if he k of inif he can can shoes discxds difficultieses and this will develop new vaccines.nd support hey save three million lives worldwide. what were once referred to as the usual diseases of childhood re now considered vaccine hiff preventable diseases. these achievements have contributed to a false perception that disease threats are minimal and vaccines are no longer necessary. we have witnessed numerous outbreaks of measles, a disease that was once considered eradicated. and in fact the world health organization has identified vaccine hesitancy as a global

health threat for 2019. there is strong evidence to suggest that at least part of the source of this trend is the degree to which medley inaccurate information about vaccines surfaces on web sites where many americans get their information. even if false can be mistaken and exposure to anti-vaccine content may shape user attitudes towards vaccines. this is a common theme in health care settings demands attention and it is imperative for public health officials to put the script to hesitancy to confidence to protect and bolster the public health. the scientific and medical communities say vaccines are effective and safe. there is no evidence to suggest that vaccines cause

life-threatening or diseases and the debumpinged theories about vaccinations pose a great risk. support for the national vaccine rogram and fighting vaccine misinformation is imperative. it is imperative that we fund research to find what works in combating hesitance, combating misinformation and encouraging responsible vaccine dismaking. with that, i reserve the balance of my time. the chair: the gentleman reserves. does any member rise in opposition? seeing none, the chair recognizes the gentleman from california. mr. schiff: i thank the chair, i'm pleased to yield one minute to the chairwoman of the appropriations subcommittee on labor, hell, and human services and related agency, ms. delauro of connecticut. the chair: the gentlelady from connecticut is recognized. ms. delauro: i rise in support of this amendment.

noted in the report accompanying the underlying bill that we are considering, the current measles outbreak that has cases confirmed in 28 states including my state of connecticut and in my colleague's state of california, highlights the importance of immunizations. vaccines are one of the greatest success stories in public health. they are the most effective way to protect the public from highly infectious and potentially deadly diseases. this amendment highlights efforts conducted by the department of health and human services to understand the reason that people do not vaccinate themselves and their children as well as to combat misinformation about vaccines. what we need is to dispel that misinformation through research and which is in fact today right now putting the lives of our children and families at risk. so vaccines are safe, they are effective, and i urge my

colleagues to support this life-saving amendment. i yield back. the chair: the gentlelady yields back. the chair recognizes the gentleman from california. mr. schiff: i thank the chair for her support. this amendment sends a clear message to the american people that congress recognizes the importance of vaccination and immunization in the united states and urges individuals to follow the advice of their doctors in favor of timely vaccinations for themselves and their children. with that, madam chair, i again ask my colleagues to support this amendment and yield back the balance of my time. the chair: the gentleman yields back. the question is on the amendment offered by the gentleman from california. those in favor say aye. those opposed, no. in the ponch the chair, the ayes have it. the amendment is agreed to. >> madam chair. the chair: for what purpose does the gentleman seek recognition? >> i request a recorded vote. the chair: pursuant to clause 6

of rule 18, further proceedings on the amendment offered by the gentleman from california will e postponed. it is now in order to consider amendment number 25 printed in part b of house report 116-109. for what purpose does the gentleman from west virginia seek recognition? mr. mckinley: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 25 printed in part b of house report 116-109, offered by mr. mckinley of west virginia. the chair: pursuant to house resolution 431, the gentleman from west virginia, mr. mckinley, and a member opposed, each will control five minutes. the chair recognizes the gentleman from west virginia. mr. mckinley: thank you. madam chair, i rise in support of this bipartisan amendment to h.r. 2740. last fall, president trump signed into law comprehensive opioid package. included in that package was a

power act which provides competitive grants to hospitals in high overdose or rural areas. sadly, congress has not yet funded that program. the grants included in the power act -- the grants in the power act will help provide emergency rooms the resources they need to offer overdose patients, not only for short-term care, but long-term treatment that is proven to help prevent repeat overdoses. this bipartisan amendment intro deuced by my colleague mr. doyle, of pennsylvania, would fund the grant program with the $10 million congress has already previously authorized. madam chair, if you -- if we believe this is a good program and we voted to authorize it, then let's vote nor amendment

and fund it. i reserve the balance of my time. the chair: the gentleman reserves. for what purpose does the gentlelady from connecticut rise? ms. delauro: i claim time in opposition although i do not oppose the amendment. the chair: without objection. the gentlelady is recognized. ms. delauro: i rise in support of this bipartisan amendment. drug overdose deaths continue to increase in the united states. nearly 70% of these deaths involve an opioid. staggering. on average, 130 americans die every day from an opioid overdose. this amendment provides $10 million for new program at the substance abuse and mental ealth services administration, samhsa, develop best practices for emergency treatment and the coordination and continuation of care for overdose patients. by providing overdose reversal

medication, we can save lives. by providing overdose reversal medication, we can, i'll repeat it, save lives. we have no higher calling in this institution than to save lives. and those who have experienced a nonfatal drug everdose can benefit from evidence-based long-term treatment to prevent relapse and future overdoses. i urge my colleagues to support this bipartisan amendment and i yield back the balance of my time. the chair: the gentlelady yields back. the gentleman from west virginia is recognized. mr. mckinley: let's do something novel here. let's do what we said we were going to do let's fund this program and i ask for support for this bipartisan amendment. thank you, i yield back. the chair: the gentleman yields back. the question is on the amendment offered by the gentleman from west virginia. those in favor say aye. those opposed, no. in the opinion of the chair, the

ayes have it. mr. cloud: madam chair. the chair: the gentleman is recognized. mr. cloud: i request a recorded vote. the chair: pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentleman from west virginia will be postponed. it is now in order to consider amendment number 26 printed in part b of out are -- house report 16-109. for what purpose does the gentleman from north carolina seek recognition? mr. butterfield: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 26 printed in part b of house report 116-109 offered by mr. butterfield of north carolina. the chair: pursuant to house resolution 431, the gentleman from north carolina, mr. butterfield, and a member

opposed, each will control five minutes. the chair recognizes the gentleman from north carolina. mr. butterfield: thank you, madam chair, for yielding time this evening. i know it's been a long evening and we have several hours in front of us so i'll try to be brief. madam chair, i rise in support of my amendment to provide funding for the expansion of the nationaler is survey of child and adolescent well being to include data collection, data collection on the child victims of parental substance abuse. especially those of the opioid epidemic. as this epidemic continues, madam chair, the child welfare system across the country is being overwhelmed. that's the report we're getting. they're just absolutely being overwhelmed. in my home state of north carolina, foster care placements have been on the rise in 2016. over 5,600 children were placed in foster care and 38% of infant

placement, parental substance abuse was a factor. as my colleagues unfortunately know, similar increases have occurred all across the country. the nscaw is the only national survey of -- that provides longitudinal data on children involved in state child protective service programs. it helps examine the current characteristics and needs of children and families involved with child protective services and makeance effort to improve child and family well being. however it doesn't gather detailed information about the unique service needs of the child victims of the opioid epidemics, their parents they care givers, or their child welfare professionals. this information would help fill this gap by providing funding to expand data collection for those child victims of parental substance abuse, positioning the

nscaw to be the source for critical information on the impacts and need of child victims of the opioid epidemic. my amendment will fill the holes that currently exist in our data collection for these children and enable us to fully understand the critical service needs of these children. this data will empower caseworkers and child welfare agency administrators to provide the best services and supports for these children and their families. our communities are suffering, my colleagues know that our communities are suffering from substance abuse and the opioid crisis. especially children who are the most vulnerable in these communities. we must have the nest information needed to better understand the full impact these children and their families are experiencing in order to provide for their needs. i think all of us on both sides of the aisle hopefully can agree on. this i want to thank the chair of the subcommittee for her friendship and her support for this.

i hope her support for this and i strongly urge many my colleagues to support this amendment. thank you and i yield back. the chair: the gentleman yields back. mr. butterfield: or i'll yield to anyone seeking to claim time. the chair: the gentleman yields back. mr. butter fooled: i reserve. the chair: the gentleman ve serving now. does anyone wish to claim time in opposition? the gentleman from north carolina is recognized. mr. butterfield: i would like to yield one minute to the chairwoman of the subcommittee, ms. delauro. the chair: the gentlelady from connecticut is recognized. ms. delauro: i thank the gentleman, i thank the chair. i rise to support the gentleman's amendment there is no doubt that the child welfare system is overwhelmed by the opioid epidemic. this additional funding would build pob existing data efforts, provide child welfare caseworkers with evidence-based data that can better inform how children are cared for if they

are in the system because of parental substance abuse. think about the tragedy of these youngsters. please, let us not let these children fall through the cracks. and that we don't provide them with the kinds of services that they need. we have both sides of the aisle recognizing the ongoing opioid crisis. i think this effort to help these innocent bystanders to the crisis is an important one. i urge my colleagues to support the amendment and i yield back the balance of my time. mr. butterfield: i thank the gentlelady for her passion, her leadership and her support for this amendment. i reserve. the chair: the gentleman reserves. the gentleman has all the time. mr. butterfield: all right, i see no other speakers, i yield back the balance of my time. the chair: the gentleman from north carolina yields back. the question is on the amendment offered by the gentleman from north carolina. those in favor say aye. those opposed, no.

