that healthcare providers can hold long-acting injectable buprenorphine before administering it to a patient, giving patients and practitioners greater flexibility when accessing opioid use disorder treatment.

Finally, this amendment package includes an amendment offered by Representative Gottheimer that would ensure that veterans are included within the crisis response continuum of best practices included in H.R. 7666.

I thank the sponsors of these provisions. These bipartisan amendments provide strong tools to address the ongoing overdose crisis and will save lives. I urge my colleagues to support this package of amendments and include them in the overall bill.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, on that I demand the yeas and nays.

Madam Speaker, I claim the time in opposition to the amendment, but I do not oppose the amendment.

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, I rise in support of this amendment. Like the bill that passed the House last year, H.R. 2877, and other House-passed provisions we hope to include through amendment into the Restoring Hope Act, this bipartisan amendment is part of the bipartisan approach Ranking Member Rodgers and I have taken since day one with this critical bill.

This amendment requires the Secretary to consult with a range of experts, including mental health and education professionals, to develop best practices for schools and universities to establish behavioral intervention teams to identify concerning behaviors and manage risks among students. The guidance must determine how these teams can operate effectively while relying on evidence-based, objective protection of the constitutional and civil rights of students and staff.

Madam Speaker, I understand that some disability and civil rights organizations have concerns about the provisions of this amendment and opposed the original bill. I agree that we must be sensitive to the concerns of these organizations and not inadvertently perpetuate a false association of psychiatric disability and gun violence, nor promote the preemptive use of law enforcement to address problematic student behaviors, particularly among students with disabilities and/or students of color, who are already disproportionately excessively disciplined compared to their peers.

At the same time, I think there is merit to the idea of teams of behavioral health specialists working in concert with educators to identify youth and college students who may be at risk of harming themselves or others and making sure they get the support they need.

This bill has passed the full House twice, as I said, on suspension, both this Congress and last Congress. My understanding is that the bill's sponsors have made changes when reintroducing the bill this Congress to address some of the stakeholders' concerns by including more robust privacy protections and inappropriate referral protections. I think these changes improve the bill.

I understand the stakeholders would like to see additional changes, and as I have indicated in the past, I am committed to examining ways to address these concerns and add additional guardrails as the bill progresses through negotiations with our Senate counterparts, including this amendment for consideration for adoption into H.R. 7666, but we need to pass the amendment to allow those kinds of negotiations with the Senate.

I look forward to working closely with stakeholders, Congressman Ferguson, and the other original leads of H.R. 2877, and, of course, our ranking member, to strike the right balance that protects the health, privacy, and rights of all students.

Madam Speaker, I yield back the balance of my time.

Madam Speaker, I claim the time in opposition to the amendment.

Madam Speaker, I yield myself 2 minutes.

Madam Speaker, I thank the gentleman from Virginia for expressing his concerns relating to the MAT Act, but I respectfully disagree with his proposal.

First of all, I take issue with some of his characterizations regarding buprenorphine. Buprenorphine is not broadly available to all Americans who need it. In fact, only 1 in 10 individuals with opioid use disorder receive medications for their condition, including buprenorphine.

Over half of all rural counties in the United States do not have a single waivered buprenorphine provider, and 40 percent of all counties in the United States don't have a single waivered provider, according to the HHS-OIG.

This is a huge treatment gap. A treatment gap for opioid use disorders means lives are lost every day unnecessarily when there is treatment available. This is tragic and not acceptable.

Second, the gentleman has made the argument that buprenorphine is not effective against fentanyl, but that is not accurate. Buprenorphine is proven to reduce fentanyl use and overdose deaths, according to the National Academies of Sciences Consensus Report on Medications for Opioid Use Disorders and the United States Commission on Combating Synthetic Opioid Trafficking.

Delaying the elimination of the X waiver to 2024 means extending the time in which a barrier to treatment is in place, leading to an increased risk of overdose and death.

It is clear that we are experiencing record numbers of overdose deaths in America. This is a public health emergency and needs to be addressed immediately.

