[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2260 Reported in House (RH)]

                                                 Union Calendar No. 229

106th CONGRESS

  1st Session

                               H. R. 2260

                  [Report No. 106-378, Parts I and II]

_______________________________________________________________________

                                 A BILL

 To amend the Controlled Substances Act to promote pain management and 
palliative care without permitting assisted suicide and euthanasia, and 
                          for other purposes.

_______________________________________________________________________

                            October 18, 1999

 Reported from the Committee on Commerce with amendments, committed to 
the Committee of the Whole House on the State of the Union, and ordered 
                             to be printed





                                                 Union Calendar No. 229
106th CONGRESS
  1st Session
                                H. R. 2260

                  [Report No. 106-378, Parts I and II]

 To amend the Controlled Substances Act to promote pain management and 
palliative care without permitting assisted suicide and euthanasia, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 17, 1999

    Mr. Hyde (for himself, Mr. Stupak, Mr. Aderholt, Mr. Baker, Mr. 
Ballenger, Mr. Barcia, Mr. Barton of Texas, Mr. Blunt, Mr. Bryant, Mr. 
 Burr of North Carolina, Mr. Burton of Indiana, Mr. Canady of Florida, 
 Mr. Chabot, Mr. Coburn, Mr. Collins, Mr. Cunningham, Mr. Dickey, Mr. 
  Doolittle, Mr. Doyle, Mrs. Emerson, Mr. Everett, Mr. Fossella, Mr. 
  Graham, Mr. Goode, Mr. Goodlatte, Mr. Hall of Texas, Mr. Hayes, Mr. 
 Herger, Mr. Hoekstra, Mr. Hutchinson, Mr. Istook, Mr. John, Mr. King, 
  Mr. Knollenberg, Mr. LaFalce, Mr. LaHood, Mr. Largent, Mr. Lewis of 
 Kentucky, Mr. Lucas of Kentucky, Mr. Lucas of Oklahoma, Mr. McIntyre, 
  Mr. Miller of Florida, Mrs. Myrick, Mr. Nussle, Mr. Nethercutt, Mr. 
 Peterson of Pennsylvania, Mr. Peterson of Minnesota, Mr. Phelps, Mr. 
 Pickering, Mr. Pitts, Mr. Portman, Mr. Rahall, Mr. Rogan, Mr. Rogers, 
 Mr. Salmon, Mr. Schaffer, Mr. Sensenbrenner, Mr. Shimkus, Mr. Shows, 
 Mr. Skelton, Mr. Smith of Texas, Mr. Smith of New Jersey, Mr. Spence, 
  Mr. Stearns, Mr. Tancredo, Mr. Terry, Mr. Walsh, Mr. Wamp, and Mr. 
Weldon of Florida) introduced the following bill; which was referred to 
  the Committee on Commerce, and in addition to the Committee on the 
 Judiciary, for a period to be subsequently determined by the Speaker, 
 in each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

                            October 13, 1999

              Reported from the Committee on the Judiciary

                            October 18, 1999

    Additional sponsors: Mr. DeMint, Mrs. Northup, Mr. Bartlett of 
   Maryland, Mr. Calvert, Mr. Pombo, Mr. Hostettler, Mr. Armey, Mr. 
   English, Mr. Taylor of Mississippi, Mr. Hunter, Mr. Packard, Mr. 
 Ehlers, Mr. Barr of Georgia, Mr. Goodling, Mr. Watts of Oklahoma, Mr. 
Thune, Mr. Souder, Mr. Deal of Georgia, Mr. Kildee, Mr. Brady of Texas, 
  Mr. Radanovich, Mr. Hilleary, Mr. Gibbons, Mr. Moran of Kansas, Mr. 
  Coble, Mr. Hastings of Washington, Mr. LaTourette, Mr. Talent, Mr. 
Tauzin, Mr. Norwood, Mr. Jones of North Carolina, Mr. Oxley, Mr. Wolf, 
Mr. McInnis, Mr. Lipinski, Mr. Pease, Mr. Ryun of Kansas, Mr. Jenkins, 
 Mr. Hill of Montana, Mr. Costello, Mr. Sununu, Mr. Camp, Mr. Mascara, 
 Mr. Wicker, Mr. Watkins, Mr. Forbes, Mr. Hall of Ohio, Mr. Petri, Mr. 
 McIntosh, Mr. Taylor of North Carolina, Mr. Chambliss, Mr. Klink, Mr. 
  Simpson, Mr. Diaz-Balart, Mr. Tiahrt, Mrs. Kelly, Mr. Fletcher, Mr. 
Riley, Mr. Gutknecht, Mr. Latham, Mr. Whitfield, Mr. Crane, Mr. Bachus, 
 Mrs. Cubin, Mr. Barrett of Nebraska, Mr. Sweeney, Mr. Sam Johnson of 
 Texas, Mr. Upton, Mr. Cannon, Ms. Pryce of Ohio, Mr. Hefley, Mr. Gary 
   Miller of California, Mr. Vitter, Mr. Kingston, Mr. Combest, Mr. 
 Sessions, Mr. Cook, Mr. Callahan, Mr. Duncan, Mr. Ryan of Wisconsin, 
 Mr. Quinn, Mr. Bliley, Mr. Gallegly, Mr. Mica, Mr. Brown of Ohio, Mr. 
Green of Wisconsin, Mr. Bateman, Mr. Neal of Massachusetts, Mr. Lazio, 
Mr. Shadegg, Mr. Bilirakis, Mr. Isakson, Mr. Reynolds, Mrs. Fowler, Mr. 
            Berry, Mr. Weller, and Mr. Franks of New Jersey

