[Congressional Record Volume 162, Number 74 (Wednesday, May 11, 2016)]
[House]
[Pages H2270-H2273]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1800
LALI'S LAW
Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 4586) to amend the Public Health Service Act to authorize
grants to States for developing standing orders and educating health
care professionals regarding the dispensing of opioid overdose reversal
medication without person-specific prescriptions, and for other
purposes, as amended.
The Clerk read the title of the bill.
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The text of the bill is as follows:
H.R. 4586
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 ``Lali's Law''.
SEC. 2. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND
EDUCATION GRANT PROGRAMS.
(a) Technical Clarification.--Effective as if included in
the enactment of the Children's Health Act of 2000 (Public
Law 106-310), section 3405(a) of such Act (114 Stat. 1221) is
amended by striking ``Part E of title III'' and inserting
``Part E of title III of the Public Health Service Act''.
(b) Amendment.--Title III of the Public Health Service Act
is amended by inserting after part D of such title (42 U.S.C.
254b et seq.) the following new part E:
``PART E--OPIOID USE DISORDER
``SEC. 341. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND
EDUCATION GRANT PROGRAMS.
``(a) Grants to States.--The Secretary may make grants to
States for--
``(1) developing standing orders for pharmacies regarding
opioid overdose reversal medication;
``(2) encouraging pharmacies to dispense opioid overdose
reversal medication pursuant to a standing order;
``(3) implementing best practices for persons authorized to
prescribe medication regarding--
``(A) prescribing opioids for the treatment of chronic
pain;
``(B) co-prescribing opioid overdose reversal medication
with opioids; and
``(C) discussing the purpose and administration of opioid
overdose reversal medication with patients;
``(4) developing or adapting training materials and methods
for persons authorized to prescribe or dispense medication to
use in educating the public regarding--
``(A) when and how to administer opioid overdose reversal
medication; and
``(B) steps to be taken after administering opioid overdose
reversal medication; and
``(5) educating the public regarding--
``(A) the public health benefits of opioid overdose
reversal medication; and
``(B) the availability of opioid overdose reversal
medication without a person-specific prescription.
``(b) Certain Requirement.--A grant may be made under this
section only if the State involved has authorized standing
orders regarding opioid overdose reversal medication.
``(c) Preference in Making Grants.--In making grants under
this section, the Secretary shall give preference to States
that--
``(1) have not issued standing orders regarding opioid
overdose reversal medication;
``(2) authorize standing orders that permit community-based
organizations, substance abuse programs, or other nonprofit
entities to acquire, dispense, or administer opioid overdose
reversal medication;
``(3) authorize standing orders that permit police, fire,
or emergency medical services agencies to acquire and
administer opioid overdose reversal medication;
``(4) have a higher per capita rate of opioid overdoses
than other applicant States; or
``(5) meet any other criteria deemed appropriate by the
Secretary.
``(d) Grant Terms.--
``(1) Number.--A State may not receive more than 1 grant
under this section.
``(2) Period.--A grant under this section shall be for a
period of 3 years.
``(3) Amount.--A grant under this section may not exceed
$500,000.
``(4) Limitation.--A State may use not more than 20 percent
of a grant under this section for educating the public
pursuant to subsection (a)(5).
``(e) Applications.--To be eligible to receive a grant
under this section, a State shall submit an application to
the Secretary in such form and manner and containing such
information as the Secretary may require, including detailed
proposed expenditures of grant funds.
``(f) Reporting.--Not later than 3 months after the
Secretary disburses the first grant payment to any State
under this section and every 6 months thereafter for 3 years,
such State shall submit a report to the Secretary that
includes the following:
``(1) The name and ZIP Code of each pharmacy in the State
that dispenses opioid overdose reversal medication under a
standing order.
``(2) The total number of opioid overdose reversal
medication doses dispensed by each such pharmacy, specifying
how many were dispensed with or without a person-specific
prescription.
``(3) The number of pharmacists in the State who have
participated in training pursuant to subsection (a)(4).
``(g) Definitions.--In this section:
``(1) Opioid overdose reversal medication.--The term
`opioid overdose reversal medication' means any drug,
including naloxone, that--
``(A) blocks opioids from attaching to, but does not itself
activate, opioid receptors; or
``(B) inhibits the effects of opioids on opioid receptors.
``(2) Standing order.--The term `standing order' means a
document prepared by a person authorized to prescribe
medication that permits another person to acquire, dispense,
or administer medication without a person-specific
prescription.
