[Congressional Record Volume 156, Number 172 (Tuesday, December 21, 2010)]
[Senate]
[Page S10925]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          LEONHART NOMINATION

  Mr. KOHL. Madam President, I rise to announce that I have lifted the 
hold I placed earlier this month on Michele Leonhart's nomination to be 
Administrator of the U.S. Drug Enforcement Agency, DEA. I had placed 
the hold reluctantly after numerous failed attempts to work with the 
agency for over a year on the issue of delivering pain medication to 
nursing home residents in a timely matter.
  At a Special Committee on Aging hearing I chaired earlier this year, 
panelists detailed a recent DEA enforcement initiative that has delayed 
many nursing home patients from receiving much-needed medication to 
control their pain. For several years, nurses had been able to call 
into pharmacies urgently needed prescriptions following a doctor's 
order. Pharmacies would fill the order, patients would get their pain 
medication, and doctors would follow up with written confirmation of 
the prescription. Due to the DEA's new enforcement initiative, 
pharmacies face huge administrative fines if they continue to follow 
this practice. Most disturbingly, nursing home residents sometimes must 
endure the pain for hours or even days as nursing home staff try to 
adhere to the newly enforced regulations. Finally, nursing homes have 
been forced to send frail and pain-ridden residents to the emergency 
room, at great cost, simply to get pain medication that they used to be 
able to get in their nursing home.
  At Ms. Leonhart's nominating hearing before the Judiciary Committee 
in November, I expressed my disappointment that the DEA had not 
followed through on the pledges made to the Aging panel in March to 
work with us to address the problem swiftly. Nearly 2 weeks after her 
confirmation hearing--and three months after submitting a draft 
proposal to DEA--I was told that any solution would require each State 
to grant nursing homes the authority to dispense controlled substances 
pain medications. However, any solution requiring ``state-by-state'' 
action would take many years to achieve. The urgent pain relief 
situation in nursing homes will not permit such a long-term approach. 
When the Judiciary Committee approved Ms. Leonhart's nomination, I 
asked to see meaningful progress on the issue prior to her final 
confirmation.
  I am pleased to have recently received Attorney General Eric Holder's 
assurance that he will promptly deliver the DOJ's support for a 
legislative fix. As a result of our discussion, I am releasing the hold 
on Michele Leonhart's nomination, and I look forward to introducing a 
mutually acceptable legislative fix in the opening days of the 112th 
Congress.
  Based on our agreement, DOJ will deliver draft legislation to me in 
January to permit the timely delivery of pain medications to nursing 
home residents. The legislation will deem certain nurses or other 
licensed health care professionals to be ``authorized agents.'' Those 
agents will be chosen and designated by the nursing home as agents of 
DEA-licensed practitioners--practitioners being the resident's 
attending physician or specialist. They will be authorized to transmit 
the practitioner's order for a controlled substance, specifically 
schedule II drugs, to DEA-licensed pharmacies orally or by fax. The 
nursing home, while not licensed by DEA, will designate those 
authorized to transmit a practitioner's order and to make a list of 
those authorized agents available to the pharmacy. In exchange, nursing 
homes, practitioners, and pharmacies will be required to take certain 
steps to verify their accountability.
  I happily submit for the record a document detailing the specifics of 
our agreed-upon framework for the legislation outlined above. I am 
confident that it will ensure our mutual interests are met by enabling 
nursing home residents to have the pain medication they need while 
preventing drug diversion and misuse. I would like to thank Attorney 
General Holder for his strong commitment to seeing that a Federal 
legislative solution can be moved forward in the opening weeks of the 
112th Congress. After all, time is of the essence for nursing home 
residents who are in need of immediate pain relief.

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