in the opinion of the chair -- for what purpose does the gentleman rise? >> i'd like to request a recorded vote. the chair: in the opinion of the chair, the ayes have it. now i recognize the gentleman from kentucky. >> thank you. i request a recorded vote. the chair: pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentleman from north carolina ill be postponed. the chair: it is in order to consider amendment number 27

printed in part b of house report 116-109. mr. johnson: i have an amendment at the desk. the clerk: amendment number 27 printed in part bmp of house report number 116-109 offered by mr. johnson of ohio. the chair: pursuant to house resolution 431, the gentleman from ohio, mr. johnson, and a member opposed each will control five minutes. the chair recognizes the gentleman from ohio. mr. johnson: i will try to be very brief. it has been a long day. my amendment would address the ongoing opioid by funding the regional disorder education. that program which was authorized last year as a part of h.r. 6, this program aims to increase the amount of education to help professional students receive on substance use disorder, pain management and

addiction. while students are eager to address the opioid epidemic, only a handful of medical schools have robust curriculums on substance use disorders. by recognizing institutions that have put a focus on these areas and sharing their strategies publicly, we hope to ensure that the next generation are fully prepared to address the opioid ep dem nick and other forms of addictions. they are in a unique position to recognize the addiction and that their training prepares to take them on this lifesaving role. i reserve. the chair: the gentleman from ohio reserves. the gentlelady from connecticut is recognized. ms. delauro: i claim the time in opposition although i do not

oppose the amendment. i rise in support of this bipartisan amendment. this amendment calls for funding of a new program and in fact, it would establish regional centers of excellence in substance use disorder education. 17, approximately 19 million had a substance use disorders. this would improve training, treatment and recovery so that more people can get treatment and we can reduce the number of those who do need the treatment. part of this is to be able to educate and train folks to be able to deal with the scale and the scope of this public health emergency which is what i call it, across the nation. i urge my colleagues to support this amendment. the chair: the gentleman from ohio is recognized. mr. johnson: i thank my colleague for supporting the

amendment. i urge my colleagues to support this amendment and i thank representative tonko for working with me on this program in the energy and commerce committee and on this particular amendment. i yield back the balance of my time. the chair: the gentleman yields back the balance of his time. the gentlelady from connecticut? ms. delauro: i yield back. the chair: the gentlelady yields back. the question is on the amendment offered by the gentleman from ohio. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. for what purpose does the gentleman from texas seek recognition? >> i would like to request a recorded vote. the chair: i hear your request and pursuant to clause 6, rule 18, further proceedings on the amendment offered by the gentleman from ohio will be

postponed. it is now in order to consider amendment number 28 printed in 116-109. house report for what purpose does the gentlewoman from wisconsin seek recognition? ms. moore: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 28 printed in part b of house report 116-109 offered by ms. moore of wisconsin. the chair: pursuant to house resolution 131, the gentlewoman from wisconsin and a member opposed each will control five minutes. ms. moore: thank you, madam chair. my amendment relates to the centers for disease control establishing a national standard for investigating sudden infant death, childhood delingts from

sudden death syndrome. the unis explained nature of some of these deaths only makes it harder for grieving families as well as public health first and policy makers who are working to prevent them. i have had the heart-rendering experience of walking into the home of parents who are grieving and that grief does president begin when their infant dice but goes on for a lifetime wondering if it was my fault, am i a bad parent. my amendment would help better understand why thousands of infants between the age of birth and one and hundreds of children between the ages of 1-4 are still dying unexpect he hadly in our country. that includes those, scarlet pauley was one of those

children. scarlet loved her pet including her dog stitch and her cat colby, she called max. scarlet loves to smile and loved books and her favorite book was . arnyard dance" a few hours later, her mom went to check on her and scarlet was not breathing in her crib. after being taken to the hospital, this beautiful 16-month-old baby was declared on january 8, 2017. that is just one story. because there are -- in 2017, who were 3,600 infants ied suddenly and unexpectedly, including 1,400 from sids.

and right now without a national standard to investigate these deaths, different states and different municipalities collect inconsistent and often incomplete data on these unexplained deaths. that hippeders the ability to find answers and i'm so pleased that chairwoman delauro has included funding for the c.d.c. to increase efforts to better train those to carry out stronger death investigations and improve data collection. and i reserve the balance of my time. the chair: the gentlelady reserves. anyone seek time in opposition? the gentlelady is recognize dollars. ms. moore: how much time do i have? the chair: three minutes. ms. moore: i thank the ranking member, mr. cole, who is the lead co-sponsor of my

stand-alone legislation to see that children and infants who die suddenly get some resolution. this is an example of smart investment sprinkled throughout this bill. and i yield the balance of my time to the gentlelady from connecticut. the chair: gentlelady is recognized. ms. delauro: i rise in support of this amendment. would note and my colleague noted, the underlying bill under consideration includes $2 million for a new dedicated effort on sudden unexplained death in childhood in c.d. despite the decline in the past two decades, significant racial and ethnic differences continue. c.d.c. is working to better understand the circumstances so that public awareness and provider education can be

improved to reduce these risks. i strongly support the congresswoman's efforts to prevent these tragic deaths of very young children and the profound suffering of their families. now i just say to my colleagues, those who are here and those who are not here, think about the power of the institution that we serve in. and what it can do in so many of these areas to profoundly change people's lives, to save people and to give people comfort to now that we have not forgotten them and that while they have experienced a tragedy, we will work to see that others will not have to face that tragedy. and saving the lives of

children. i urge my colleagues to vote yes on this amendment. the chair: the gentlelady's time has expired. the question is on the amendment offered by the gentlelady from wisconsin. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. >> madam chair. i request a recorded vote. the chair: i hear your request and pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentlewoman from wisconsin will e postponed. it is now in order to consider amendment number 29 printed in art b of house report 116-109.

for what purpose does the gentlewoman from wisconsin seek recognition? ms. moore: madam chair, i have an amendment at the desk. the clerk: amendment number 29 printed in part bmp of house report number 116109 offered by ms. moore of wisconsin. the chair: pursuant to house resolution 431, the gentlewoman from wisconsin, ms. moore, and a member opposed each will control five minutes. the chair recognizes the gentlewoman from wisconsin. ms. moore: this amendment would provide $4.5 million in additional funding to the domestic violence prevention enhance and leadership through alliances known as the delta program to reach the level that the domestic level advocates have made it clear that they need to support this effort. the delta program is dedicated to the prevention of domestic violence. while most federal programs

provide victim services and hold perpetrators accountable and pot -- and respond to domestic violence, they respond to 50 communities nationwide to prevent first-time victims and prevent first-time perpetrators. with one in three women and one in four men experiencing partner violence in their life times, we need this funding now more than ever. this program works with stakeholders, meantors to teach youth about sexual assault while promoting healthy relationships. this investment was important in my home state where the delta program created initiatives like the tribal communities and milwaukee's own diverse and resilient organization that worked with lgbtq youth on safe

relationships. i would reserve the balance of my time. the chair: the gentlelady reserves. does anyone seek time in opposition? the gentlelady from wisconsin is recognized. ms. moore: thank you, madam chair. woy yield to the chairwoman of the subcommittee. the chair: the gentlewoman from is recognized. ms. delauro: i rise in support of this. intimate partner violence is a public health problem that affects millions of americans. this would increase funding to implement proven prevention strategies including programs that mobilize boys and men to be allies in sexual violence prevention and coalitions with local governments, community partners and police to increase safe places in neighborhood

parks. the negative consequences associated with intimate partner violence underscore the importance of stopping it before it occurs. i commend the amendment's sponsors for raising attention to this important program and i urge my colleagues to vote yes on this amendment and i yield back. the chair: the gentlelady yields back the gentlelady from wisconsin. ms. moore: i yield back. the chair: the question is on the amendment offered by gentlelady from wisconsin. those in favor say aye. those opposed, no. for what purpose does the gentleman dr >> i request a recorded vote. he chair: i hear your request.

in the opinion of the chair, the ayes have it. the gentleman from texas is now recognized. >> i request a recorded vote. the chair: pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentleman from texas will be postponed. . . it is now in order to consider amendment number 30 printed in part b of house report 116-109. for what purpose does the jerusalem from wisconsin seek recognition? ms. moore: madam chair, i rise to aumb an amendment to add funding to the the substance abuse and mental health services administration. the chair: the clerk will designate the amendment. the clerk: amendment number 30 printed in part b of house report 116-109, offered by ms.