``(h) Authorization of Appropriations.--
``(1) In general.--To carry out this section, there is
authorized to be appropriated $5,000,000 for the period of
fiscal years 2017 through 2019.
``(2) Administrative costs.--Not more than 3 percent of the
amounts made available to carry out this section may be used
by the Secretary for administrative expenses of carrying out
this section.''.
SEC. 3. CUT-GO COMPLIANCE.
Subsection (f) of section 319D of the Public Health Service
Act (42 U.S.C. 247d-4) is amended by inserting before the
period at the end the following: ``(except such dollar amount
shall be reduced by $5,000,000 for fiscal year 2017)''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Kentucky (Mr. Guthrie) and the gentleman from Texas (Mr. Gene Green)
each will control 20 minutes.
The Chair recognizes the gentleman from Kentucky.
General Leave
Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Kentucky?
There was no objection.
Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 4586, Lali's Law,
introduced by my colleagues in the House, the gentleman from Illinois
(Mr. Dold) and the gentlewoman from Massachusetts (Ms. Clark).
The rate of overdose for individuals age 24 to 34 has nearly tripled,
going from 8.1 overdose deaths per 100,000 to 23.1 overdose deaths per
100,000. Families across the country are losing loved ones to
reversible opioid overdose. Naloxone is an opioid antagonist that can
prevent opioid overdose deaths by binding to the opioid receptors in
the body and preventing the overdose.
H.R. 4586 amends the Public Health Service Act to authorize grants to
States for developing standing orders and educating healthcare
professionals regarding the dispensing of opioid overdose reversal
medication without person-specific prescriptions.
This legislation is a first step in promoting wider access of
naloxone or other opioid overdose reversal drugs that may come to
market. Standing orders are prescriptions that are not person-specific.
If a pharmacy has a standing order, anyone needing the medication may
come and fill a prescription for it.
Naloxone, while incredibly effective at stopping opioid overdose,
does not have severe side effects if used incorrectly or if used when
not needed. Many States have standing order laws in place but need help
bridging the gap between law and a functioning program. The grants
funded by this legislation will help aid that process.
Mr. Speaker, I urge my colleagues to support this legislation.
I reserve the balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I
may consume. I rise in support of H.R. 4586, Lali's Law.
Mr. Speaker, between 2001 and 2014, there was a threefold increase in
prescription drug overdoses and a sixfold increase in heroin overdoses
in the United States. We must do more to prevent drug misuse and abuse
to avoid these tragedies in the first place. We must also ensure that
those suffering from addiction to prescription and nonprescription
drugs have access to potentially lifesaving treatments when and where
they need it.
Naloxone has proven to be a successful lifesaving intervention for
patients presenting with overdose if administered quickly. When used,
naloxone helps restore breathing that has been stopped by the overdose
and has potential for saving thousands of lives each year.
H.R. 4586 would create a competitive grant program to help States
increase access to overdose reversal medications. The primary purpose
of the grant is to fund State programs that allow pharmacists to
distribute overdose reversal drugs without a person-prescription to
qualified individuals or entities.
To be effective, overdose reversal drugs must be given to the patient
almost immediately. In an emergency situation, the ability for
emergency medical technicians, law enforcement, substance abuse
treatment providers, and qualified individuals to have such medications
on hand can make the difference between life and death. Qualified
individuals and entities often need
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to possess treatment before a specific patient is identified.
Many States have established and use these programs to allow local
law enforcement officers or emergency medical technicians to carry and
use the overdose reversal drug naloxone. H.R. 4586 would expand these
programs by helping States develop standing orders and educate
healthcare professionals about dispensing these medications without
person-specific prescriptions.
I want to thank the bill's sponsors, the gentlewoman from
Massachusetts (Ms. Clark) and the gentleman from Illinois (Mr. Dold),
for introducing this legislation. I urge my colleagues to join me in
supporting H.R. 4586.
Mr. Speaker, I reserve the balance of my time.
Mr. GUTHRIE. Mr. Speaker, I yield 2 minutes to the gentleman from
Georgia (Mr. Carter), my friend.
Mr. CARTER of Georgia. Mr. Speaker, I rise today in support of H.R.
4586 because it is critical that we educate healthcare professionals
about opioid overdose reversal medications.
This bill allows the CDC to authorize grants to States based on their
ability to educate healthcare professionals in dispensing opioid
reversal medication. Specifically, this opioid reversal medication,
called naloxone, can be used in emergency situations to stop an opioid
overdose death.
