[Congressional Record Volume 162, Number 76 (Friday, May 13, 2016)]
[House]
[Pages H2355-H2374]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2016
Mrs. BROOKS of Indiana. Mr. Speaker, pursuant to House Resolution
725, I call up the bill (S. 524) to authorize the Attorney General to
award grants to address the national epidemics of prescription opioid
abuse and heroin use, and ask for its immediate consideration in the
House.
The Clerk read the title of the bill.
The SPEAKER pro tempore. Pursuant to House Resolution 725, an
amendment in the nature of a substitute described in the first section
of that resolution is adopted, and the bill, as amended, is considered
read.
The text of the bill, as amended, is as follows:
S. 524
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Table of Contents.
TITLE I--PAIN MANAGEMENT BEST PRACTICES INTER-AGENCY TASK FORCE
Sec. 101. Development of best practices for the use of prescription
opioids.
TITLE II--COMPREHENSIVE OPIOID ABUSE REDUCTION ACT
Sec. 201. Short title.
Sec. 202. Comprehensive Opioid Abuse Grant Program.
Sec. 203. Audit and accountability of grantees.
Sec. 204. Veterans treatment courts.
Sec. 205. Emergency Federal law enforcement assistance.
Sec. 206. Inclusion of services for pregnant women under family-based
substance abuse grants.
Sec. 207. GAO study and report on Department of Justice programs and
research relative to substance use and substance use
disorders among adolescents and young adults.
TITLE III--JASON SIMCAKOSKI PROMISE ACT
Sec. 301. Short title.
Sec. 302. Improvement of opioid safety measures by Department of
Veterans Affairs.
Sec. 303. Strengthening of joint working group on pain management of
the Department of Veterans Affairs and the Department of
Defense.
Sec. 304. Review, investigation, and report on use of opioids in
treatment by Department of Veterans Affairs.
Sec. 305. Mandatory disclosure of certain veteran information to State
controlled substance monitoring programs.
Sec. 306. Modification to limitation on awards and bonuses.
TITLE IV--KINGPIN DESIGNATION IMPROVEMENT ACT
Sec. 401. Short title.
Sec. 402. Protection of classified information in Federal court
challenges relating to designations under the Narcotics
Kingpin Designation Act.
TITLE V--GOOD SAMARITAN ASSESSMENT ACT
Sec. 501. Short title.
Sec. 502. Finding.
Sec. 503. GAO Study on Good Samaritan laws pertaining to treatment of
opioid overdoses.
Sec. 504. Definitions.
TITLE VI--OPEN ACT
Sec. 601. Short title.
Sec. 602. Evaluation of performance of Department of Justice program.
Sec. 603. Evaluation of performance of Department of Health and Human
Services program.
Sec. 604. Definition.
Sec. 605. No additional funds authorized.
Sec. 606. Matters regarding certain Federal law enforcement assistance.
TITLE VII--INFANT PLAN OF SAFE CARE IMPROVEMENT ACT
Sec. 701. Short title.
Sec. 702. Best practices for development of plans of safe care.
Sec. 703. State plans.
Sec. 704. Data reports.
Sec. 705. Monitoring and oversight.
Sec. 706. Rule of construction.
TITLE VIII--NAS HEALTHY BABIES ACT
Sec. 801. Short title.
Sec. 802. GAO report on neonatal abstinence syndrome (NAS).
Sec. 803. Excluding abuse-deterrent formulations of prescription drugs
from the Medicaid additional rebate requirement for new
formulations of prescription drugs.
Sec. 804. Limiting disclosure of predictive modeling and other
analytics technologies to identify and prevent waste,
fraud, and abuse.
Sec. 805. Medicaid Improvement Fund.
TITLE IX--CO-PRESCRIBING TO REDUCE OVERDOSES ACT
Sec. 901. Short title.
Sec. 902. Opioid overdose reversal drugs prescribing grant program.
Sec. 903. Providing information to prescribers in certain Federal
health care and medical facilities on best practices for
prescribing opioid overdose reversal drugs.
Sec. 904. Authorization of appropriations.
Sec. 905. Cut-Go Compliance.
TITLE X--IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM WOMEN ACT
Sec. 1001. Short title.
[[Page H2356]]
Sec. 1002. Reauthorization of residential treatment programs for
pregnant and postpartum women.
Sec. 1003. Pilot program grants for State substance abuse agencies.
Sec. 1004. Cut-Go Compliance.
TITLE XI--VETERAN EMERGENCY MEDICAL TECHNICIAN SUPPORT ACT
Sec. 1101. Short title.