moore of wisconsin. the chair: pursuant to house resolution 131, the gentlewoman from wisconsin, ms. moore, and a member opposed, each will control five minutes. the chair recognizes the gentlewoman from wisconsin. ms. moore: thank you so much, madam chair. this amendment to add funding to the substance abuse and mental health services administration would support the distribution of fentanyl test strips by our state and local public health partners. unintentional drug overdose deaths have climbed to record high levels, claiming around 70,000 lives in the united states in 2017. one of the drivers is fentanyl. a powerful, synthetic opioid that is significantly more potent than heroin. because fentanyl is so cheap and strong, deal verse an ainent sieve -- have an incentive to use to it cut drugs such as heroin and cocaine.

in new york city in 2017, just to name one locality, but the story is the same in many other places. fentanyl was involved in 57% of all the drug everdose deaths between 2000 and 2012. that rate was only 2%. but in 2017, it was much higher. this crisis, a public health epidemic in emergency means the need that -- we need to bring more tools to the fight. while some agencies like the n.i.h. have noted the need to consider all evidence-based programs that can help address the damage being caused in our communities by opioids, others, like sahmsa, have clearly not. which is troubling. in april, the n.i.h. awarded a grant to the university of kentucky that aimed at reducing opioid everdose deaths by 40% in

16 counties using evidence-based solutions. one of the evidence-based solutions that could be pursued would be using these funds in overdose prevention efforts such distribution and test strip distribution. unfortunately, it appears that sahmsa has taken the opposite stance and warned its grantees against funding such efforts. this is perplexing, madam chair, since it receives hundreds of millions of dollars from this congress to address the opioid crisis, including overdoses. what is a fentanyl strip? they're used to detect the presence of fentanyl in drugs. while there are other ways to detect the presence of fentanyl in drugs, testing strips are

more sensitive and significantly less expensive than other methods. studies have found this approach works to positively influence behavior. and i would reserve my time. the chair: the gentlelady reserves. does anybody rise in opposition? the gentlelady from wisconsin is recognized. ms. moore: madam chair, recent studies have found that using these strips can be help to feel reduce fentanyl overdose risks, including leading some individuals to discard their drug supply or taking some other action to reduce harm to themselves. in one study, those who saw the positive results for five times more likely to change the way they used the drug in an effort to avoid overdosing. so people want to make moral judgments about it, and sure we need to provide rehabilitation

services to people, madam chair, but it is impossible to rehab someone who is dead. and with that, madam chair, i ask unanimous condition sent to withdraw my amendment. the chair: the amendment is withdrawn. the chair understands that amendment number 31 will not be offered. it is now in order to consider amendment number 32, printed in part b of house report 116-109. for what purpose does the gentlelady from california seek recognition? ms. matsui: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 32 printed in part b of house report 116-109, offered by ms. matsui of california. the chair: pursuant to house resolution 431, the gentlelady

from california, ms. matsui, and a member opposed each will control five minutes. the chair now recognizes the gentlelady from california. ms. matsui: thank you madam chair. i'm pleased to join my colleagues today in supporting critical investments made by this bill. i rise today in support of my amendment which provides additional assistance for innovative programs that help young people with developmental disabilities and obtain -- in obtaining and sustaining long-term employment. one in 6 children are diagnosed with autism spectrum disorder. more than 50,000 individuals with autism turn 18 every year and 500,000 will age out of school systems in the next 10 years. a significant number of young adults with autism spectrum disorder remain unemployed and unenrolled in higher education in the two years after high school. young adults on the autism spectrum often do not have access to an educational environment that assists them in

developing practical life skills, increase social capacity and transition to work and independence. this amendment is a critical first step toward remedying that. specifically, it will help support and promote innovative educational programs and focus on preparing students for entry into the work force or pursuing higher education. the support offered through these initiative programs helps young cults find and maintain employment. in turn, this is a critical step toward infence, an opportunity to be more productive and to truly participate in all facets of community life. my amendment will support young adults with developmental disabilities to access care and education necessary to find jobs by focusing on inclusion and integration. it is critically important that all children and young adults, particularly those who are challenged with autism, have the opportunity to fully participate in our community and society.

i hope my colleagues will join me in supporting this amendment. thank you and i reserve my time. the chair: the gentlelady reserves. does anyone seek recognition in opposition? the gentlelady from california is recognized. ms. matsui: i yield time to my dear friend, the subcommittee chair, ms. delauro. the chair: the gentlelady from connecticut is recognized. ms. delauro: i thank the gentlelady and i rise to strongly support the developmental disabilities project of national significance program, which is why this bill rejects the administration's proposal to virtually eliminate funding for it. why? and instead provides a $1 million increase over fiscal year 2019 level. these grants fund innovative projects, create opportunities for those with developmental disabilities. they promote equality of opportunity, inclusion of persons with disabilities, in

all aspects of community life which benefit ours society as a whole. and i want to say a thank you to my friend for highlighting this particular grant initiative for schools that serve young adults on the autism spectrum by helping them develop practical life skills that will help them transition to work and independence. we need innovative programs like this one. they create and enhance opportunities for individuals with developmental disabilities to contribute to, to participate in, to feel their value, to know that we recognize their value, and give them respect and independence and self-confidence in who they are. this means they can participate in all facets of community life. i urge my colleagues to support the amendment and yield back the balance of my time. the chair: the gentlelady yields back. the gentlelady from california is recognized. ms. mat cue see --

ms. matsui: i would like to add to this too, the program supported by this amendment offers those with intellectual disabilities to be placed in paid job, internships and other positions. often the people who participate are passionate an capable about a work opportunity but need help along the way. i think we can all agree that learning tuns to better train and encourage young adults to seek and maintain long-term work is a goal we all support. hese problem solving abilities learned in the right environment can have a last, long-term impact on those with autism and i really do really feel that this is something that will really help the individuals i have met along the way and i strongly urge my colleagues to join me in supporting this amendment. with that, i yield back. the chair: the gentlelady yields back. the question is on the amendment offered by the gentlelady from california. those in favor say aye.

those opposed, no. in the opinion of the chair, the ayes have it. the gentleman from texas is recognized. mr. cloud: i request a railroaded vote. the chair: -- a recorded vote. the chair: i hear your request and pursuant to clause 6 of rule 18 further proceedings on the amendment offered by the gentleman from texas will be postponed. i'm sorry. the gentlewoman from california. it is now in order to ar kept aurm 33 printed in part b of ouse report 116-109. for what purpose does the gentleman from kentucky seek recognition? mr. barr: madam speaker, i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 33 printed in part b of house report 116-109 offered by mr. barr of kentucky.

the chair: pursuant to houseres. 431, the gentleman from kentucky, mr. barr, and a member opposed each will control five minutes. the chair now recognizes the gentleman from kentucky. mr. barr: thank you, madam speaker. i rise today to offer my amendment to increase funding for the building communities of recovery program. we all know that the opioid ep democrat sick a major health crisis that has impacted every community and every condition gregsal district. my home state of kentucky suffers from the fifth highest overdose mortality rate in the country and we learned from the c.d.c. that last year, 72,000 of our fellow citizens died of an opioid overdose. this is a national crisis. last fall, congress passed a historic package of legislation to address the opioid epidemic through research, treatment, and prevention. the support for patients and communities act build upon past resources, authorized and funded by congress including the 21st

century cures act. additional congress has appropriated $4 billion, the largest federal investment to date, address the opioid epidemic. but there is more work to be done. we cannot continue to focus our federal efforts on prevention and treatment without looking toward long-term recovery through housing, job placement, financial literacy and life skills. not all recovery is the same. everyone has a different recovery journey and we must not prioritize one pathway to recovery over another. if there's one thing i've learned talking to folks who are struggle bug a-- through addiction recovery it is that what works for one individual may not work for another. aye heard from think sthoists need for funding to be made available for programs that provide alternatives to medication assisted treatment for opioid use disorder. obviously, med case assisted treatment is considered evidence-based and the gold

standard in many cases for helping people to recovery. but there's alternatives. some individuals need a different course. currently the building communs of recovery program is one of the only sources of funding for noon medication for opioid use disorder. according to sahmsa, nonm.a.t. programs are ineligible for the state opioid response grant which is constitute the majority of opioid funding. many i office has been told time and time again that the reason they cannot receive funding is because they do not offer medication-assisted treatment. i would like to emphasize, i'm not critical of medication-assisted treatment recovery programs. but i do believe that nonmarket alterntives to recovery complement -- that nonmarket alternatives to recovery complement these programs. we must make critical, nonmedication resources available to those who need them. treatment programs that choose to offer nonm.a.t. recovery

options are doing incredible work despite their inability to access most federal grant programs we enacted last year. so i'd like to highlight the story of zachary thomasing, my constituent, and a prime example of someone who successfully worked through addiction to recovery. at the age of 18, he dropped out of mercer county high school just four months before graduation. he was hooked on methamphetamines, heroin, and alcohol and was homeless. at age 19, zack was in the boyle county detention center on drug charges. upon recommendation of the county attorney, he was sent to the shepherd ears house a recovery residence in lexington, kentucky that provides transitional residential treatment for men 18 years and older. shepherd's house has been providing treatment for clients who suffer from drug and alcohol issues for the past 0 years. it offers structured programs that promote personal responsibility and accountability for those seeking to sustain abstinence from mood