Also, through this bill, pharmacists will be able to dispense
naloxone to patients without a prescription, increasing access to this
lifesaving antidote. This access will help save lives in emergency
situations when patients do not have the time or ability to seek or
receive professional medical care. The World Health Organization states
that this increased access will save up to 200,000 lives.
As a lifelong pharmacist, I believe it is our duty to always educate
Americans about the lifesaving tools available to them. I encourage my
colleagues to support H.R. 4586 so more people can be educated and have
access to lifesaving medication related to opioid overdose.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield 3 minutes to the
gentlewoman from Massachusetts (Ms. Clark), a cosponsor of the bill.
Ms. CLARK of Massachusetts. Mr. Speaker, I thank Representative Dold
for joining me in this legislation, and I also thank the family of Alex
Laliberte for sharing their story. We offer our deepest sympathies.
Mr. Speaker, across Massachusetts and the Nation, too many parents
are desperately trying to save their child from the deadly grip of the
opioid crisis. In the past year alone, this public health crisis has
claimed nearly 1,400 lives in the Commonwealth of Massachusetts. The
bill before us today, Lali's Law, is a critical part of addressing this
crisis.
Naloxone, commonly known as Narcan, is a lifesaving drug. It stops
the effect of heroin within minutes after it is administered, and it
allows breathing to resume. But it is critical that it is widely
available.
Under this bill, States that have authorized a standing order that
allows anyone to obtain naloxone from a pharmacist would be eligible
for a grant that can be used for public education campaigns and
training for healthcare providers and pharmacists.
I want to share the story of a family from my district that
illustrates the difference training and the availability of Narcan can
make.
One night, a 911 call came in, a desperate and frantic new mother
with a very young baby who was unresponsive. The first responders
arrived at the scene, but despite their best efforts, this baby was not
reviving. A responding firefighter relied on his training and quick
thinking to save this child's life by administering Narcan. It worked.
Even though the mom had not revealed that she was addicted to
prescription painkillers, the first responder knew the symptoms and
made the right guess and saved this child's life. If he had not been
trained to administer Narcan and not had the lifesaving drug with him
that night, that baby would not be alive. But the man was, and now the
baby and mom have a future.
This crisis presents an urgent calling for all of us, Democrats and
Republicans alike, to put aside our differences and do what we can to
save lives. That is what we are talking about here: increasing the
availability of Narcan will save lives.
I am happy to join with my friend from Illinois to offer this
important bill. I urge all of my colleagues to support this
legislation.
Mr. GUTHRIE. Mr. Speaker, I yield 5 minutes to the gentleman from
Illinois (Mr. Dold), my good friend.
Mr. DOLD. Mr. Speaker, I want to thank my good friend for yielding. I
want to thank my friend from Massachusetts for her work on this
legislation. Representative Clark sharing that story is extremely
powerful.
In the suburbs of Chicago, Mr. Speaker, somebody dies from using
heroin every 3 days. Nationally, that statistic is 1 every 19 minutes.
Every single one of them leaves behind a family in grief.
Today, Mr. Speaker, I am joined in the Chamber by Chelsea Laliberte,
Jody Daitchman, and Gary Laliberte, the family of a young man from
Buffalo Grove named Alex.
Alex graduated from Stevenson High School. He played sports. He got
good grades and made a lot of friends. He was a typical teenager who
had his whole life ahead of him. But behind his happy exterior, Alex
was sick. He was struggling with escalating drug abuse.
During Alex's sophomore year in college, he came down with an unknown
illness. He would go to the hospital, and he would get better--at least
for a while. But then a few months later he would get sick. He would be
admitted to the hospital and again would repeat the cycle. His family
didn't know it then, but Alex was dependent on prescription drugs and
was suffering from withdrawal.
Alex continued this pattern until just a few days before his final
exams. At that point in time, Alex actually overdosed on prescription
drugs and heroin and, at the age of 20, passed away. His family never
even had the chance to seek help for his dependency.
Unfortunately, this story is far too common across our country.
As a father, I can't even imagine the pain of losing a child to a
drug overdose; but sadly, too many families like the Lalibertes have
experienced this loss. Heroin and heroin abuse have become an epidemic
in our country.
During my work as the co-chair of the Suburban Anti-Heroin Task
Force, I have met countless families who have been affected by drug
abuse--literally torn apart. This is not an isolated issue. It affects
every community, every ZIP Code, regardless of your socioeconomic
status, regardless of your educational status.
I talk to parents who say, ``It is not in my community.'' It is. It
is in your community, let me just assure you.
My work with Live4Lali and the Lake County Opioid Initiative inspired
me to introduce this law with Representative Clark. Our bipartisan bill
is named in Alex Laliberte's memory.