Sec. 1102. Assisting veterans with military emergency medical training
to meet requirements for becoming civilian emergency
medical technicians.
TITLE XII--JOHN THOMAS DECKER ACT
Sec. 1201. Short title.
Sec. 1202. Information materials and resources to prevent addiction
related to youth sports injuries.
TITLE XIII--LALI'S LAW
Sec. 1301. Short title.
Sec. 1302. Opioid overdose reversal medication access and education
grant programs.
Sec. 1303. Cut-Go Compliance.
TITLE XIV--REDUCING UNUSED MEDICATIONS ACT
Sec. 1401. Short title.
Sec. 1402. Partial fills of schedule II controlled substances.
TITLE XV--OPIOID REVIEW MODERNIZATION ACT
Sec. 1501. Short title.
Sec. 1502. FDA opioid action plan.
Sec. 1503. Prescriber education.
Sec. 1504. Guidance on evaluating the abuse deterrence of generic solid
oral opioid drug products.
TITLE XVI--EXAMINING OPIOID TREATMENT INFRASTRUCTURE ACT
Sec. 1601. Short title.
Sec. 1602. Study on treatment infrastructure.
TITLE XVII--OPIOID USE DISORDER TREATMENT EXPANSION AND MODERNIZATION
ACT
Sec. 1701. Short title.
Sec. 1702. Finding.
Sec. 1703. Opioid use disorder treatment modernization.
Sec. 1704. Sense of Congress.
Sec. 1705. Partial fills of schedule II controlled substances.
TITLE XVIII--NATIONAL ALL SCHEDULES PRESCRIPTION ELECTRONIC REPORTING
REAUTHORIZATION ACT
Sec. 1801. Short title.
Sec. 1802. Amendment to purpose.
Sec. 1803. Amendments to controlled substance monitoring program.
TITLE I--PAIN MANAGEMENT BEST PRACTICES INTER-AGENCY TASK FORCE
SEC. 101. DEVELOPMENT OF BEST PRACTICES FOR THE USE OF
PRESCRIPTION OPIOIDS.
(a) Definitions.--In this section--
(1) the term ``Secretary'' means the Secretary of Health
and Human Services; and
(2) the term ``task force'' means the Pain Management Best
Practices Inter-Agency Task Force convened under subsection
(b).
(b) Inter-Agency Task Force.--Not later than December 14,
2018, the Secretary, in cooperation with the Secretary of
Veterans Affairs, the Secretary of Defense, and the
Administrator of the Drug Enforcement Administration, shall
convene a Pain Management Best Practices Inter-Agency Task
Force to review, modify, and update, as appropriate, best
practices for pain management (including chronic and acute
pain) and prescribing pain medication.
(c) Membership.--The task force shall be comprised of--
(1) representatives of--
(A) the Department of Health and Human Services;
(B) the Department of Veterans Affairs;
(C) the Food and Drug Administration;
(D) the Department of Defense;
(E) the Drug Enforcement Administration;
(F) the Centers for Disease Control and Prevention;
(G) the Health Resources and Services Administration;
(H) the Indian Health Service;
(I) the National Academy of Medicine;
(J) the National Institutes of Health;
(K) the Office of National Drug Control Policy;
(L) the Substance Abuse and Mental Health Services
Administration; and
(M) the Office of Women's Health;
(2) State medical boards;
(3) subject to subsection (e), physicians, dentists, and
nonphysician prescribers;
(4) hospitals;
(5) subject to subsection (e), pharmacists and pharmacies;
(6) first responders;
(7) experts in the fields of pain research and addiction
research;
(8) experts in the fields of adolescent and young adult
addiction research;
(9) representatives of--
(A) pain management professional organizations;
(B) the mental health treatment community;
(C) the addiction treatment and recovery community;
(D) pain advocacy groups;
(E) veteran service organizations; and
(F) groups with expertise on overdose reversal;
(10) a person in recovery from addiction to medication for
chronic pain;
(11) a person in recovery from addiction to medication for
chronic pain, whose addiction began in adolescence or young
adulthood;
(12) a person with chronic pain;
(13) an expert on active duty military, armed forces
personnel, and veteran health and prescription opioid
addiction;
(14) an expert in the field of minority health; and
(15) other stakeholders, as the Secretary determines
appropriate.
(d) Condition on Participation on Task Force.--An
individual representing a profession or entity described in
paragraph (3) or (5) of subsection (c) may not serve as a
member of the task force unless such individual--
(1) is currently licensed in a State in which such
individual is practicing (as defined by such State) such
profession (or, in the case of an individual representing an
entity, a State in which the entity is engaged in business);
and
(2) is currently practicing (as defined by such State) such
profession (or, in the case of an individual representing an
entity, the entity is in operation).
