[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5842 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 5842

   To direct the Secretary of Veterans Affairs to carry out a pilot 
    program to improve treatment for veterans suffering from opioid 
          addiction and chronic pain, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 14, 2016

Ms. Kuster (for herself and Mr. Coffman) introduced the following bill; 
        which was referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To direct the Secretary of Veterans Affairs to carry out a pilot 
    program to improve treatment for veterans suffering from opioid 
          addiction and chronic pain, 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 ``Helping Our Veterans with Chronic 
Pain and Opioid Addiction Act of 2016''.

SEC. 2. FINDINGS; SENSE OF CONGRESS.

    (a) Findings.--Congress makes the following findings:
            (1) Many veterans and their families have been affected by 
        the national opioid epidemic caused in part by the prescription 
        of opioid medication to manage pain.
            (2) Prescription opioid overdose rates for veterans 
        receiving medical care furnished by the Department of Veterans 
        Affairs are twice the national average.
            (3) More than 50 percent of veterans receiving such care 
        are suffering from chronic pain.
            (4) Almost one in three veterans receiving such care are 
        prescribed opioids to manage pain.
            (5) Many veterans prescribed opioids for the management of 
        chronic pain are at risk of developing a dependency on opioids.
            (6) Many veterans receive health care from both the 
        Department and community providers but the lack of care 
        coordination among the Department and community providers when 
        veterans receive purchased care places veterans at risk for 
        poor health outcomes and results in inefficient use of finite 
        health care resources.
            (7) Veteran-centric care coordination is associated with 
        improved patient outcomes, as Department and non-Department 
        health care teams coordinate and collaborate to provide the 
        best care for veterans.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) veterans suffering from opioid dependency should 
        receive timely access to treatment and social services at 
        Department of Veterans Affairs facilities or through qualified 
        community providers and should have care and services managed 
        and coordinated by the Department of Veterans Affairs;
            (2) veterans who are authorized by the Secretary of 
        Veterans Affairs to receive opioid addiction treatment in the 
        community must not lose the high quality, safety, care 
        coordination, and other veteran-centric elements that the 
        health care system of the Department of Veterans Affairs 
        provides; and
            (3) if the Secretary purchases care for veterans from a 
        community provider, such care must be secured in a cost-
        effective manner, in a way that complements the larger health 
        care system of the Department by using industry standards for 
        care and costs.

SEC. 3. PILOT PROGRAM TO IMPROVE TREATMENT FOR VETERANS SUFFERING FROM 
              OPIOID ADDICTION AND CHRONIC PAIN.

    (a) In General.--Beginning not later than 120 days after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
conduct a pilot program under which the Secretary provides health and 
social services and coordination of care and case management to covered 
veterans in need of treatment for opioid addiction and chronic pain 
through facilities of the Department and through qualified non-
Department health care providers.
    (b) Program Locations.--
            (1) In general.--The pilot program shall be carried out 
        within at least five areas within different States.
            (2) Selection.--
                    (A) In general.--The Secretary shall select five 
                States with Department medical facilities to 
                participate in the pilot program. Each of the five 
                Department facilities selected shall be located in 
                States that demonstrate--
                            (i) the need for additional resources to 
                        provide health care services, including mental 
                        health, chronic pain management and social 
                        services to veterans in need of treatment for 
                        opioid abuse based upon the community 
                        assessment in subsection (a) of this section;
                            (ii) demographic, population, and census 
                        data showing the highest rates per capita of 
                        opioid addiction in the United States or 
                        greater demand in the veteran patient 
                        population than capacity in facilities of the 
                        Department for treatment for opioid addiction; 
                        and
                            (iii) lack of sufficient Department 
                        capacity to meet the demand of all patients in 
                        need of treatment for opioid addiction.
                    (B) Other requirements.--In addition to the 
                requirements in subparagraph (A), not fewer than four 
                of the five selected States shall include--
                            (i) at least one highly rural county, as 
                        determined by the Secretary upon consideration 
                        of the most recent decennial census with the 
                        highest per capita rate of opioid addiction;
                            (ii) an urban county as determined by the 
                        Secretary upon consideration of the most recent 
                        decennial census with the largest population 
                        per capita of opioid addiction;
                            (iii) a county as determined by the 
                        Secretary in a State with one of the highest 
                        statistically significant drug and opioid 
                        overdose death rate increases from 2013 to 2014 
                        according to the Centers for Disease Control 
                        and Prevention and a low expenditure of funding 
                        per capita on substance abuse treatment in 
                        comparison to other States; and
                            (iv) a county as determined by the 
                        Secretary in a State with a high rate per 
                        capita of veterans diagnosed with chronic pain 
                        and prescribed prescription opioids.
    (c) Provision of Services Through Contract.--The Secretary may 
provide health care services to veterans under the pilot program by 
entering into contracts with non-Department health care providers which 
are qualified to provide such services, as determined by the Secretary.
    (d) Exchange of Medical Information.--In conducting the pilot 
program under this section, the Secretary shall develop and use a 
functional capability to provide for the exchange of appropriate 
medical information between the Department and any non-Department 
provider with which the Secretary enters into a contract under 
subsection (c).
    (e) Report.--Not later than the 30 days after the end of each year 
in which the pilot program under this section is conducted, the 
Secretary shall submit to the Committee on Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report which includes--
            (1) the assessment of the Secretary of the pilot program 
        during the preceding year, including its cost, volume, quality, 
        patient satisfaction, benefit to veterans, and such other 
        findings and conclusions with respect to the pilot program as 
        the Secretary considers appropriate; and
            (2) such recommendations as the Secretary considers 
        appropriate regarding--
                    (A) the continuation of the pilot program;
                    (B) extension of the pilot program to additional 
                Veterans Integrated Service Networks of the Department; 
                and
                    (C) making the pilot program permanent.
    (f) Covered Veteran.--In this section, the term ``covered veteran'' 
means a veteran who--
            (1) is enrolled in the system of patient enrollment 
        established under section 1705(a) of title 38, United States 
        Code, as of the date of the commencement of the pilot program 
        under subsection (a)(2);
            (2) is eligible for health care under section 1710(e)(3)(C) 
        of title 38, United States Code; or
            (3) is determined by the Secretary to be in need of 
        treatment for opioid addiction and chronic pain.
    (g) Termination.--The authority to carry out a pilot program under 
this section shall terminate on the date that is three years after the 
date of the commencement of the pilot program.