and mind altering substances. he now works at db8 kitchen, a restaurant that has a practice of hiring employees in recovery zach's success is a test ta metropolitan of the shepard house and what these programs are doing. the shepard's house is to live in the solution of recovery and make a positive impact and to put a small dent in the national crisis that we know as addiction. is a spark program that educates families on addiction and recovery resources at a time when families don't know what to do, spark provides an outlet. but these great organizations,

spark and the shepard's house, they are not eligible for the federal grant programs that we have funded. and so this amendment would simply provide increased funding for that program, building and recovery program that would provide funding for alternatives that are desperately needed. and i yield back. the chair: the gentleman yields back the balance of his time. for what purpose does the gentleman from. ms. delauro: i claim time in opposition. i rise in support of this amendment. i appreciate my colleague. i'm a strong supporter of recovery supporting services and the recovery in the role of substance use disorders. in my district in connecticut, i met with my own constituents who credit their recovery to recovery coaches. a t with a constituent

substance use abusers and providers and they said one of the difficulties that someone can get treatment and go back out on the street and no one to be in touch as a support system in order to be able to continue on a road to recovery and they slip back and they are once again on the streets. what you are talking about is increasing the funding for building communities of recovery so that people don't feel that they are alone and that there is nowhere to go but to take up an unhealthy lifestyle once again. this will expand access to critical lifesaving services and support for drug and alcohol addiction, employment services, that maybe we can put together a

number that they can call and the kinds of services that people need when they find thepses in this situation. i commend my colleague on this amendment. and i urge my colleagues to support the amendment. the chair: the gentlelady yield back? ms. delauro: i yield back. the chair: the question is on the amendment offered by the gentleman from kentucky. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. and the amendment is agreed to. the gentleman from kentucky. >> i request a roll call vote. the chair: i hear your request, pursuant to clause 6, rule 18, further proceedings offered by the gentleman from kentucky will e postponed.

it is now in order to consider amendment number 34 printed in part bmp of house report 116-10. mr. cleaver: i have an amendment at the desk. the clerk: amendment number 34, printed in part b of house report number 116-10 offered by mr. cleaver of missouri. the chair: pursuant to house resolution 431, the gentleman from missouri and a member opposed each will control five minutes. mr. cleaver: i propose a funding increase of $6.5 million for the lee smith grants to be used for

suicide awareness and prevention for mental health services administration and this includes training school personnel and high school students on the signs of suicide. suicide is the second leading cause of death in america for young people between the ages of 15-19. missouri surpasses that on almost every account from every age group and ethnicity. the high school principal of the year came to my office recently and his chief concern was our youth today are in distress, that suicide rates are rising and school personnel resources to help these vulnerable students. two years ago in his lee summit north high school which is located in my district, a hard

byrking young women you died suicide in the school. she went into the girl's rest room and shot her self. my grandson was in the school and i was speaking to him by phone and he was trying to figure out what was going on. this is a tragedy. there is no other word for it. but we have to prevent this. discxds difficulties tushingly, this situation is becoming more and more common and we have to do something about it. these situations exist. four out of five teens who attempt suicide give clear warning sign. i applaud the committee's commitment ol suicide prevention. however, we must do more. this is why i prop an increase in funding because it putsry

sources on the front line. let's do everything in our power to reduce death by suicide and give our future leaders. yield the remaining time, madam chair. ms. delauro: i thank the gentleman and i rise in support of this amendment. suicides are devastating our communities. as evidence by 47,000 deaths in 2017 and makes me proud what we put together in the underlying bill that we consider tonight includes $20 million of new funding of suicide prevention efforts and the substance and mental health services administration. this amendment would increase funding for efforts to prevent suicide among our youth at the places that many of them can be

found. colleges and universities, youth-serving organizations through training and activities aimed at identifying youth at risk for suicide. the screenings and connection to appropriate services that can prevent suicide and suicide attempts. we shouldn't be dealing with this after the fact. but what we ought to be doing is trying to provide the kinds of counseling and have people who are trained to recognize the signs, the tell-tale signs of a young steer who is in difficulty and who needs help. as the underlying bill that we consider shows, we strongly support suicide prevention efforts and i commend the gentleman and i urge my colleagues to support this amendment and i yield back. the chair: does the gentleman

from missouri reserve? mr. cleaver: yes. the chair: does anyone seek time in opposition? the gentleman from missouri is recognized. mr. cleaver: i yield back. the chair: the gentleman yields back the balance of his time. the question is on the amendment offered by the gentleman from most. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. the amendment is agreed to. >> madam speaker. i request a recorded vote. the chair: i hear your request, pursuant to clause 6, rule 18, further proceedings on the amendment offered by the gentleman from missouri will be postponed. it is now in order to consider amendment number 35 printed in 116-109. house report

it is now in order to consider number 36 printed in part b of ouse report 116-109. ms. castor: i have an amendment at the desk. the clerk: amendment number 36 printed in part b of house report 116-10 offered by ms. castor of florida. the chair: the gentlelady from florida and a member opposed each will control five minutes. the chair recognizes the gentlelady from florida. mr. castro: my amendment is an -- ms. castor: this is an important

amendment. my amendment is an important one for the 130 million americans who have a pre-existing condition like cancer or diabetes or heart disease, asthma, als i'mer'. this is a proposed rule by the trump administration that encourages insurance companies to issue junk insurance plans. they call them because they often don't cover vital health services like a trip to the hospital or emergency room or may not cover prescription drugs or mental health services that you need. they are often marketed as a good deal. but they don't show you the fine print that they may cap benefits and what they do is they allow discrimination against our

neighbors who have a pre-existing health condition. this is not in question because in committee, i asked the h.h.s. secretary point blank, i said these short-term junk plans, they allow insurance plans to discriminate, right, mr. secretary? he said yes. the law of the land, after we passed the affordable care act says that no longer are we going to allow insurance companies to discriminate our neighbors. so how can the trump administration be moving forward? they are moving forward with a proposed rule that would allow these plans to operate for one year, two years, three years, that's a short-term limited duration plan. just over a month ago, democrats stood up and passed a bill h.r.

1010 that would halt the trump administration's plan that weaken the protection for americans who have a pre-existing conditions. we are building on this by to ring on this amendment prohibit any funds being used to implement, administer and force the expansion of jumping plans because you see we are going to safeguard families from republican attempts to push them into junk plans that don't cover the essential health insurance they need. they value affordable health care and the bed rom protection of the affordable care act that prohibits discrimination based upon a pre-existing health condition. i reserve. the chair: the gentlelady reserves. for what purpose does the gentleman from arkansas recognition? >> i rise in opposition to the

gentlelady's amendment. i rise in opposition to the gentlelady's amendment and count me as one who stands in the trum administration for limited health plans. this has everything to do with giving our citizens options. these plans serve as an affordable alternative to obamacare health insurance plans particularly for individuals and families not eligible for obamacare tax subsidies. i have heard from countless small businesses in my district say they cannot afford health insurance for their employees. these alternative plans can have have lower premiums and deduct i believe so and provide access as some of the obamacare plans. this amendment needs to be

defeated. and i reserve. the chair: the gentleman reserves the balance of his time. the gentlelady from florida. ms. castor: instead of ripping affordable coverage away, my republican colleagues should be working with the democrats to lower health care costs and protect coverage for pre-existing conditions. one way we can do that is by supporting this amendment. i yield the balance of my time to a health care champion, ms. delauro. . . ms. delauro: i rise in strong support of this amendment which in fact blocks the trump administration's rule to promote junk health insurance plans. plain and simple, that is what they are. and, you know, this is just another attempt by the administration to sabotage the affordable care act. their policies have increased

the cost of health care, the level of unir-- uninsured in this nation has gone up, and they want to bring us back to a time when those folks with a pre-existing condition could no longer get health care coverage, and some today who say they for the first time in their lives have gotten that coverage, otherwise twhee have died. but maybe that just doesn't cut it with some folks here. short-term plans do not have to cover the a.c.a.'s essential health benefits. they frequently do not include maternity services, prescription drugs, mental health care, or substance use disorder treatment. short-term plans can deny coverage or charge higher prices to people with pre-existing conditions -- pre-existing conditions. as i said a moment ago, remember those days when even being a

woman was a pre-existing condition? if your child had asthma, it was a pre-existing condition. you couldn't get any help. hey will not cover, often, medical services associated with pre-existing conditions. we reiterate, they are junk plans. every american, every american deserves affordable, high-quality health coverage, which is why we need block these junk plans which provide the opposite. i urge my colleagues to support this amendment and i yield back. the chair: the gentlelady yields back the balance of her time. the gentleman from arkansas is recognized. >> i'll just finish by saying that all through this health care debate that we've had over the last 10 years, and i've been here 8 1/2 years of that, it's all been about access to health care. this gentlelady's amendment, madam chair, limits access to health care.