(e) Duties.--The task force shall--
(1) not later than 180 days after the date on which the
task force is convened under subsection (b), review, modify,
and update, as appropriate, best practices for pain
management (including chronic and acute pain) and prescribing
pain medication, taking into consideration--
(A) existing pain management research;
(B) research on trends in areas and communities in which
the prescription opioid abuse rate and fatality rate exceed
the national average prescription opioid abuse rate and
fatality rate;
(C) recommendations from relevant conferences and existing
relevant evidence-based guidelines;
(D) ongoing efforts at the State and local levels and by
medical professional organizations to develop improved pain
management strategies, including consideration of differences
within and between classes of opioids, the availability of
opioids with abuse deterrent technology, and pharmacological,
nonpharmacological, medical device alternatives to opioids to
reduce opioid monotherapy in appropriate cases and the
coordination of information collected from State prescription
drug monitoring programs for the purpose of preventing the
diversion of pain medication;
(E) ongoing efforts at the Federal, State, and local levels
to examine the potential benefits of electronic prescribing
of opioids, including any public comments collected in the
course of those efforts;
(F) the management of high-risk populations, other than
populations who suffer pain, who--
(i) may use or be prescribed benzodiazepines, alcohol, and
diverted opioids; or
(ii) receive opioids in the course of medical care;
(G) the distinct needs of adolescents and young adults with
respect to pain management, pain medication, substance use
disorder, and medication-assisted treatment;
(H) the 2016 Guideline for Prescribing Opioids for Chronic
Pain issued by the Centers for Disease Control and
Prevention;
(I) the practice of co-prescribing naloxone for both pain
patients receiving chronic opioid therapy and patients being
treated for opioid use disorders;
(J) research that has been, or is being, conducted or
supported by the Federal Government on prevention of,
treatment for, and recovery from substance use by and
substance use disorders among adolescents and young adults
relative to any unique circumstances (including social and
biological circumstances) of adolescents and young adults
that may make adolescent-specific and young adult-specific
treatment protocols necessary, including any effects that
substance use and substance use disorders may have on brain
development and the implications for treatment and recovery;
(K) Federal non-research programs and activities that
address prevention of, treatment for, and recovery from
substance use by and substance use disorders among
adolescents and young adults, including an assessment of the
effectiveness of such programs and activities in--
(i) preventing substance use by and substance use disorders
among adolescents and young adults;
(ii) treating such adolescents and young adults in a way
that accounts for any unique circumstances faced by
adolescents and young adults; and
(iii) supporting long-term recovery among adolescents and
young adults; and
(L) gaps that have been identified by Federal officials and
experts in Federal efforts relating to prevention of,
treatment for, and recovery from substance use by and
substance use disorders among adolescents and young adults,
including gaps in research, data collection, and measures to
evaluate the effectiveness of Federal efforts, and the
reasons for such gaps;
(2) solicit and take into consideration public comment on
the practices developed under paragraph (1), amending such
best practices if appropriate;
(3) develop a strategy for disseminating information about
the best practices developed under paragraphs (1) and (2) to
prescribers, pharmacists, State medical boards, educational
institutions that educate prescribers and pharmacists, and
other parties, as the Secretary determines appropriate;
(4) review, modify, and update best practices for pain
management and prescribing pain medication, specifically as
it pertains to physician education and consumer education;
and
(5) examine and identify--
(A) the extent of the need for the development of new
pharmacological, nonpharmacological, and medical device
alternatives to opioids;
(B) the current status of research efforts to develop such
alternatives; and
(C) the pharmacological, nonpharmacological, and medical
device alternatives to opioids that
[[Page H2357]]
are currently available that could be better utilized.
(f) Consideration of Study Results.--In reviewing,
modifying, and updating, best practices for pain management
and prescribing pain medication, the task force shall take
into consideration existing private sector, State, and local
government efforts related to pain management and prescribing
pain medication.
(g) Limitation.--The task force shall not have rulemaking
authority.
(h) Report.--Not later than 270 days after the date on
which the task force is convened under subsection (b), the
task force shall submit to Congress a report that includes--
(1) the strategy for disseminating best practices for pain
management (including chronic and acute pain) and prescribing
pain medication, as developed under subsection (e);
(2) the results of a feasibility study on linking the best
practices described in paragraph (1) to receiving and
renewing registrations under section 303(f) of the Controlled
Substances Act (21 U.S.C. 823(f));
(3) recommendations for effectively applying the best
practices described in paragraph (1) to improve prescribing
practices at medical facilities, including medical facilities
of the Veterans Health Administration and Indian Health
Service;
(4) the modified and updated best practices described in
subsection (e)(4); and
(5) the results of the examination and identification
conducted pursuant to subsection (e)(4), and recommendations
regarding--
(A) the development of new pharmacological,
nonpharmacological, and medical device alternatives to
opioids; and
(B) the improved utilization of pharmacological,
nonpharmacological, and medical device alternatives to
opioids that are currently available.