Lali's Law increases access to a lifesaving antidote called naloxone,
which, in Lake County, Illinois, has already saved nearly 100 lives
since first responders and the police force requested the opportunity
to be able to use this lifesaving antidote. The police officers
actually would respond, would get there before the paramedics--often 5
to 7, sometimes 9 minutes faster--and refused to sit by idly as they
watched these young people die from an overdose.
When used properly, naloxone helps restore breathing that has been
stopped by an overdose. You have heard the statistics, but the World
Health Organization predicts that increased access to naloxone could
save another 20,000 lives each and every year.
Lali's Law is a decisive step to not only save young people like Alex
Laliberte from falling victim to drug abuse, but also to help those in
our communities struggling to get their lives back on track. Our bill--
and, frankly, the work that has been done here in this body today, and
I think we have got some 18 different bipartisan bills coming together
to try to solve this prescription drug epidemic, this heroin epidemic
that is sweeping our country--is proof of what is possible when we set
aside partisanship and get to work for the people that we all
represent.
Lali's Law has already brought Alex's story to the United States
Congress and has amplified the lifesaving
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benefit of Live4Lali's amazing work. Now, by passing this overwhelming
bipartisan bill, we can ensure that Alex's lasting legacy includes
helping countless others get a second chance at recovery and saving
their families from the unbearable heartbreak.
Mr. Speaker, together, we truly can save lives.
Again, I want to thank Representative Clark. I want to thank the
Laliberte family. I want to thank the first responders, the
stakeholders back in Lake County, and all those here in this body who
are working to try to create an environment, create the opportunity for
us to be able to take a huge step forward in combating this
prescription drug and heroin epidemic.
I thank the gentleman for yielding the time.
{time} 1815
Mr. GENE GREEN of Texas. Mr. Speaker, I yield back the balance of my
time.
Mr. GUTHRIE. Mr. Speaker, I encourage my colleagues to vote for H.R.
4586.
I yield back the balance of my time.
Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4586, also
known as Lali's Law.
Sadly, Lali's Law was named after Alex Laliberte: a Buffalo Grove,
Illinois resident who tragically passed away seven years ago from a
drug overdose.
Alex was a good kid. He was an athlete during high school, and also
did well academically.
During his sophomore year in college, he began being hospitalized for
a mysterious illness.
Unknown to his friends and family, Alex soon developed an addiction
to the prescription drugs and was being hospitalized for withdrawal.
He would stay in the hospital until his symptoms subsided only to
leave the hospital and repeat the cycle.
Alex continued this cycle until he died of an opioid overdose a few
days before his final exams.
He was only 20 years old.
Our lack of education on opioids and harm reduction contributed to
Alex's early death, and we must act to prevent a repeat of this
tragedy.
Lali's Law is an important piece of legislation that would authorize
grants to states to develop standing orders and educate health care
professionals about the dispensing of opioid overdose reversal
medication without person-specific prescriptions.
In addition, this bill would encourage pharmacies to dispense opioid
overdose reversal medication pursuant to a standing order.
According to the National Institute on Drug Abuse, 2.1 million people
nationwide abuse opioids.
Mr. Speaker, Lali's Law is instrumental in helping these victims
reverse their addiction.
Lali's Law would also implement the following guidelines and
practices for those people authorized to prescribe the medication:
Only prescribe opioids for chronic pain
Opioid overdose reversal medication must be co-prescribed with
opioids; and
the purpose and administration of opioid overdose reversal medication
must be discussed with the patients.
Furthermore, H.R. 4586 would require the development and adaptation
of training materials and methods for the people authorized to
prescribe or dispense the medication to use in educating the public,
which includes:
When and how to administer opioid overdose reversal medication, and
The steps that should be taken after administering the opioid
overdose reversal medication.
Lastly, Lali's Law would educate the public regarding the health
benefits of the opioid reversal medication and the availability of the
medication without a person-specific prescription.
In 2014, rates of opioid overdose deaths jumped significantly, from
7.9 per 100,000 in 2013 to 9.0 per 100,000, which is a 14 percent
increase.
Mr. Speaker, I join my colleagues in support of H.R. 4586.
This legislation is vital for reducing opioid-related deaths across
our nation, protecting the lives of those at risk to opioid abuse.
It is our job to make sure that Alex's lasting legacy includes
helping others get a second chance at recovery and a second chance at
life.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules
and pass the bill, H.R. 4586, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. GUTHRIE. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further
proceedings on this motion will be postponed.
____________________