                            October 18, 1999

 Reported from the Committee on Commerce with amendments, committed to 
the Committee of the Whole House on the State of the Union, and ordered 
                             to be printed
  [Omit the part struck through and insert the part printed in italic]

_______________________________________________________________________

                                 A BILL


 
 To amend the Controlled Substances Act to promote pain management and 
palliative care without permitting assisted suicide and euthanasia, and 
                          for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Pain Relief Promotion Act of 1999''.

 TITLE I--USE OF CONTROLLED SUBSTANCES CONSISTENT WITH THE CONTROLLED 
                             SUBSTANCES ACT

SEC. 101. REINFORCING EXISTING STANDARD FOR LEGITIMATE USE OF 
              CONTROLLED SUBSTANCES.

    Section 303 of the Controlled Substances Act (21 U.S.C. 823) is 
amended by adding at the end the following:
    ``(i)(1) For purposes of this Act and any regulations to implement 
this Act, alleviating pain or discomfort in the usual course of 
professional practice is a legitimate medical purpose for the 
dispensing, distributing, or administering of a controlled substance 
that is consistent with public health and safety, even if the use of 
such a substance may increase the risk of death. Nothing in this 
section authorizes intentionally dispensing, distributing, or 
administering a controlled substance for the purpose of causing death 
or assisting another person in causing death.
    ``(2) Notwithstanding any other provision of this Act, in 
determining whether a registration is consistent with the public 
interest under this Act, the Attorney General shall give no force and 
effect to State law authorizing or permitting assisted suicide or 
euthanasia.
    ``(3) Paragraph (2) applies only to conduct occurring after the 
date of enactment of this subsection.''.

SEC. 102. EDUCATION AND TRAINING PROGRAMS.

    Section 502(a) of the Controlled Substances Act (21 U.S.C. 872(a)) 
is amended--
            (1) by striking ``and'' at the end of paragraph (5);
            (2) by striking the period at the end of paragraph (6) and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(7) educational and training programs for local, State, 
        and Federal personnel, incorporating recommendations by the 
        Secretary of Health and Human Services, on the necessary and 
        legitimate use of controlled substances in pain management and 
        palliative care, and means by which investigation and 
        enforcement actions by law enforcement personnel may 
        accommodate such use.''.

                  TITLE II--PROMOTING PALLIATIVE CARE

SEC. 201. ACTIVITIES OF AGENCY FOR HEALTH CARE POLICY AND RESEARCH.

    Part A of title IX of the Public Health Service Act (42 U.S.C. 299 
et seq.) is amended by adding at the end the following section:

``SEC. 906. PROGRAM FOR PALLIATIVE CARE RESEARCH AND QUALITY.