now, either they want more access to health care or they don't and i think if you pass this amendment, you're limiting the access to health care. and it's for that reason that i believe we should defeat the amendment and i now yield back the balance of my time. thank you. the chair: the gentleman from arkansas yields back. the question is on the amendment offered by the gentlelady from florida. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. mr. womack: madam chair. the chair: the gentleman is recognized. mr. womack: with that i'd like the yeas and nays. a recorded vote. the chair: does the gentleman request a recorded vote? mr. womack: yes. the chair: pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentlelady from florida will be postponed.

it is now in order to consider amendment number 37 printed in art b of house report 116-109. for what purpose does the gentleman from arkansas seek recognition? mr. hill: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 37 printed in part b of house report 116-109 offered by mr. hill of arkansas. the chair: pursuant to house resolution 431, the gentleman from arkansas, mr. hill, and a member opposed each will control five minutes. the chair now recognizes the gentleman from arkansas. mr. hill: i thank the chair. madam chair, i rise in support of my amendment to the labor, health and human services appropriations pact, which strikes all guidance related to the obligation of funds for the affordable care act's navigator program. by passing this amendment we can prevent further wasteful spending on this failed and very inefficient program.

for the plan year 2017, navigators received $62.5 million in grants and enrolled 81,000 individuals. each of these enrollments cost taxpayers $767. further, those 81,000 individuals accounted for less than 1% of all the enrollment in the a.c.a. plans for that year. arkansas does not use the federal marketplace, but i think it's worth noting that according to c. smmplet -- c.m.s., only 2.3% of the people in my district purchased their health care on the exchange in 2017. nationwide less than 4% of the population bought affordable care act plans. so with a little bit of math, we can come to the conclusion that enrollg $62.5 million to less than 3/10 of 1% of the

population. the administration wisely decided that this money could be better spent elsewhere. and cut funding for the program to a more reasonable level of $10 million. yet for some reason my colleagues on the other side of the aisle would like to force the administration to spend $100 million on this, in my view, wasteful and ineffective program. i reserve the balance of my time. the chair: the gentleman reserves the balance of his time. for what purpose does the gentlelady from connecticut seek recognition? ms. delauro: i claim time in opposition. the chair: without objection, the gentlelady is recognized. to claim : i rise time in opposition and i strongly oppose my colleague's amendment that would strike $100 million from the c.m.s. program management. this is funding that has been designated to support the affordable care act navigators program, as well as outreach, enrollment and advertising

during the a.c.a. open enrollment period. further attempts to sabotage the affordable care act. because of the affordable care act, more than 20 million people gained health insurance. many for the first time in their lives. the uninsured rate declined from a high of 18% before the affordable care act to a low of less than 11%. for families it meant that insurance companies could no longer discriminate against people because of their medical history and being a woman was no longer a pre-existing condition. the a.c.a. was not perfect, but it was a significant achievement. unfortunately the trump administration has tried to sabotage the affordable care act since the day the president took office. it was not successful, i might add. at least legislatively not successful. but they've come around through the appropriations process to

continue the sabotage. h.h.s. shortened open enrollment, cut the annual budget for outreach by advertising by 90%, they cut funding by 80% for the a. crmple a. navigators -- a.c.a. navigators who are the navigators, the people who provide in-person assistance to a consumer who may need help in finding a health plan. we held a hearing in february to highlight the administration's efforts to undermine the affordable care act. one of our expert witnesses estimated that h.h.s.'s cuts to outreach advertising -- outreach, advertising and enrollment activities resulted in more than a million fewer enrollments in 2017 and a similar shortfall in 2018. the labor-hhs-education appropriations bill sent a clear message to the administration. stop undermining health care for millions of americans. members of congress have health

care. they shouldn't be undermining other americans' health care. stop allowing insurance companies to discriminate against -- again with junk insurance plans. stop attacking the mechanisms that we put in place to hold down costs for american families. our bill specifically designates $100 million from a.c.a. user fees to support a.c.a. navigators, as well as outreach, enrollment and advertising during the a.c.a. open enrollment period. these funds will help millions of american families navigate the complicated maze of health insurance to find a health plan that works for them. it strengthens the affordable care act's individual market by bringing healthier individuals into the risk pool, thereby reducing premiums for everyone. the gentleman's amendment seeks to eliminate those funds which will make it harder for americans to enroll in high

quality health insurance. i strongly oppose the amendment and i reserve the balance of my time. the chair: the gentlelady reserves the balance of her time. the gentleman from arkansas is recognized. mr. hill: thank you, madam chair. we're all interested in having affordable health care and that's why we have more market-based health care, open up this market, reduce constraints, we'll get more affordable policies. because i would submit to the chair tonight that the reason people don't accept these policies is not due to a lack of advertising, madam chair, but due to the expense, complexity and unaffordability of these plans and in this regard i'd like it yield two minutes to my good friend from tennessee, dr. phil roe, the ranking member on the house veterans' affairs committee. the chair: the gentleman from tennessee is recognized. mr. roe: thank you, i rise today in support of my good friend from arkansas' amendment. this bill contains a line item directing $100 million be spent on the a.c.a. navigator program. unless i'm mistaken, just last month the house democrats decided it was more important to

play politics than consider legitimate, bipartisan proposals to address the constantly increasing health care costs. in tennessee since the a.c.a. went into effect, our premiums 174%.one up in the a.c.a. 174%. we remember that long ago the claim that the a.c.a. would eliminate, including $100 million for the navigator program in that bill. how many times will we go through this exercise before my colleagues on the other side of the aisle realize this program just doesn't work? i've never heard of a government program in the history of the country that suddenly started to work without making any changes, by simply throwing $100 million at it. you can't do the same thing over and over again and expect a different outcome. the planned year 2017 navigators received $62.5 million and enrolled 81,426 people. with just over eight million enroll e.s.a. for 2019, i'm not sure -- enrollees for 2019, i'm not sure how it makes sense to

spend $768 per enrollee to sign them up, but now house democrats want to tchauble money for a program that's been shown to be ineffective, its sole function just to enroll people in the a.c.a. the obamacare enrollment, nearly 20 million people below the original c.b.o. estimate this years, and over three million more people gaining private employer-sponsored coverage over last two years because of the strong economy and job market. we should be using this money for programs that actually work. i support this amendment which eliminates this line item funding mandate because i offered a similar amendment the democratic leadership decided was not in order which would have moved money from the navigator program to the substance abuse treatment fund. allowing additional grants to treat those suffering from substance abuse disorders which actually would save lives. let's stop wasting time and money on programs that don't work and support those that do and i ask my colleagues to support this amendment and i yield back the balance of my time. the chair: the gentleman yields

back the balance of his time. the gentleman from arkansas is recognized. mr. hill: i reserve. the chair: the gentleman reserves the balance of his time. the gentlelady from connecticut is recognized. ms. delauro: let me just repeat a statistic. because of the affordable care act, more than 20 million people gained health insurance. many for the first time in their lives. and the uninsured rate declined from a high of 18% before the affordable care act to a low of less than 11%. now, keep in mind, from the outset of the trump administration, the effort was to repeal and replace the affordable care act. the umpteen times that my colleagues on the other

side of the aisle tried to repeal the affordable care act. they could never find a way to replace it. ultimately they failed legislatively to repeal and replace the affordable care act. so what have they done subsequently? they move through the appropriations bills and they cut back. they work to do away with the cost sharing subsidies for the insurance companies which drives the cost up. they say no to the navigators, to help people go through the -- through the system and understand insurance. i'll bet everyone in this institution has somebody who explains an insurance policy to them. so therefore i just finish this and say, let's defeat this amendment because it is just one more attempt to sabotage the affordable care act. i yield back. the chair: the gentlelady yields back the balance of her time.

the gentleman from arkansas is recognized. mr. hill: may i inquire how much time i have remaining? the chair: 30 seconds. mr. hill: thank you very much. let me simply say that simply put, $768 per enrollee, the navigator program is a waste of taxpayer resources. with an ever-shrinking budget pressure, we're better off spending this money on n.i.h. research or doing something that will help the long-term health as my friend dr. roe was interested in, drug abuse, mental health, those are the those are a better use of this money. thank you, madam chair, i yield back the balance of my time, i urge a yes vote on the amendment. the chair: the question is on the amendment offered by the gentleman from arkansas. those in favor say aye. those opposed, no. in the opinion of the chair, the noes have it. for what purpose does the gentleman from texas rise? mr. cloud: i request a recorded vote. the chair: i hear your request. pursuant to clause 6 of rule 18,

further proceedings on the amendment offered by the gentleman from arkansas will be postponed. it is now in order to consider amendment number 38 printed in art b of house report 116-109. for what purpose does the gentleman from arkansas seek recognition? mr. hill: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 38 printed in part b of house report 116-109, offered by mr. hill of arkansas. the chair: pursuant to house resolution 431, the gentleman from arkansas, mr. hill, and a member opposed, each will control five minutes. the chair now recognizes the gentleman from arkansas. mr. hill: i thank the chairism appreciate that. i'd like to return to the topic today of apprenticeships that are so important to our work force across this country.