Buprenorphine is a proven, evidence-based treatment for opioid use disorder. Buprenorphine prevents painful withdrawal symptoms, reduces opioid cravings, and cuts the risk of overdose in half. This is due to buprenorphine's ceiling effect, which makes it nearly impossible to overdose on the medication. For these reasons, it is considered safer than commonly prescribed medications like insulin and blood thinners.

Madam Speaker, eliminating the X waiver is a cornerstone of the Restoring Hope Act. The MAT Act amendment to this package was adopted at markup by a vote of 45-10. It received support from the majority of Republicans and Democrats on the committee.

Further, nothing in this bill limits the ability of States to prepare and act on the overdose crisis.

Madam Speaker, I yield myself an additional 30 seconds.

To the contrary, this legislation empowers States to determine the appropriate training, licensing requirements, and tools for providers who dispense controlled substances and treat patients with substance use disorders. All the MAT Act does is remove an unnecessary and outdated Federal barrier to States effectively addressing the opioid overdose crisis.

If we don't act now, we risk tens of thousands of additional overdoses and unnecessary loss of life. I urge my colleagues to reject this amendment, and I reserve the balance of my time.

Madam Speaker, I yield such time as he may consume to the gentleman from New York (Mr. Tonko).

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today in support of H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act.

We are taking urgent action to help States and communities provide lifesaving mental health care to people in need, especially for our children and those suffering from severe mental illness.

I think about Austin, a 9-year-old boy who struggled to cope when his school was shut down, and his parents were going through a divorce. He was socially isolated and didn't know where to turn. When he confessed suicidal thoughts to his mom, they faced long waiting lists and no beds for the care that he needed.

Cases like Austin's can't be ignored. Parents, teachers, and medical professionals are talking about this everywhere I go.

In Spokane, Washington, we are seeing more violence in our schools and rising crime. Drug overdose deaths and fentanyl poisoning were up 300 percent last year. There is an overwhelming sense of despair, anxiety, fear, and isolation. This has been heightened by the horrific shootings in Uvalde and Buffalo. Especially for our children, we need to deliver hope and healing in every community in our country.

This bill will help children in crisis and improve school safety. For example, Congresswoman Ashley Hinson is leading with Richard Hudson on a provision that will expand access to behavioral and mental health services to kids in schools.

It also includes a solution I led on with Congresswoman Young Kim to reauthorize the Garrett Lee Smith Memorial Act, which supports community-based youth and young adult suicide prevention programs.

Like with Representative French Hill's solution in this, we are removing red tape, boosting treatment access, and making sure communities have resources to combat the substance use disorder epidemic in America.

More than 100,000 people are dying a year, and our communities are in desperate need of help to prevent, treat, and rescue people from overdoses and despair.

The priorities in this bill are targeted to responsibly address our most urgent needs so we can build stronger families, communities, and a brighter future. We are accomplishing this by stopping duplicative programs and cutting the deficit by $200 million. The bulk of the programs in this bill are block grants that have been successful in providing our States and communities with the resources and flexibilities to meet the specific and unique needs in combating mental illness and addiction while keeping the Federal Government out of the decisionmaking process for treatments and care.

By protecting charitable choice, we are also making sure faith-based and religious organizations are competing on an equal footing. This is a victory for conscience protections.

The provisions in this bill also support care for maternal mental health and substance use disorders, which are among the leading causes of death for pregnant and postpartum women. We are saving lives and caring for women at every stage of pregnancy and beyond.

Mr. Speaker, I again urge support for this legislation. I thank Chairman Pallone for his leadership and for working with us on solutions from our colleagues on both sides of the aisle.

While families and communities will lead the way to address the root causes of despair, isolation, violence, and overdose deaths that are tearing nearly every community apart and destroying people's lives, this bill takes an important step forward to help them in these efforts.

We are taking action to turn this despair into hope. Children like Austin in communities like mine in eastern Washington are counting on it. Let's

deliver today and keep building on this work.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the gentleman from Minnesota (Mr. Emmer), who has led on important provisions for children in this bill.

