21st Century Cures Bill

Floor Speech

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Mr. President, we are winding down the final days of the 114th Congress, and some of the work we have been engaged in is coming to fruition.

I spoke to the chairman of the Environment and Public Works Committee, who told me he thought the WRDA bill--the water resources development bill--was coming together and would likely be voted on in the House tomorrow.

I believe that Senator McCain and Chairman Thornberry in the House-- the Armed Services Committee--have a national defense authorization bill that on Friday will be voted on in the House and then will be coming over here to the Senate.

We know that we have to, by the December 9 deadline, pass an appropriations bill that will keep the lights on for the Federal Government for an undetermined, at this point, period of time, probably sometime into next spring, when we will have a new President and a new administration.

This afternoon in the House, they are going to be voting on another important piece of legislation that I wanted to talk about briefly. It is called the 21st Century Cures Act. This has been a product of a lot of methodical and very deliberate hard work on both sides of the aisle in both Chambers, and it will make a big difference in the lives of Americans because it will help make our country healthier and stronger.

As its name suggests, it will help develop medical treatments and cures for some of the most tragic health problems facing families today. Recently, I was at the 75th anniversary celebration at the MD Anderson hospital in Houston, TX, and it is the premier cancer facility in the country. Some time ago, the hospital started their own MD Anderson Moon Shots Program and is doing all that it can do to study and research various forms of cancer with the goal to eliminate cancer as a public health threat. Of course, we know that Vice President Biden, who was part of that 75th anniversary celebration at MD Anderson in Houston, and this administration have their own Cancer Moonshot Program to help eliminate cancer, and that will also be part of this 21st Century Cures bill. The whole idea of the Moonshot, even to the current generation, reminds us that at one time we thought putting a man on the Moon was impossible, outside the realm of possibility, but because of a vision and because of a commitment and a desire to push the bounds of our capabilities, they persevered and we found a way. MD Anderson's Moon Shots Program serves as another example of American ingenuity, ambition, and dogged determination to make the lives of our families and the future generations better than our own.

Fortunately, as I said, this Cures bill the House will be voting on today, which we will vote on next week, will provide funding for cancer and Alzheimer's research, among other terrible diseases, so that the best medical community in the world can help make great strides in fighting them.

This legislation will also fund the battle against opioid abuse, prescription drug abuse--something we have discussed a lot here on the floor during the last year because of the devastation that it has brought about in many parts of the country. Of course, we know that when the opioids aren't available, cheap heroin imported into the United States from south of our border is part of that scourge as well.

Overdoses and the abuse of opioid drugs are tearing families apart. This bill will provide additional grant funding to States to combat it and to help people who are already in the grips of this terrible addiction to find a way to freedom.

I am particularly glad that this legislation includes bipartisan mental health reforms that I introduced in this Chamber last year, known as the Mental Health and Safe Communities Act. I want to express my gratitude to Senator Alexander, Senator Murray, and others on a bipartisan basis and bicameral basis for working with us to make sure we include mental health reform as a component of the 21st Century Cures legislation.

We all know that mental health problems are something that American families have to deal with. I dare say there is probably not a family in America that doesn't have to deal with this in some way or another-- either at work, with people you go to church with, or with people you live next door to. In some way or another, mental health problems are rampant.

A lot of that has to do with well-intended but unintended consequences of deinstitutionalization of our mentally ill back in the 1990s. The idea was that it was not appropriate to institutionalize people with mental illness, and so we ought to deinstitutionalize them. But we contemplated that there would be some sort of safety net after they went back to their communities where they could get treatment and where they would get the care they needed. Unfortunately, what has happened and what my legislation is designed to address is that our jails have become the de facto default mental health treatment facilities in this country.

I recently was at a meeting of a large county sheriffs association in Washington, DC, and a friend of mine, the current sheriff of Bexar County, TX, Sheriff Pamerleau, said: How would you like to meet the largest mental health provider in America? I said: Well, sure.

She walked across the floor and introduced me to the sheriff of Los Angeles County, who runs the Los Angeles County jails. You get my point. We are warehousing people in jails and other places and not giving them the treatment they need in order to get their basic underlying problem taken care of. Of course, people with untreated mental illness frequently engage in petty crimes--trespassing and other things--which end them up in jail. But if they don't get treated, they are going to stay in that turnstile and keep coming back.

We all know the problem of homelessness in our streets. You walk down the street in Washington, DC, or any city in the country--such as Austin, TX--and you see people who have obvious symptoms of mental illness who are not being treated. What this legislation does is to provide a pathway to treatment, primarily by using preexisting appropriations to make grants to our States and local communities so they can deal with these using the very best practices in the country.

For example, the Federal Government already spends about $2 billion a year on grants to State and local law enforcement. Doesn't it make sense to prioritize dealing with these mental health problems and particularly with the best practices in places such as San Antonio, TX, where the mental health community and law enforcement and other leaders have come together to try to come up with a program to divert people with mental illness to treatment and to provide additional training to law enforcement, to deescalate some of the conflicts that occur--for example, when the police show up and confront somebody with obvious mental illness. If the police don't get the kind of training they need, then that could end up in a tragedy, either for the person being arrested or for the police officers.

It is really important that we deal with this in a sensible way, and this legislation helps to do that--again, using some of that $2 billion in grant funding we give to State and local law enforcement but prioritizing and authorizing some of the very best practices occurring in communities around the country so that more people can benefit from these programs.

This also provides families additional tools. For example, if you have a family member who is suffering from severe mental illness--let's say they are an adult--there is not a whole lot you can do about it if they refuse to seek treatment or comply with their doctor's orders. There is a means--a very difficult means--for temporary institutionalization. For example, you have to get a doctor's order and then go to court and get somebody put in a State hospital or an institution, but they are not there forever. They may be there for 30 days or so, until their symptoms abate because they are complying with their doctor's orders and taking their medication.

The great news in mental health treatment is there are a lot of miraculous treatments, and if the person afflicted with mental illness will comply with their doctor's orders and take their medication, they can lead relatively normal and productive lives. But the great problem is that so often people refuse to take their medication. They start feeling better. They quit, and they become sicker and sicker, until they become a danger both to themselves and the community.

One of the things this legislation does is to provide an additional procedure, called assisted outpatient treatment, which gives local courts and civil courts the authority to consider a petition whereby a family member can come in and say: My son, my daughter, my husband, my relative is having serious problems with their mental illness and they are noncompliant with their treatments. Judge, will you please enter an order, which essentially is like probation, saying that periodically you have to come back and report to the court on your compliance with the order, but part of that is to follow your doctor's orders and to take your medication. I am not saying it is a panacea, but it provides family members another tool when their loved ones become mentally ill and when there are no good options for the family members to assure that they will get the treatment or remain compliant with their doctor's orders by taking their medication.

I applaud the House for taking up these critical reforms. I know Congressman Tim Murphy has worked on this long and hard in the House.

There are a lot of other people who have worked on this mental health reform. In this Chamber, Senator Bill Cassidy has been a champion and Chris Murphy, among others. Really, the persons who have gotten us this far--there are two of them--are Senator Alexander and Senator Murray, the chairman and the ranking member of the HELP Committee. But it has taken a bipartisan, bicameral effort to try to get us to this point, and I am glad that we will be voting on this next week, after the House passes it today.

With that, I yield the floor.

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