    ``(a) In General.--The Administrator shall carry out a program to 
accomplish the following:
            ``(1) Develop and advance scientific understanding of 
        palliative care.
            ``(2) Collect and disseminate protocols and evidence-based 
        practices regarding palliative care, with priority given to 
        pain management for terminally ill patients, and make such 
        information available to public and private health care 
        programs and providers, health professions schools, and 
        hospices, and to the general public.
<DELETED>    ``(b) Definition.--For purposes of this section, the term 
`palliative care' means the active total care of patients whose 
prognosis is limited due to progressive, far-advanced disease. The 
purpose of such care is to alleviate pain and other distressing 
symptoms and to enhance the quality of life, not to hasten or postpone 
death.''.</DELETED>
    ``(b) Definition.--For purposes of this section, the term 
`palliative care' means the active, total care of patients whose 
disease or medical condition is not responsive to curative treatment or 
whose prognosis is limited due to progressive, far-advanced disease. 
The purpose of such care is to alleviate pain and other distressing 
symptoms and to enhance the quality of life, not to hasten or postpone 
death.''.

SEC. 202. ACTIVITIES OF HEALTH RESOURCES AND SERVICES ADMINISTRATION.

    (a) In General.--Part D of title VII of the Public Health Service 
Act (42 U.S.C. 294 et seq.), as amended by section 103 of Public Law 
105-392 (112 Stat. 3541), is amended--
            (1) by redesignating sections 754 through 757 as sections 
        755 through 758, respectively; and
            (2) by inserting after section 753 the following section:

``SEC. 754. PROGRAM FOR EDUCATION AND TRAINING IN PALLIATIVE CARE.

    ``(a) In General.--The Secretary, in consultation with the 
Administrator for Health Care Policy and Research, may make awards of 
grants, cooperative agreements, and contracts to health professions 
schools, hospices, and other public and private entities for the 
development and implementation of programs to provide education and 
training to health care professionals in palliative care.
    ``(b) Priorities.--In making awards under subsection (a), the 
Secretary shall give priority to awards for the implementation of 
programs under such subsection.
    ``(c) Certain Topics.--An award may be made under subsection (a) 
only if the applicant for the award agrees that the program carried out 
with the award will include information and education on--
            ``(1) means for alleviating pain and discomfort of 
        patients, especially terminally ill patients, including the 
        medically appropriate use of controlled substances;
            ``(2) applicable laws on controlled substances, including 
        laws permitting health care professionals to dispense or 
        administer controlled substances as needed to relieve pain even 
        in cases where such efforts may unintentionally increase the 
        risk of death; and
            ``(3) recent findings, developments, and improvements in 
        the provision of palliative care.
    ``(d) Program Sites.--Education and training under subsection (a) 
may be provided at or through health professions schools, residency 
training programs and other graduate programs in the health 
professions, entities that provide continuing medical education, 
hospices, and such other programs or sites as the Secretary determines 
to be appropriate.
    ``(e) Evaluation of Programs.--The Secretary shall (directly or 
through grants or contracts) provide for the evaluation of programs 
implemented under subsection (a) in order to determine the effect of 
such programs on knowledge and practice regarding palliative care.
    ``(f) Peer Review Groups.--In carrying out section 799(f) with 
respect to this section, the Secretary shall ensure that the membership 
of each peer review group involved includes one or more individuals 
with expertise and experience in palliative care.
<DELETED>    ``(g) Definition.--For purposes of this section, the term 
`palliative care' means the active total care of patients whose 
prognosis is limited due to progressive, far-advanced disease. The 
purpose of such care is to alleviate pain and other distressing 
symptoms and to enhance the quality of life, not to hasten or postpone 
death.''.</DELETED>
    ``(g) Definition.--For purposes of this section, the term 
`palliative care' means the active, total care of patients whose 
disease or medical condition is not responsive to curative treatment or 
whose prognosis is limited due to progressive, far-advanced disease. 
The purpose of such care is to alleviate pain and other distressing 
symptoms and to enhance the quality of life, not to hasten or postpone 
death.''.
    (b) Authorization of Appropriations; Allocation.--
            (1) In general.--Section 758 of the Public Health Service 
        Act (as redesignated by subsection (a)(1) of this section) is 
        amended in subsection (b)(1)(C) by striking ``sections 753, 
        754, and 755'' and inserting ``section 753, 754, 755, and 
        756''.
            (2) Amount.--With respect to section 758 of the Public 
        Health Service Act (as redesignated by subsection (a)(1) of 
        this section), the dollar amount specified in subsection 
        (b)(1)(C) of such section is deemed to be increased by 
        $5,000,000.

SEC. 203. EFFECTIVE DATE.

    The amendments made by this title take effect October 1, 1999, or 
upon the date of the enactment of this Act, whichever occurs later.