Mr. Speaker, I yield 3 minutes to the gentleman from Kentucky (Mr. Guthrie), our lead on the Subcommittee on Health.

Mr. Speaker, I yield 2 minutes to the gentleman from Arkansas (Mr. Hill), a leader on this issue, who sponsored the underlying bill that is incorporated in this package.

Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Tony Gonzales), whose community understands the importance of hope and healing like no other right now.

Mr. Speaker, I yield 2 minutes to the gentlemen from North Dakota (Mr. Armstrong), a leader on the committee.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 2 minutes to the gentleman from Florida (Mr. Bilirakis), a leader on the committee and on this legislation.

Mr. Speaker, may I inquire as to how much time is remaining.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from California (Mrs. Kim), who is a leader on a provision within the larger package.

Mr. Speaker, I yield 1 minute to the gentleman from Georgia (Mr. Carter), who is a leader on the issue.

Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from Iowa (Mrs. Miller-Meeks).

Madam Speaker, I yield 1\1/2\ minutes to the gentleman from Kentucky (Mr. Comer).

Madam Speaker, I yield 3 minutes to the gentleman from Pennsylvania (Mr. Joyce), a member of the Committee on Energy and Commerce.

Madam Speaker, I yield 1 minute to the gentleman from Ohio (Mr. Balderson).

Madam Speaker, I yield 2 minutes to the gentleman from Indiana (Mr. Bucshon).

Madam Speaker, I yield myself the balance of my time.

Madam Speaker, I want to again just express appreciation to the chairman of the committee, all the Members that have participated in helping bring this package of very important mental health proposals to the House today. I urge a strong ``yes'' vote.

As many have said, we have a mental health crisis. At a time when there is so much fear and anxiety and stress, we see increased suicide. We see drug overdoses, and it is time that we act, and act in a way that is really going to make a difference for America's families and our youth in particular.

Madam Speaker, I urge support, and I yield back the balance of my time.

Madam Speaker, I yield myself such time as I may consume. I rise in support of the amendments offered en bloc. I rise today to express my strong support for this group of amendments. Included in this en bloc are important bills that have already overwhelmingly passed the House, including Representative Katko's Suicide Prevention Lifeline Improvement Act, which reauthorizes the National Suicide Prevention Lifeline program and ensures resources are available for the continued operation of the hotline, especially with 9-8-8 going live next month.

Representative Katko also has included in this en bloc the Mental Health Services for Students Act, which provides an authorization for the Substance Abuse and Mental Health Services Administration's Project AWARE grant.

Project AWARE is a successful program which supports partnerships between the State and local systems in increasing awareness of mental health issues among school-aged youth; providing training for school personnel to detect and respond to mental health issues; and connecting students with behavioral health issues and their families to needed services.

The en bloc also includes the Reschenthaler amendment, which would authorize a study on the cost of untreated serious mental illness on families, the health system, the justice system, and the economy.

While very treatable, serious mental illness remains a neglected health issue, and I am hopeful that the data gleaned from this study will convince policymakers to do more to address this condition, including addressing the IMD exclusion.

This group of amendments demonstrates the good work Congress can do when both parties come together to find meaningful solutions to address mental health in America.

Madam Speaker, I urge adoption, and I reserve the balance of my time.

Madam Speaker, I yield 3 minutes to the gentleman from Ohio (Mr. Joyce).

Madam Speaker, I yield back the balance of my time.

Madam Speaker, I rise in support of the amendments offered en bloc and yield myself such time as I may consume.

Madam Speaker, I rise today to express my strong support for this group of amendments addressing substance use disorder.

Included in this en bloc are important bills that have already passed with overwhelming support, including Representative Rodney Davis' Opioid Prescription Verification Act, which incentivizes States to use prescription drug monitoring programs; requires certain controlled substances to be prescribed electronically; and directs Federal agencies to develop, disseminate, and periodically update training materials to help pharmacists identify and report potential cases of bad actors who attempt to illegally buy and sell controlled substances.