asks portionsould of the bill that spend hundreds of millions of dollars to only support department of labor internship brams, a stipulation that has not been in place in previous bills regarding apprenticeship grant funding. so let me be clear. i support department of labor registered apprenticeship programs. i'm not here to speak ill of those programs because they do a good job of equiping workers across the country with skills they need to be successful. but i am here because i have a problem with the congress telling the american public that the only way to fill the skills gap and create opportunities is through government-define aid prenticeship programs. right now our economy is facing an enormous skilled work force shortage. according to the department of labor, there are 7.4 million job

vacancies. with our continued economic prosperity, that number will only grow. i speak with businesses in my district on a regular basis and in all sectors. many would like to expand, create new jobs, but a consistent message, madam chair is they are not able to because they cannot find workers with he necessary skills. it's an unfortunate fact that registered internship programs come up short of adequate skills for our entire work force. for example, in the construction industry that uses more registered internship programs than any other industry, only 26,000 people graduated from a registered internship program in 016. nearly the construction industry ememployed 7.5 million people

which means less than 1% of the workers in that program went through a registered apprenticeship program. economic estimates have the number of current job openings in construction at 444,000 in total. so if we were to rely only on register apprenticeship programs, it would take 17 years to fill those openings, madam chair. that's why this amendment is so important to offer flexibility and to let other industry-related apprenticeship programs also get grant funding. we're not denying registered apprenticeship grant funding, we're just saying nonindustry registered grant funding should be effective. they're safe, efficient, result in stackable, affordable credentials. i'd like to call on my friend from kentucky, andy barr, a member of the house services committee, a man who chairs the

republican study committee work on work force and ask him for his views. i yield the gentleman one minute. the chair: the gentleman is recognized. mr. barr: i thank my friend, the gentleman from arkansas, for his leadership on this very important issue, providing employers with flexibility. we want to support department of labor registered apprenticeships but we need employers to be able to fill these job open wgs skilled workers using ai prenticeships that are tailored for the jobs that are available. when i visit the employers in central and eastern kentucky, they all tell me the same story. because of tax cuts and deregulation, the economy is booming, they are creating jobs, but they can't find workers. there is a labor supply shortage in this country and we need more skills. the bureau of labor statistics reports that labor force participation among prime age men dropped from 4% to a rate of 71.5%. we've got to get that labor

participation rate up and because of that we need skills. that's why i'm proud as chairman of the republican study committee's american worker task force to support the hill amendment which would allow federal grant funds to be used for apprenticeship programs that are not just d.o.l. registered programs. not just d.o.l. registered programs but apprenticeship programs tailored by employers for those particular jobs. so while the economy does need to utilize d.o.l. apprenticeship programs, not all -- not a one size fits all solution is the answer. many employers need specific tailored apprenticeship programs. i urge support for the gentleman's amendment and i yield back. the chair: the gentleman reserves. the gentlelady from connecticut is recognized. ms. delauro: -- the chair: for what purpose does the gentlelady seek recognition? ms. delauro: i rise to claim time in opposition. the chair: the gentlelady is recognized.

ms. delauro: this amendment would open up scarce federal dollars to untested and unproven nonregistered apprenticeship programs. in fiscal year 2016, the labor-hhs subcommittee established funding for the apprenticeship grant program which has been expanding work-based learning programs in in-demand industries through registered apprenticeship. a proven strategy for meeting the yeeds of the nation's work force and employers simultaneously. the model has been expanding rapidly over the last several years. it's gone from -- it's grown 56% since 2016. in diverse careers like software development, insurance agencies. according to the dotcht labor more than 3,000 new apprenticeship programs were established in fiscal year 2018 air loan. to further this important work, the underlying bill provides an

uns pretented $250 million investment in register aid prenticeship programs. a $90 million increase over last year. yet, instead of supporting and investing in a tried and true program, amendment would roll back worker protections and quality assurances. wasting millions of federal dollars on an entirely duplicative system called i.v. -- ira. industry recognized apprentice ship pram programs. i've spoken with some of the industry groups, represented on the president's task force, and frankly i hear a different story. they like the registered model. during a panel discussion i held on apprenticeships, brinth gaynor, vice president of aeon commented on the ease of registration, saying, quote, it was not an overly -- overwhelmingly or overly onerous

process. a former staffer at the department of labor and education who was now with new america wrote an excellent piece in inside higher ed on the risk of the trump administration's plan to deregulate apprenticeships. she said, and i quote, rather than focus its efforts on growing our small but high performing system of registered apprenticeship, eadministration has opted for building an entirely new system of industry-recognized apprenticeship programs or ira. these iraps have little or no accountability, much like the predatory for-profit colleges. the inside higher education piece makes that point, quote, the administration is copying the system used to ensure quality in the lowest performing and most fraud-ridden sector of higher education. a system that's repeatedly failed to protect students and taxpayers. for its new approach to

apprenticeships. one federal dollars are on the lie, the risk and scale of potential harm increase exponentially. we should be focusing federal dollars on expanding the existing system that's working for employers and for apprentices alike. and not only a confusing due public -- coupely cat system. i urge my leagues to vote no on this amendment and i reserve the balance of my time. the chair: the gentlelady reserves. the gentleman from arkansas is recognized. mr. hill: may i inquire how much time? the chair: you have 30 seconds. mr. hill: i appreciate the in-demand job work the committee has put in place in the bill and that's wonderful. i appreciate my friend from connecticut's passion nor topic. i share it. i support d.o.l.-supported apprenticeships, that has nothing to do with it. this simply says we strike the word only. and that if there's a gap somewhere in a local economy in this country we have the flexibility to have an industry apprenticeship receive a grant.

this is supported by the associated buildings and contractor, general contractor, equipment manufacturers, electrical contractors, roofing contractors. i would like to put their letters in the record, if i might, madam chair. the chair: without objection. mr. hill: i urge a yes vote to offer flexibility for contract apprenticeships across this country and i yield back. the chair: the gentleman yields back. the gentlelady from connecticut is recognized. ms. delauro: can i ask how much time? the chair: a minute and a half. ms. delauro: ok. my republican colleagues talk about a need for fiscal restraint, government waste, the problem of duplication. many will oppose the underlying bill claiming fiscal responsibility. but now they are offering an amendment that is the antithesis of fiscal restraint. let's be clear. iraps are duplicative, promote government waste this would open up federal resources to support a program that does not exist. there are no iraps. the dotcht labor has yet to

produce any binding definition of what these programs are or what they will do. it's easy to make promises when you do not have to deliver. reg sfered apprenticeship programs do, currently are delivering. that's why in a bipartisan fashion congress increased funding year after year in testing, proven model. if the gentleman and my club republican colleagues want to support work force development they can work in favor of the underlying bill that prvidse millions for states to train dislocated workers. i have a feeling they will not. like the trump administration's proposed irap they support work force development in name only. i urge my colleagues to vote no on this amendment. we have many supporters of this effort. north american building trade union. united association of plumbers and pipe fitters. afl-cio. international union of operating engineers. national electrical contractors association. new america.

international union of painters and allied trades. laborers. union of north america. vote no on this eafment i yield back. the chair: the gentlelady yields back. the question is on the amendment offered by the gentleman from arkansas. those in favor say aye. those opposed, no. in the opinion of the chair, the noes have it. mr. cloud: madam chair. the chair: for what purpose does the gentleman from texas seek recognition? mr. cloud: i request a recorded -- a recorded vote. the chair: i hear your request and pursuant to clause 6 of rule 18 further proceedings on the amendment offered by the gentleman from arkansas will be postponed. it is now in order to consider amendment number 39 printed in art b of house report 116-109. for what purpose does the gentlelady from massachusetts seek recognition?

ms. pressley: i rise as designee of the -- the chair: do you have an amendment at the desk? ms. pressley: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 39 printed in part b of house report 116-109 offered by ms. pressley of massachusetts. the chair: pursuant to house resolution 431, the gentlewoman from massachusetts, ms. pressley, and a member opposed each will control five minutes. the chair now recognizes the gentlewoman from massachusetts. ms. pressley: thank you, madam chair. i rise as the designee of the gentlewoman from california. i not only rise in strong support of this amendment proposed by my colleague, congresswoman speier, but i rise today as a survivor of sexual violence. let me be clear, every single survivor of sexual assault and sexual violence deserves justice and deserves healing. for far too long we have made excuses about a culture that

tolerate violence, and justice has been delayed. we are fighting to change that. we are speaking up, standing up, speaking out to demand we end an intolerant rape culture. . the program has been woefully ignored and underfunded. our amendment increases critical funding and puts us one step closer to treating sexual assault as the public health crisis that it is and using a public health frame to attack the systemic issue, can have a transformtific impact on the lives of women and men and nonbinary individuals affected by sexual violence. our prevention aproaches must be grounded in data and the lived experiences of our constituents. we must teach consent, promote understanding and reshape the status ghow our workplaces, our households and our schools. to my survivor tribe, we hear you. we see you. we are fighting for you and this one is for you. i thank the gentlewoman from california for her partnership on this issue and i yield the

remainder of my time to the gentlelady from connecticut. the chair: the gentlelady is recognized. ms. delauro: i thank the gentlelady and thank the chair. i rise in support of this amendment. i would note the underlying bill under consideration tonight includes a 10% increase, $5 million, for rape prevention and education activities at the centers for disease control and prevention. as the increase in our bill highlights, i'm a strong supporter of this program. we must stop sexual violence before it begins. this amendment would add an additional increase of $5.57 million. i commend my colleagues for bringing further attention to this scourge that still exists in our society today. and puts women at grave risk. it's an important program so that we can look at and address and prevent sexual violence. i urge my colleagues to vote yes on this amendment. yield back.