TITLE II--COMPREHENSIVE OPIOID ABUSE REDUCTION ACT
SEC. 201. SHORT TITLE.
This title may be cited as the ``Comprehensive Opioid Abuse
Reduction Act of 2016''.
SEC. 202. COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM.
(a) In General.--Title I of the Omnibus Crime Control and
Safe Streets Act of 1968 (42 U.S.C. 3711 et seq.) is amended
by adding at the end the following:
``PART LL--COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM
``SEC. 3021. DESCRIPTION.
``(a) Grants Authorized.--From amounts made available to
carry out this part, the Attorney General may make grants to
States, units of local government, and Indian tribes, for use
by the State, unit of local government, or Indian tribe to
provide services primarily relating to opioid abuse,
including for any one or more of the following:
``(1) Developing, implementing, or expanding a treatment
alternative to incarceration program, which may include--
``(A) pre-booking or post-booking components, which may
include the activities described in part DD or HH of this
title;
``(B) training for criminal justice agency personnel on
substance use disorders and co-occurring mental illness and
substance use disorders;
``(C) a mental health court, including the activities
described in part V of this title;
``(D) a drug court, including the activities described in
part EE of this title;
``(E) a veterans treatment court program, including the
activities described in subsection (i) of section 2991 of
this title;
``(F) a focus on parents whose incarceration could result
in their children entering the child welfare system; and
``(G) a community-based substance use diversion program
sponsored by a law enforcement agency.
``(2) In the case of a State, facilitating or enhancing
planning and collaboration between State criminal justice
agencies and State substance abuse systems in order to more
efficiently and effectively carry out programs described in
paragraph (1) that address problems related to opioid abuse.
``(3) Providing training and resources for first responders
on carrying and administering an opioid overdose reversal
drug or device approved by the Food and Drug Administration,
and purchasing such a drug or device for first responders who
have received such training to carry and administer.
``(4) Investigative purposes to locate or investigate
illicit activities related to the unlawful distribution of
opioids.
``(5) Developing, implementing, or expanding a medication-
assisted treatment program used or operated by a criminal
justice agency, which may include training criminal justice
agency personnel on medication-assisted treatment, and
carrying out the activities described in part S of this
title.
``(6) In the case of a State, developing, implementing, or
expanding a prescription drug monitoring program to collect
and analyze data related to the prescribing of schedules II,
III, and IV controlled substances through a centralized
database administered by an authorized State agency, which
includes tracking the dispensation of such substances, and
providing for interoperability and data sharing with other
States.
``(7) Developing, implementing, or expanding a program to
prevent and address opioid abuse by juveniles.
``(8) Developing, implementing, or expanding an integrated
and comprehensive opioid abuse response program, including
prevention and recovery programs.
``(9) Developing, implementing, or expanding a program
(which may include demonstration projects) to utilize
technology that provides a secure container for prescription
drugs that would prevent individuals, particularly
adolescents, from gaining access to opioid medications that
are lawfully prescribed for other individuals.
``(10) Developing, implementing, or expanding a program to
prevent and address opioid abuse by veterans.
``(11) Developing, implementing, or expanding a
prescription drug take-back program.
``(b) Contracts and Subawards.--A State, unit of local
government, or Indian tribe may, in using a grant under this
subpart for purposes authorized by subsection (a), use all or
a portion of that grant to contract with or make one or more
subawards to one or more--
``(1) local or regional organizations that are private and
nonprofit, including faith-based organizations;
``(2) units of local government; or
``(3) tribal organizations.
``(c) Program Assessment Component; Waiver.--
``(1) Program assessment component.--Each program funded
under this subpart shall contain a program assessment
component, developed pursuant to guidelines established by
the Attorney General, in coordination with the National
Institute of Justice.
``(2) Waiver.--The Attorney General may waive the
requirement of paragraph (1) with respect to a program if, in
the opinion of the Attorney General, the program is not of
sufficient size to justify a full program assessment.
``(d) Administrative Costs.--Not more than 10 percent of a
grant made under this subpart may be used for costs incurred
to administer such grant.