Also included is Representative David McKinley's Block, Report, And Suspend Suspicious Shipments Act, which places additional obligations on drug manufacturers and distributors to identify and stop suspicious orders of controlled substances.

We have seen a devastating increase in overdose deaths that I think should be called poisonings, teens buying one pill via Snapchat and immediately overdosing because of a small amount of fentanyl in those pills. Just because it looks like a pill and someone says it was from a pharmacy does not make it so. We need to do more to stop both diversion of legitimate medication and counterfeits that are devastating our communities.

These amendments are a good step in that direction, and I urge adoption.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, I yield 3 minutes to the gentleman from West Virginia (Mr. McKinley), who has been a longtime leader on the issues of substance abuse.

Madam Speaker, I claim the time in opposition, but I urge adoption of the amendment.

Madam Speaker, I rise to urge adoption of the Demings amendment, which requires a report on the mental health issues experienced by law enforcement and the available resources or programs that are available to law enforcement officers to address mental health and stress.

According to the National Alliance on Mental Illness, law enforcement officers report high rates of depression, anxiety, and post-traumatic stress disorders, with nearly one in four having considered suicide. In fact, more officers die from suicide than do in the line of duty.

The report will include recommendations to Federal, State, and local law enforcement agencies on how to improve the mental health and well- being of our officers.

It is a necessary first step in helping us understand what resources are available to improve the mental health and wellness of law enforcement officials. Those risking their lives to keep America safe deserve passage of this amendment.

Madam Speaker, I yield back the balance of my time.

Madam Speaker, as the designee of the gentleman from Georgia (Mr. Ferguson), I have an amendment at the desk.

Mr. Speaker, I yield myself such time as I may consume.

I rise to express my strong support for the Ferguson amendment, which would incorporate the language of the bipartisan, House-passed Behavioral Intervention Guidelines Act to the underlying package.

This important amendment authorizes the Substance Abuse and Mental Health Services Administration to develop best practices for establishing and appropriately using behavioral intervention teams in schools.

Behavioral intervention teams are multidisciplinary teams that support students' mental health and wellness by identifying students experiencing stress, anxiety, or other behavioral disturbances, and conducting intervention and outreach to these students to help manage risk.

These teams are already active in some educational settings, such as Texas Tech and the University of California, Los Angeles.

By acting in a proactive manner to assist students and connecting them with needed resources, behavioral intervention teams help schools create a safe environment for their students and improve mental health outcomes in young people.

It is more important now than ever that schools and communities have guidance on how to provide behavioral health resources and interventions for their students to facilitate the early intervention and treatment of mental health conditions.

This amendment will help children get help before their conditions worsen or reach a crisis level. I strongly urge a ``yes'' vote on this amendment, and I reserve the balance of my time.

Madam Speaker, I appreciate the gentleman for yielding.

Madam Speaker, I rise in support of the Griffith amendment which provides additional time for implementation of the provisions of the Mainstreaming Addiction Treatment Act included in this bill.

I supported the inclusion of this language at committee, as I believe it will help increase access to substance use disorder treatment, the underlying language. However, enacting this language will be a huge policy change from the status quo.

Furthermore, States do regulate the practice of medicine, and each State has unique, individual regulations and procedures regarding the dispensing and the prescribing of scheduled narcotics. States could use the additional time to update their laws with any changes they may want now that Federal restrictions will be removed.

This is exactly what Mr. Griffith's amendment does. It sets the implementation date for removing the X waiver requirement to take effective on January 1, 2024.

Madam Speaker, I support this commonsense amendment that will ensure that the Mainstreaming Addiction Treatment Act gets appropriately implemented.

Mr. Speaker, I thank the chairman for yielding. As I begin--I am going to ask the chairman to enter into a colloquy--but, first, let me express my strong support for H.R. 7666 and the work that has been done in a bipartisan manner by both the chairman and the ranking member, and the importance of the issue of dealing with opioid addictions and other addictions that require this additional work. I am gratified to rise to support that.