SEC. 4. ASSESSMENT OF DEPARTMENT AND NON-DEPARTMENT CAPABILITIES TO 
              TREAT OPIOID DEPENDENCY AND ENSURE ACCESS TO NEEDED 
              HEALTH CARE SERVICES.

    (a) Assessment of Department Capabilities.--The Secretary shall 
conduct an assessment of the capabilities of the Department of Veterans 
Affairs, using such data, including demographic data and patient access 
data, as the Secretary determines necessary to provide--
            (1) health care services related to the treatment of opioid 
        dependency and abuse, including mental health, opioid agonist 
        treatment, social services, and non-opioid chronic pain 
        management necessary for treating opioid addiction nationally, 
        regionally, and locally;
            (2) management of chronic pain without the long-term use of 
        opioids, including alternative therapies such as physical 
        therapy, chiropractic care, acupuncture, massage, exercise 
        programs, and other such evidence-based and experimental 
        treatments;
            (3) evidence-based methods for safely reducing the dose and 
        duration of the prescription of opioids for patients;
            (4) methods by which health care services are coordinated 
        by the Department when care is provided by community providers; 
        and
            (5) the manner by which the Department ensures placement of 
        veterans in need of treatment for opioid dependency in 
        treatment programs within a clinically sufficient time period 
        according to published practice guidelines for the treatment of 
        patients with opioid dependency.
    (b) Assessment of Non-Department Capabilities.--In addition to the 
assessment required under subsection (a), the Secretary shall 
concurrently conduct an assessment of community providers to provide 
health care, mental health, social services, and alternative chronic 
pain management treatments necessary for the treatment of veterans 
diagnosed with an opioid addiction and for the treatment of veterans 
suffering from chronic pain.
    (c) Community Providers.--In this section, the term ``community 
provider'' means a non-Department of Veterans Affairs health care 
provider or social services provider determined by the Secretary as 
capable of providing health care services related to the treatment of 
opioid dependency and abuse, including mental health, opioid agonist 
treatment, social services, and non-opioid chronic pain management.
    (d) Report.--At the conclusion of the assessments conducted under 
this section, and not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives a 
comprehensive summary of the results of the assessments, including any 
implementation plans resulting from such assessments, and any 
recommendations for ways to better enable the Department to provide 
health care services within the programs and facilities of the 
Department and in coordination with community providers to veterans 
needing treatment for pain management and opioid addiction.

SEC. 5. INCREASED ACCESS TO NALOXONE AND OTHER TREATMENTS FOR REVERSING 
              OPIOID OVERDOSE.

    (a) In General.--The Secretary of Veterans Affairs shall require 
all appropriate health care facilities of the Department of Veterans 
Affairs, and all Vet Centers and other Department facilities providing 
mental health and social services to veterans, to have a supply of 
naloxone or other medication for reversing opioid overdose.
    (b) Training on Use of Medication.--The Secretary shall ensure that 
all appropriate employees of the Department who are employed at 
facilities referred to in subsection (a) receive training on the 
administration of naloxone or other medication for reversing opioid 
overdose.
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