ms. pressley: i yield back. the chair: the gentlelady yields back the balance of her time. does anybody seek time in opposition? all right. the question is on the amendment offered by the gentlelady from massachusetts. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. mr. roy: madam chair. the chair: for what purpose does the gentleman from texas seek seek recognition? mr. roy: i request a recorded vote. the chair: i hear your request. pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentlelady from massachusetts will be postponed. it is now in order to consider amendment number 40 printed in part b of house report 116-109. for what purpose does the gentleman from california seek recognition?

mr. khanna: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 40 printed in part b of house report 116-109 offered by mr. khanna of california. the chair: pursuant to house resolution 431, the gentleman from california, mr. khanna, and a member opposed each will control five minutes. the chair now recognizes the gentleman from california. mr. khanna: thank you, madam chair. i have a bipartisan amendment with the gentleman from ohio, mr. gonzalez. today's amendment adds $3 million to the national institute of allergy and infectious disease with the intent to support the consortium of food allergy research. as you know this consortium drives vital research necessary to fight innumerable conditions and diseases suffered by millions of americans. it is foundational to so much of our medical breakthroughs and competitive advantage. key to one of their missions is food allergies.

food allergies afflict 32 million americans and almost six million children. that's nearly 10% of the country battling at some point with food allergies. food allergies do not just consist of sensitivity to certain kinds of food. that's a myth. many times they can be life-threatening. in fact, 40% of children with food allergies have experienced severe reaction known as an flackses i and 200,000 americans each year require emergency medical care. a glance through facebook pages or support pages will detail many of the sad and scary stories. this is equivalent to one trip to the emergency room every three minutes. and the problem continues to grow. the prevalence of food allergies has increased by 80% in the last two decades with peanut and tree nut allergies appearing to be more than triple in the years in the 19 -- than the 1990's. we really don't know yet why

that is happening. in 2005 n.i.h. established could he far -- co-far to focus on these efforts? just 14 years it has made terrific advances, discovered jeans associated with an increased risk for peanut allergy and also identified promising cures for peanut allergy and egg allergy immunothey are pill. i want to -- immunotherapy. i want to absolute the staff. an egg treatment allowed reintroduction of eggs into diet after years of be a stention. it has achieved all of this on a budget of just $6.1 million. increasing it $3 million is well worth the investment. just think of all the families who could be made better by this , their fear of sending their children to school or to a neighbor's house or to daycare without knowing the consequences

could be alleviated. we're a long way away still but i believe someday we can prevent life threatening food allergies. this amendment brings us closer to that day. i want to yield one minute of my time to the gentlelady from -- or the gentlelady from california. i know the gentlelady from california very well who is stepping in. great admirer of hers, representative barbara lee. the chair: the gentlelady from california is recognized. ms. lee: thank you very much. i thank the gentleman for yielding. i rise in strong support of this bipartisan amendment. recent research has found that food allergies are far more common in the united states than previously thought. and the prevalence has been increasing in the last two decades. food allergies can cause severe reactions and can even be deadly. allergic reactions to food lead for this than 200,000 emergency room visits each year. the consortium of food allergy research at the national institute of allergy and

infectious diseases is supporting research to identify the causes of and treatments for food allergies. the proposed funding increase will allow this critical research to continue and to accelerate. i urge my colleagues to support this amendment and i thank the gentleman from california again for offering it. the chair: does the gentleman reserve? mr. khanna: i reserve. the chair: the gentleman from -- does the gentleman from ohio seek recognition? mr. gonzalez: yes. i claim time in opposition although i do not oppose the amendment. i rise in support of this amendment and am proud to work with my colleague, representative khanna, in the effort to increase research funding for food allergies. when my colleague asked know join his efforts, i could not help but think of my 1-year-old son and his probability of developing an allergy later in life. the c.d.c. reports the prevalence of food allergies in children increased by 50% between 1997 and 2011.

in recent years we have seen the prevalence of peanut or tree nut allergy more than triple in american children. the food allergy research and education, also known as fara, estimates five million children and more than 32 million americans have food allergies in the u.s. furthermore, state by state data shows that in my state of ohio, foodaler jiss increased by 169% 2016.009 to eggs, peanuts, shell fish and tree nuts were the most. about half of the food allergies occurred in kids under 13. clearly we need to do more to find the scientific causes for this spike in allergies. our amendment is a step in the right direction. last year a local foundation, the alison rose foundation in northeast ohio, was launched to education the public about the real risks of food allergies can pose on individuals who suffer from it. the foundation was established in the name of alison rose, a

young college student who died as a result of a reaction due to her peanut allergy. i urge my colleagues to support this bipartisan amendment, to increase research for food allergies, and help us prevent future tragedies like alison rose. with that, i yield back the balance of my time. the chair: the gentleman from ohio yields back. the gentleman from california is recognized. mr. khanna: i one of the would like to recognize -- i just would like to recognize the gentleman from ohio, mr. gonzalez, for his leadership, his willingness to work across the aisle on this and his passion for this issue and i appreciate the leadership of representative delauro as well and their staffs. i yield back the balance of my time. the chair: the gentleman yields back the balance of his time. the question is on the amendment offered by the gentleman from california. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. for what purpose does the gentleman from texas seek recognition? mr. cloud: i request a recorded vote.

the chair: i yet again hear your request and pursuant -- and pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentleman from california will e postponed. it is now in order to consider amendment number 41 printed in art b of house report 116-109. for what purpose does the gentleman from louisiana seek recognition? ms. richardson: -- mr. richmond: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 41 printed in part b of house report 116-109 offered by mr. richmond of louisiana. the chair: pursuant to house resolution 431, the gentleman from louisiana, mr. richmond, and a member opposed each will control five minutes. the chair now recognizes the gentleman from louisiana. mr. richmond: thank you, madam

chairwoman. first let me start off by introducing into the record a harvard public health journal which is titled america is failing its black mothers. with that i rise today with an amendment to increase funding for state maternal health innovation program by $7 million. this program is specifically tasked with reducing care gaps and reducing maternal mortality and the disparities in maternal health. the united states is the greatest country in the world. with the most innovative health care system around. and we continue to develop cutting edge treatments that stretch the bounds of what's possible. within the last two decades, we've mapped the human gee known, conducted -- genome, conducted surgeries over the internet and grown organs out of stem cells. we've cured diseases and revolutionized treatments. despite all that progress, more of our mothers and mothers-to-be are dying today than were at the turn of the century. somehow we've seen our maternal mortality rate increase over the past 25 years and preventable

near-deaths related to pregnancy have increased over 200%. the statistics are shocking and the reality for black mothers is a crisis. black mothers in louisiana are now four times more likely to die than white mothers. the rate of black maternal deaths is closer to the rates in developing countries than the nations we usually compare ourselves to. with our vast resources and advanced technology, these deaths are unacceptable. this is a problem that demands our immediate attention. that's why i'm here today with this amendment. with this increased funding, more states can implement programs to improve the care that mothers receive. more families can remain whole and more children can grow up ith their mothers. i'll reserve the balance of my time. the chair: the gentleman reserves the balance of his time. does anyone seek time in opposition? the gentleman from louisiana is recognized.