I thank Chairman Pallone, and ask, as I said, that he engages in a colloquy with me on the need to support the mental health needs of trauma victims impacted by trauma and, yes, mass

shootings. I think I have been here in the United States Congress during Columbine, Virginia Tech, Sandy Hook, Mother Emanuel, Santa Fe, Parkland--and the list goes on--and tragically Uvalde with 19 children, 2 adults, and 1 individual who died of heartbreak. I was in Uvalde, and I saw the impact on our children, to see 9-year-olds--9-year-olds-- crying and saying that because I spoke to them, they said you are making me happy because you spoke to me, and you said you care. Out of the mouth of a 9-year-old.

So we know there is a mental health crisis as relates to the trauma of those who certainly are survivors and those who are in the community.

We also know that too many families and children in this country are hurting from the preventable epidemic of gun violence, shootings, and mass casualty events. These tragic events have lasting scars on the families, friends, and communities. I have seen this pain with my own eyes. And so I am interested in--as my amendment that I withdrew indicated--is there a prioritization of those children who are impacted by trauma?

Madam Speaker, I would like to be able to work with Chairman Pallone on this issue. Will the gentleman yield for the purpose of a colloquy?

I thank the chairman for answering my questions regarding the Restoring Hope Act that there will be provisions for mental health care and services for children, families, and communities who experience these traumatic and violent events.

I look forward working with the chairman on these vital resources. With your partnership I would like to continue to work with you and the administration to ensure that when this legislation is enacted, the needs of the vulnerable victims and those closest to them are in the front of our minds.

Will the gentleman commit to working with me on this matter?

Madam Speaker, I thank the chairman for his support. I will support this legislation.

Mr. Speaker, I rise as a staunch advocate for mental health services to speak in favor of the Restoring Hope for Mental Health and Well- Being Act of 2022.

This bill amends the Public Health Service Act to reauthorize critical mental health programs for those dealing with mental health or substance abuse disorders.

H.R. 7666 works to mitigate some of the most pressing issues of our time by designating grants, expanding the availability of high-quality recovery housing, reauthorizing treatment programs, and combatting substance abuse.

In 2019, an estimated 10.1 million people in the U.S. aged 12 or older misused opioids in the past year. Specifically, 9.7 million people misused prescription pain relievers and 745,000 people used heroin.

The bill eliminates a key restrictive classification of opioid addiction so that access to treatment programs is expanded.

These issues disproportionately impact tribal communities. According to the American Addiction Centers, 10% of Native Americans have a substance use disorder.

H.R. 7666 specifically funds the prevention and treatment of mental health and substance use disorders for tribal populations.

This is a needed step in protecting a community with a history of being mistreated by the Federal government.

This bill's expansion of access to mental health care services, most importantly of all, would make these services much more available to children and adolescents, who must always be our top priority.

For example, this bill increases mental health services for our youth by integrating behavioral health into public education in primary schools and creating a grant for pediatric mental health services.

This legislation also addresses another pressing issue that afflicts young Americans: eating disorders. As many as 10 in 100 young women suffer from an eating disorder.

H.R. 7666 provides federal funding for the identification and treatment of eating disorders.

But, above all, Mr. Speaker, who among all of our children, need mental health services more than those who have just experienced the unconscionable? Senseless shootings leave our students, some as young as five years old, devastated and vulnerable.

As adults, the thought of having our peers murdered in front of us is disturbing. How much more traumatizing would that be for pre-school students?

This bill acts as a conduit for protecting children who are victims of a mass shooting or mass casualty event.

Mass shootings, especially school shootings, can leave lethal and obvious physical wounds on victims.

However, the long-lasting and subtle mental trauma is the invisible scar left on many survivors. Friends, family, and classmates often suffer with extreme guilt and sadness.

There have been 278 mass shooting in this year alone. Firearms are now the leading cause of death for children and teens.

In addition to those tragically killed, millions more are left behind, coping with these deaths. An estimated 3 million children in the US are exposed to shootings per year.