``(e) Period.--The period of a grant made under this part
may not be longer than 4 years, except that renewals and
extensions beyond that period may be granted at the
discretion of the Attorney General.
``SEC. 3022. APPLICATIONS.
``To request a grant under this part, the chief executive
officer of a State, unit of local government, or Indian tribe
shall submit an application to the Attorney General at such
time and in such form as the Attorney General may require.
Such application shall include the following:
``(1) A certification that Federal funds made available
under this subpart will not be used to supplant State, local,
or tribal funds, but will be used to increase the amounts of
such funds that would, in the absence of Federal funds, be
made available for the activities described in section
3021(a).
``(2) An assurance that, for each fiscal year covered by an
application, the applicant shall maintain and report such
data, records, and information (programmatic and financial)
as the Attorney General may reasonably require.
``(3) A certification, made in a form acceptable to the
Attorney General and executed by the chief executive officer
of the applicant (or by another officer of the applicant, if
qualified under regulations promulgated by the Attorney
General), that--
``(A) the programs to be funded by the grant meet all the
requirements of this part;
``(B) all the information contained in the application is
correct;
``(C) there has been appropriate coordination with affected
agencies; and
``(D) the applicant will comply with all provisions of this
part and all other applicable Federal laws.
``(4) An assurance that the applicant will work with the
Drug Enforcement Administration to develop an integrated and
comprehensive strategy to address opioid abuse.
``SEC. 3023. REVIEW OF APPLICATIONS.
``The Attorney General shall not finally disapprove any
application (or any amendment to that application) submitted
under this part without first affording the applicant
reasonable notice of any deficiencies in the application and
opportunity for correction and reconsideration.
``SEC. 3024. EQUITABLE DISTRIBUTION OF FUNDS.
``In awarding grants under this part, the Attorney General
shall ensure equitable distribution of funds based on the
following:
``(1) The geographic distribution of grants under this
part, taking into consideration the needs of underserved
populations, including rural and tribal communities.
``(2) The needs of communities to address the problems
related to opioid abuse, taking into consideration the
prevalence of opioid abuse and overdose-related death in a
community.
``SEC. 3025. DEFINITIONS.
``In this part:
``(1) The term `first responder' includes a firefighter,
law enforcement officer, paramedic, emergency medical
technician, or other individual (including an employee of a
legally organized and recognized volunteer organization,
whether compensated or not), who, in the course of
professional duties, responds to fire, medical, hazardous
material, or other similar emergencies.
``(2) The term `medication-assisted treatment' means the
use of medications approved by the Food and Drug
Administration for the treatment of opioid abuse.
``(3) The term `opioid' means any drug, including heroin,
having an addiction-forming or addiction-sustaining liability
similar to morphine or being capable of conversion into a
drug having such addiction-forming or addiction-sustaining
liability.
``(4) The term `schedule II, III, or IV controlled
substance' means a controlled substance that is listed on
schedule II, schedule III, or schedule IV of section 202(c)
of the Controlled Substances Act (21 U.S.C. 812(c)).
``(5) The terms `drug' and `device' have the meanings given
those terms in section 201 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 321).
``(6) The term `criminal justice agency' means a State,
local, or tribal--
``(A) court;
[[Page H2358]]
``(B) prison;
``(C) jail;
``(D) law enforcement agency; or
``(E) other agency that performs the administration of
criminal justice, including prosecution, pretrial services,
and community supervision.
``(7) The term `tribal organization' has the meaning given
that term in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b).''.
(b) Authorization of Appropriations.--Section 1001(a) of
the Omnibus Crime Control and Safe Streets Act of 1968 (42
U.S.C. 3793(a)) is amended by inserting after paragraph (26)
the following:
``(27) There are authorized to be appropriated to carry out
part LL $103,000,000 for each of fiscal years 2017 through
2021.''.
SEC. 203. AUDIT AND ACCOUNTABILITY OF GRANTEES.
(a) Definitions.--In this section--
(1) the term ``covered grant program'' means a grant
program operated by the Department of Justice;
(2) the term ``covered grantee'' means a recipient of a
grant from a covered grant program;
(3) the term ``nonprofit'', when used with respect to an
organization, means an organization that is described in
section 501(c)(3) of the Internal Revenue Code of 1986, and
is exempt from taxation under section 501(a) of such Code;
and
(4) the term ``unresolved audit finding'' means an audit
report finding in a final audit report of the Inspector
General of the Department of Justice that a covered grantee
has used grant funds awarded to that grantee under a covered
grant program for an unauthorized expenditure or otherwise
unallowable cost that is not closed or resolved during a 12-
month period prior to the date on which the final audit
report is issued.