mr. richmond: madam speaker, i'd yield one minute to the gentlewoman from california, ms. barbara lee. the chair: the gentlewoman is recognized. ms. lee: thank you very much. first, let me thank the gentleman for yielding and for this amendment. i rise in strong support of this amendment. more women die from pregnancy-related complications in the united states than any other developed country. there are major disparities, for example, black women are three to four times more likely than white women to die during pregnancy or child birth. i was proud to support a new initial toive address maternal mortality in the fiscal year 2019 appropriations act. this amendment will enable the bureau to expand support for state maternal health innovation grants which fund evidence-based state-led demonstrations to improve maternity care service delivery and ultimately reduce maternal mortality. i urge my colleagues to support this amendment and i yield back

the balance of my time and thank the gentleman for offering this tonight. the chair: the gentleman from louisiana. mr. richmond: if there are no other speakers, i'm prepared to close. madam speaker, let me just say, simply put, for black women, far more than for white women, giving birth can amount to a death sentence. when black women express concern about their symptoms, clinicians are more delayed and seemed less likely to believe them. the question becomes, whether it's clinical intuition versus unconscious

if we look around the country and we see the complications from motherhood for african-american women, you can look at serena williams, you can look at beyonce, you can look in my household, you can look at ashley mitchell whose funeral i went to just this past weekend. this is a crisis. we have the ability to overcome it. we are america, we do great things when we put our mind to it. and this amendment simply asks this body to put our mind to maternal health, especially for african-american women. but for all women in this country, to make sure that the best thing about womanhood and the ability to give birth does not become a death sentence. with, that i would ask everyone's support and i yield back the balance of my time. the chair: the gentleman yields back the balance of his time. the question is on the amendment offered by the gentleman from louisiana. those in favor say aye. those opposed, no. in the opinion of the chair, the ayes have it. for what purpose does the gentleman from texas seek recognition? mr. cloud: i request a recorded vote. the chair: i hear your request. pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentleman from louisiana will be postponed. it is now in order to consider

amendment number 42 printed in part b of house report 116-109. for what purpose does the gentleman from indiana seek recognition? mr. banks: thank you, ma tam chair, i have an amendment at the desk. the chair: the clerk will dez egg nate the amendment. the clerk: amendment number 42 printed in house report 116-109, offered by mr. banks of illinois indiana. the chair: pursuant to house resolution 431, the gentleman from indiana, mr. banks, and a member opposed each will control five minutes. the chair now recognizes the gentleman from indiana. mr. banks: thank you, madam chair. i yield myself such time as i may consume. thunder division, madam chair, we are looking at spending $189.9 billion for fiscal year 2020. $11.8 an increase of billion over the 2019 enacted level and 47.9 billion dollars

above the president's qufment with $22 trillion in debt and trillion dollar deficits for as far as the eye can see, it is long past time for congress to start making the difficult decisions necessary to balance the budget. if we do not confront this problem, we will condemn future generations to higher taxes and a lower standard of living. as a father of three daughters, this is simply unacceptable to me. madam chair, my amendment reduces the funds made available for each amount in division a of h.r. 2740 by 14%. this would reduce total appropriations in this division down to budget control act levels. as chairman of the republican study committee task force on budget and spending, i am proud to have worked with eight of my colleagues on the only serious

effort in this congress to confront our debt crisis. the result was a budget that cut $12.6 trillion in spending and balanced in six years. an important part of the budget was bringing nondefense discretionary spending down to commonsense levels. my amendment before the house today would help make those reductions a reality. adoption of this amendment would show we acknowledge our spending adiction and are taking the necessary first steps to address it. pass this commonsense amendment and rein in spending of taxpayer dollars. i reserve the balance of my time. the chair: the gentleman reserves. for what purpose does the gentlelady from california seek recognition? >> i rise to claim time in opposition to the amendment. the chair: the gentlelady is recognized. mrs. lee: this amendment would cut funding for important programs and services that provide opportunities for working families. many of these programs are already underfunded and fail to

meet the existing need. for instance, the amendment would cut head start by more billion, denying help to 80,000 children we are trying to provide with access to high quality early learning programs as well as rejecting our proposal to include funding for trauma-informed care, critical for children affected by the opioid crisis. this amendment would cut after school programs by $185 million, taking away enrichment opportunities for roughly 222,000 students. it would cut title i fund $2. billion reducing resources for an estimated 25 million students in high poverty schools. it would cut the number of new and competing research grants at n.i.h. by approximately 87% which is over 10,000 fewer new research grants. it cuts tens of millions of

nutrition tissue nutritious meals for more than two million low income seniors. also this amendment would close social security field offices in every district while worsening wait times for in-person service, phone services and exacerbating the disability hearings backlog. it would also cut federal work study programs by $200 million, resulting in 114,000 fewer awards to students. the sponsor of the amendment cites the national debt as a reason to cut funding for programs that benefit working families but i note that he did vote for the republican tax scam which added more than $2 trillion to the national debt by cutting taxes for big corporations and the wealthiest families. my republican colleagues don't object to adding to the debt then it benefits corporations and the wealthy. they only object to it if it mean prossviding opportunities for hard working families. i strongly oppose this amendment

and i reserve the balance of my time. the chair: the gentlelady reserves. the gentleman from indiana is recognized. mr. banks: the democrat majority promised the american people before the last election that they would produce a budget. they have failed the very basic first step in failing to do so. without putting a budget on the floor of the house of representatives, showing the american people the priorities of the democrat majority, we can only assume that the democrat majority has no interest in balancing the budget. that being the case, my amendment is a very basic first step toward doing just that. my daughters are 9, 7, and 6 years old. they're the ones who will be holding the bag for the lack of leadership in this congress who refuses to address the issue that's staring us in the face, a $22 trillion national debt. madam chair, i reserve the balance of my time. the chair: the gentleman reserves. the gentlelady from california

is recognized. mrs. lee: this amendment would cut $25.6 billion from programs that fund schools, pell grants, community health centers, substance abuse prevention and treatment, biomedical research, the c.d.c., childcare and early childhood learning programs. also, job training. as well as agencies that protect workers and workplaces. among so many other programs that provide opportunities to low and middle income families. the amendment is totally misguided and it will harm tens of millions of americans. i strongly oppose it. i urge a no vote. and i yield back the balance of my time. the chair: the gentlelady yields back. the is recognized. mr. banks: hoosiers sent me to washington, d.c. to do something about just this. the spin, spin, spin mantra of members of congress for many decades in the past has got to come to an end now.

that's why this amendment, a commonsense amendment, to cut spending in this appropriations package by 14% is a necessary step toward balancing the budget. that's why i'm here. i am committed to being tireless in my pursuit of a balanced budget. madam chair work that, i'm prepared to close. the chair: the gentleman is recognized. mr. banks: madam chair, as i said already before, we have a $22 trillion national debt. this division spends $189.9 billion which is an increase of $11. billion over the 2019 enacted levels. and $47.9 billion more than the president's request. if congress does not confront this problem head on and exercise fiscal discipline, we are robbing our children's children of their future.

i thank the chairwoman and i yield back. the chair: the gentleman yields back. the question is on the amendment offered by the gentleman from indiana. those in favor say aye. those opposed, no. the noes have it in the opinion of the chair. for what purpose does the gentleman from texas seek recognition? mr. cloud: you'll be surprised that i'm requesting a recorded vote. the chair: i hear your request. pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentleman from indiana will be postponed. it is now in order to consider amendment number 43 printed in art b of house report 116-109. for what purpose does the gentleman from massachusetts seek recognition? mr. keating: i have an amendment at the desk. the chair: the clerk will designate the amendment. the clerk: amendment number 43 printed in part b of house report 116-109, offered by mr.

keating of massachusetts. the chair: pursuant to house resolution 431, the gentleman from massachusetts, mr. keating, and a member opposed, each will control five minutes. the chair now recognizes the gentleman from massachusetts. mr. keating: thank you, madam chair. with every study, every research paper, every scientific breakthrough, we've come to understand that most americans realize that there's more to health care than those who are sick and those who aren't. health care cannot simply be treated by those who are -- really we can't just focus our treatment by those who are unwell. it's shortsighted strategy and unfortunately, the one this country had been employeing for far too long before the affordable care act. why would we only try to treat the problem once it's already occurred, when we can work to prevent it in the first place? the keys to prevention are healthy living environment and

swift access to care helping us deal with health care issues before they become acute. and this approach will save money. with that in mind, i'm offering my amendment to appropriate funds to study how to help bring social and behavioral programs under the same group as our traditional health care providers. we know there's a link between healthy live, house, and food security. we already allocate funds to help facilitate healthy living. why don't we house them in the same place we're housing these health centers. this works, i've seen it. a holistic approach like this will demonstrate to those in rural, underserved or underprivileged communities that no matter how seemingly dire their situation is, there are paths to healthy living. sadly, we see daily reminders that where someone is born or where they live can determine so much in their lives. my home state of massachusetts is a leader when it comes to

health care, but it's not without its own disparities. in some corners of my district, the average life expectancy is less than 70 years of age. elsewhere in the commonwealth, it can be over 90 years old. there's no easy answer to why that's the case. it's a combination of means, education, environment, and access to health care. clearly there needs to be more progress. education and access to information can help lift people into healthier circumstances. health cent verse specialists who have experience dealing with staff and w.i.c., more families would receive nutritional advice, more young mothers would raise healthier babies in those centers if we had people who could help with housing concerns we'd be able to get more people into stable shitch situations and off strait corners and away from homelessness. for those dealing with brain diseases like addiction, integrating mental health services can help improve access

to comprehensive treatment. in my district, i've seen firsthand the great work done by the great community health center in massachusetts where they try to incorporate these successfully, actually, incorporate these services that impact social detriments of human -- of health care. all under one roof. i'm also excited to note that this coming friday, the outer cape health services is reopening and expanding and a comprehensive health care center in welds lee -- wellesley to better serve an underserved rural community. over 90 minutes away from the closest hospital. nationwide, existing resources can only get us so far. we're on the verge of a break through and we need to find out how congress can take us beyond this tipping point. that's why my amendment is important. we need to know how much our health centers need to plan and what they need to successfully