Since Columbine, there have been 337 school shootings and 311,000 students have experienced gun violence at school. Even more disturbing, just since Uvalde, there have been 65 mass shootings.

This is not a one-state issue. From the 28 killed at Sandy Hook in Connecticut, to the 17 killed at Marjorie Stoneman-Douglas in Florida, to the 10 killed at Red Lake in Minnesota, to the 22 killed at Robb Elementary in my home state of Texas, school shootings have become a disgusting norm.

Children exposed to violence, crime, and abuse are more likely to abuse drugs and alcohol; suffer from depression, anxiety, and posttraumatic stress disorder; fail or have difficulties in school; and engage in criminal activity.

These children don't stay children forever. These mental health struggles translate to a life of pain and suffering where crime, drug use, and suicide are more likely.

This trauma has real consequences: in the year following the 2018 massacre at Stoneman-Douglas High school, two students took their own life after suffering with the mental anguish of the events they had lived through.

Passage of this bill will not solve the gun crisis or mass shootings in this country. Only common-sense gun-control will do that.

However, this bill will set a foundation for the government to address the toll of gun violence on children's mental health.

Additionally, enactment of this legislation demonstrates Congress' support of victims of mass casualty events by prioritizing access to mental health services.

Children are the future of our country. Far too many of them have their hopes and dreams stripped away by senseless shootings.

Mr. Speaker, I rise in strong support of the Restoring Hope for Mental Health and Well-Being Act.

I offer my thanks to Chairman Pallone and Ranking Member Rodgers and their staffs for their tireless work on this bill. It is yet another example of the profound good our committee can produce when we work together in a collaborative and bipartisan fashion.

This strongly bipartisan legislation will take several steps to improve mental health and substance use care.

Importantly, H.R. 7666 includes my Mainstreaming Addiction Treatment Act, which will eliminate outdated barriers that prevent more people in need from having access to buprenorphine, a lifesaving drug. I have worked on this legislation for years and was pleased to see it advance out of committee with a strong bipartisan majority.

By passing this legislation, we will vastly expand access to addiction medicine and move us toward a system of treatment on demand for those struggling with addiction.

It is not hyperbole to say this is one of the most meaningful steps that Congress has taken to date to address the opioid epidemic. It will save countless lives, and I am indeed grateful for the bipartisan push here to get it over the finish line.

H.R. 7666 also includes a bill that I authored to reauthorize and strengthen the Substance Use Prevention and Treatment Block Grant, which serves as the foundation for State's substance use prevention and treatment programs.

We made important improvements to the block grant, including clarifying that recovery support services are eligible for funding through this program.

We are going to keep working to increase funding levels and hopefully implement a recovery set-aside, ensuring that all States invest in critical recovery services.

Taken together, the pieces of the Restoring Hope for Mental Health and Well-Being Act will truly make a difference to families and communities struggling with mental health and substance use challenges.

Mr. Speaker, I urge all my colleagues to support this critically important legislation that delivers hope to our communities, delivers hope to the doorstep of our families.

Madam Speaker, I rise in strong opposition to the Griffith amendment. Not only does this amendment needlessly delay the implementation of the MAT Act by another year, it does so with the intent of encouraging States to enact more restrictions on buprenorphine in the interim, running directly contrary to the intent of the underlying bill.

Let's remember the facts here. We are in the middle of an unprecedented crisis. Last year alone, 107,000 were taken from us too early by drug overdoses. One all-too-common theme in these deaths is a lack of access to

treatment. Despite being recognized as the gold standard of care that can cut the risk of overdose in half, only about 1 in 10 individuals with opioid use disorder received medications like buprenorphine to treat their addiction. That is a glaring systemic failure.

H.R. 7666 takes a strong step to address that failure by expanding access to safe and effective addiction treatment through eliminating the outdated and redundant requirement that healthcare providers obtain a special waiver from the DEA to prescribe buprenorphine for the treatment of addiction.