(b) Audit Requirement.--Beginning in fiscal year 2016, and
annually thereafter, the Inspector General of the Department
of Justice shall conduct audits of covered grantees to
prevent waste, fraud, and abuse of funds awarded under
covered grant programs. The Inspector General shall determine
the appropriate number of covered grantees to be audited each
year.
(c) Mandatory Exclusion.--A grantee that is found to have
an unresolved audit finding under an audit conducted under
subsection (b) may not receive grant funds under a covered
grant program in the fiscal year following the fiscal year to
which the finding relates.
(d) Reimbursement.--If a covered grantee is awarded funds
under the covered grant program from which it received a
grant award during the 1-fiscal-year period during which the
covered grantee is ineligible for an allocation of grant
funds under subsection (c), the Attorney General shall--
(1) deposit into the General Fund of the Treasury an amount
that is equal to the amount of the grant funds that were
improperly awarded to the covered grantee; and
(2) seek to recoup the costs of the repayment to the Fund
from the covered grantee that was improperly awarded the
grant funds.
(e) Priority of Grant Awards.--The Attorney General, in
awarding grants under a covered grant program shall give
priority to eligible entities that during the 2-year period
preceding the application for a grant have not been found to
have an unresolved audit finding.
(f) Nonprofit Requirements.--
(1) Prohibition.--A nonprofit organization that holds money
in offshore accounts for the purpose of avoiding the tax
described in section 511(a) of the Internal Revenue Code of
1986, shall not be eligible to receive, directly or
indirectly, any funds from a covered grant program.
(2) Disclosure.--Each nonprofit organization that is a
covered grantee shall disclose in its application for such a
grant, as a condition of receipt of such a grant, the
compensation of its officers, directors, and trustees. Such
disclosure shall include a description of the criteria relied
on to determine such compensation.
SEC. 204. VETERANS TREATMENT COURTS.
Section 2991 of the Omnibus Crime Control and Safe Streets
Act of 1968 (42 U.S.C. 3797aa) is amended--
(1) by redesignating subsection (i) as subsection (j); and
(2) by inserting after subsection (h) the following:
``(i) Assisting Veterans.--
``(1) Definitions.--In this subsection:
``(A) Peer to peer services or programs.--The term `peer to
peer services or programs' means services or programs that
connect qualified veterans with other veterans for the
purpose of providing support and mentorship to assist
qualified veterans in obtaining treatment, recovery,
stabilization, or rehabilitation.
``(B) Qualified veteran.--The term `qualified veteran'
means a preliminarily qualified offender who--
``(i) served on active duty in any branch of the Armed
Forces, including the National Guard or Reserves; and
``(ii) was discharged or released from such service under
conditions other than dishonorable.
``(C) Veterans treatment court program.--The term `veterans
treatment court program' means a court program involving
collaboration among criminal justice, veterans, and mental
health and substance abuse agencies that provides qualified
veterans with--
``(i) intensive judicial supervision and case management,
which may include random and frequent drug testing where
appropriate;
``(ii) a full continuum of treatment services, including
mental health services, substance abuse services, medical
services, and services to address trauma;
``(iii) alternatives to incarceration; or
``(iv) other appropriate services, including housing,
transportation, mentoring, employment, job training,
education, or assistance in applying for and obtaining
available benefits.
``(2) Veterans assistance program.--
``(A) In general.--The Attorney General, in consultation
with the Secretary of Veterans Affairs, may award grants
under this subsection to applicants to establish or expand--
``(i) veterans treatment court programs;
``(ii) peer to peer services or programs for qualified
veterans;
``(iii) practices that identify and provide treatment,
rehabilitation, legal, transitional, and other appropriate
services to qualified veterans who have been incarcerated; or
``(iv) training programs to teach criminal justice, law
enforcement, corrections, mental health, and substance abuse
personnel how to identify and appropriately respond to
incidents involving qualified veterans.
``(B) Priority.--In awarding grants under this subsection,
the Attorney General shall give priority to applications
that--
``(i) demonstrate collaboration between and joint
investments by criminal justice, mental health, substance
abuse, and veterans service agencies;
``(ii) promote effective strategies to identify and reduce
the risk of harm to qualified veterans and public safety; and
``(iii) propose interventions with empirical support to
improve outcomes for qualified veterans.''.
SEC. 205. EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE.
Section 609Y(a) of the Justice Assistance Act of 1984 (42
U.S.C. 10513(a)) is amended by striking ``September 30,
1984'' and inserting ``September 30, 2021''.