Despite the lifesaving potential this legislation can bring, this amendment raises concerns about the impact the MAT Act will have on safety, abuse, and diversion, and I would take a moment to directly address these concerns.

Let's start with the basic facts on safety.

Unlike heroin and fentanyl that are causing overdose deaths, buprenorphine is a safe medication that is highly effective at protecting people from overdose.

Due to its ceiling effect, buprenorphine does not cause people to feel high and is unlikely to result in substance use disorder or be a cause of overdose deaths.

With regard to diversion and abuse, the DEA, which is responsible for policing illicit diversion, has specifically looked at this issue and found that the primary reason for buprenorphine diversion is the failure to access legitimate treatment, and that increasing, not limiting, buprenorphine treatment may be an effective response to diversion.

Indeed, as buprenorphine access has increased over the last 5 years through legislation passed by this Congress, misuse of the medication has decreased.

So I would say that it is important for us to be responsible here. We are in the midst of a pandemic, an epidemic that is causing great pain, great suffering, great death, every day, every week. Every moment we circumvent our responsibilities, someone is paying the price for that.

Madam Speaker, I strongly oppose this amendment.

Madam Speaker, I rise today in support of my amendment to require the Secretary of Health and Human Services to study the suicide crises among children living with chronic illnesses and conditions, including autoimmune diseases like alopecia.

Across this Nation, our children are carrying unprecedented amounts of trauma and grief in their emotional backpacks.

For an entire generation of youngsters living with chronic conditions, the solitude, grief, and uncertainty of the past 2 years have only exacerbated the emotional and mental health challenges that already weighed so heavily.

Like millions of Americans, I am living with the autoimmune disease alopecia. There are several forms of alopecia. I am living with alopecia universalis.

Navigating the world as a bald woman is disruptive to many. I am 48 years old, I am an adult, and I have built up some pretty thick skin, but there are days that even bring me to my knees because of the social stigmatization, the bullying, the taunting that I experience as an adult.

Although this does not threaten my life, that does not mean that it does not impact it. I was a caregiver to my mother in her cancer battle, and her very first concern and worry--even though she was fighting for her life--was, am I going to lose my hair.

This is something much more than cosmetic for all who are living with

this. Certainly, for women and girls, there is an added layer, in that this challenge defies societal norms of what is feminine, what is pretty, what is acceptable, and what is appropriate.

For the millions of children--again, I am a 48-year-old adjusted woman, but for the millions of children living with this disease, the challenges may sometimes feel too much to bear.

While there are public misconceptions that alopecia areata is purely cosmetic, the fact is the National Institute of Mental Health has found that alopecia areata has been linked to higher rates of depression, sadness, anxiety, and other mental challenges.

Some have offered: Why not just wear a wig? Well, I am working on that, too, because many of our children can't afford a medically durable wig. So for children who are just beginning their journey, growing comfortable in their own skin and finding their place in the world, these challenges can feel even harder.

Earlier this year, our alopecia community lost one of our own. She is not the first, but one of the most recent: Miss Rio Allred. May she rest in peace. She was 12 years old, and took her life by suicide because of the emotional turmoil and relentless bullying she faced every day in school due to her alopecia.

I have spoken to Rio's mother. I have heard her express the pain no parent should ever know. I asked her to tell me about Rio. She was a great big sister, a writer, a reader, was funny, and a light to the world and all around her.

Her mother has now established Rio's Rainbow, a foundation in her honor, and the mission of that, in Rio's honor, is that kids should feel safe being who they are. One life lost to the emotional distress associated with this disease, and any chronic condition for that matter, is one too many.

I make no appeal today for sympathy, but for empathy, for support, to be seen. I am not here just to take up space. I am here to create it. I choose not to wear a wig because I know what that representation means to the millions of Americans that are living with alopecia.

It is long past time that we study the troubling suicide crisis among children living with chronic illnesses and conditions, including those within our alopecia community, and invest in the early interventions and best practices necessary to save lives. I urge my colleagues to support this amendment, which would do just that.