SEC. 206. INCLUSION OF SERVICES FOR PREGNANT WOMEN UNDER
FAMILY-BASED SUBSTANCE ABUSE GRANTS.
Part DD of title I of the Omnibus Crime Control and Safe
Streets Act (42 U.S.C. 3797s et seq.) is amended--
(1) in section 2921(2), by inserting before the period at
the end ``or pregnant women''; and
(2) in section 2927--
(A) in paragraph (1)(A), by inserting ``pregnant or''
before ``a parent''; and
(B) in paragraph (3), by inserting ``or pregnant women''
after ``incarcerated parents''.
SEC. 207. GAO STUDY AND REPORT ON DEPARTMENT OF JUSTICE
PROGRAMS AND RESEARCH RELATIVE TO SUBSTANCE USE
AND SUBSTANCE USE DISORDERS AMONG ADOLESCENTS
AND YOUNG ADULTS.
(a) Study.--The Comptroller General of the United States
shall conduct a study on how the Department of Justice,
through grant programs, is addressing prevention of,
treatment for, and recovery from substance use by and
substance use disorders among adolescents and young adults.
Such study shall include an analysis of each of the
following:
(1) The research that has been, and is being, conducted or
supported pursuant to grant programs operated by the
Department of Justice on prevention of, treatment for, and
recovery from substance use by and substance use disorders
among adolescents and young adults, including an assessment
of--
(A) such research relative to any unique circumstances
(including social and biological circumstances) of
adolescents and young adults that may make adolescent-
specific and young adult-specific treatment protocols
necessary, including any effects that substance use and
substance use disorders may have on brain development and the
implications for treatment and recovery; and
(B) areas of such research in which greater investment or
focus is necessary relative to other areas of such research.
(2) Department of Justice non-research programs and
activities that address prevention of, treatment for, and
recovery from substance use by and substance use disorders
among adolescents and young adults, including an assessment
of the effectiveness of such programs and activities in
preventing substance use by and substance use disorders among
adolescents and young adults, treating such adolescents and
young adults in a way that accounts for any unique
circumstances faced by adolescents and young adults, and
supports long term recovery among adolescents and young
adults.
(3) Gaps that have been identified by officials of the
Department of Justice or experts in the efforts supported by
grant programs operated by the Department of Justice relating
to prevention of, treatment for, and recovery from substance
use by and substance use disorders among adolescents and
young adults, including gaps in research, data collection,
and measures to evaluate the effectiveness of such efforts,
and the reasons for such gaps.
(b) Report.--Not later than 2 years after the date of
enactment of this Act, the Comptroller General shall submit
to the appropriate committees of the Congress a report
containing the results of the study conducted under
subsection (a), including--
(1) a summary of the findings of the study; and
(2) recommendations based on the results of the study,
including recommendations for such areas of research and
legislative and administrative action as the Comptroller
General determines appropriate.
TITLE III--JASON SIMCAKOSKI PROMISE ACT
SEC. 301. SHORT TITLE.
This title may be cited as the ``Promoting Responsible
Opioid Management and Incorporating Scientific Expertise
Act'' or the ``Jason Simcakoski PROMISE Act''.
SEC. 302. IMPROVEMENT OF OPIOID SAFETY MEASURES BY DEPARTMENT
OF VETERANS AFFAIRS.
(a) Expansion of Opioid Safety Initiative.--
(1) Inclusion of all medical facilities.--Not later than
180 days after the date of the enactment of this Act, the
Secretary of Veterans
[[Page H2359]]
Affairs shall expand the Opioid Safety Initiative of the
Department of Veterans Affairs to include all medical
facilities of the Department.
(2) Guidance.--The Secretary shall establish guidance that
each health care provider of the Department of Veterans
Affairs, before initiating opioid therapy to treat a patient
as part of the comprehensive assessment conducted by the
health care provider, use the Opioid Therapy Risk Report tool
of the Department of Veterans Affairs (or any subsequent
tool), which shall include information from the prescription
drug monitoring program of each participating State as
applicable, that includes the most recent information to date
relating to the patient that accessed such program to assess
the risk for adverse outcomes of opioid therapy for the
patient, including the concurrent use of controlled
substances such as benzodiazepines, as part of the
comprehensive assessment conducted by the health care
provider.
(3) Enhanced standards.--The Secretary shall establish
enhanced standards with respect to the use of routine and
random urine drug tests for all patients before and during
opioid therapy to help prevent substance abuse, dependence,
and diversion, including--
(A) that such tests occur not less frequently than once
each year; and
(B) that health care providers appropriately order,
interpret and respond to the results from such tests to
tailor pain therapy, safeguards, and risk management
strategies to each patient.
(b) Pain Management Education and Training.--
(1) In general.--In carrying out the Opioid Safety
Initiative of the Department, the Secretary shall require all
employees of the Department responsible for prescribing
opioids to receive education and training described in
paragraph (2).
(2) Education and training.--Education and training
described in this paragraph is education and training on pain
management and safe opioid prescribing practices for purposes
of safely and effectively managing patients with chronic
pain, including education and training on the following:
(A) The implementation of and full compliance with the VA/
DOD Clinical Practice Guideline for Management of Opioid
Therapy for Chronic Pain, including any update to such
guideline.
(B) The use of evidence-based pain management therapies,
including cognitive-behavioral therapy, non-opioid
alternatives, and non-drug methods and procedures to managing
pain and related health conditions including medical devices
approved or cleared by the Food and Drug Administration for
the treatment of patients with chronic pain and complementary
alternative medicines.
(C) Screening and identification of patients with substance
use disorder, including drug-seeking behavior, before
prescribing opioids, assessment of risk potential for
patients developing an addiction, and referral of patients to
appropriate addiction treatment professionals if addiction is
identified or strongly suspected.
(D) Communication with patients on the potential harm
associated with the use of opioids and other controlled
substances, including the need to safely store and dispose of
supplies relating to the use of opioids and other controlled
substances.
(E) Such other education and training as the Secretary
considers appropriate to ensure that veterans receive safe
and high-quality pain management care from the Department.
(3) Use of existing program.--In providing education and
training described in paragraph (2), the Secretary shall use
the Interdisciplinary Chronic Pain Management Training Team
Program of the Department (or success program).
(c) Pain Management Teams.--
(1) In general.--In carrying out the Opioid Safety
Initiative of the Department, the director of each medical
facility of the Department shall identify and designate a
pain management team of health care professionals, which may
include board certified pain medicine specialists,
responsible for coordinating and overseeing pain management
therapy at such facility for patients experiencing acute and
chronic pain that is non-cancer related.
(2) Establishment of protocols.--
(A) In general.--In consultation with the Directors of each
Veterans Integrated Service Network, the Secretary shall
establish standard protocols for the designation of pain
management teams at each medical facility within the
Department.
(B) Consultation on prescription of opioids.--Each protocol
established under subparagraph (A) shall ensure that any
health care provider without expertise in prescribing
analgesics or who has not completed the education and
training under subsection (b), including a mental health care
provider, does not prescribe opioids to a patient unless that
health care provider--
(i) consults with a health care provider with pain
management expertise or who is on the pain management team of
the medical facility; and
(ii) refers the patient to the pain management team for any
subsequent prescriptions and related therapy.
(3) Report.--
(A) In general.--Not later than 1 year after the date of
enactment of this Act, the director of each medical facility
of the Department shall submit to the Under Secretary for
Health and the director of the Veterans Integrated Service
Network in which the medical facility is located a report
identifying the health care professionals that have been
designated as members of the pain management team at the
medical facility pursuant to paragraph (1).
(B) Elements.--Each report submitted under subparagraph (A)
with respect to a medical facility of the Department shall
include--
(i) a certification as to whether all members of the pain
management team at the medical facility have completed the
education and training required under subsection (b);
(ii) a plan for the management and referral of patients to
such pain management team if health care providers without
expertise in prescribing analgesics prescribe opioid
medications to treat acute and chronic pain that is non-
cancer related; and
(iii) a certification as to whether the medical facility--
(I) fully complies with the stepped-care model of pain
management and other pain management policies contained in
Directive 2009-053 of the Veterans Health Administration, or
successor directive; or
(II) does not fully comply with such stepped-care model of
pain management and other pain management policies but is
carrying out a corrective plan of action to ensure such full
compliance.
(d) Tracking and Monitoring of Opioid Use.--
(1) Prescription drug monitoring programs of states.--In
carrying out the Opioid Safety Initiative and the Opioid
Therapy Risk Report tool of the Department, the Secretary
shall--
(A) ensure access by health care providers of the
Department to information on controlled substances, including
opioids and benzodiazepines, prescribed to veterans who
receive care outside the Department through the prescription
drug monitoring program of each State with such a program,
including by seeking to enter into memoranda of understanding
with States to allow shared access of such information
between States and the Department;
(B) include such information in the Opioid Therapy Risk
Report; and
(C) require health care providers of the Department to
submit to the prescription drug monitoring program of each
State information on prescriptions of controlled substances
received by veterans in that State under the laws
administered by the Secretary.
(2) Report on tracking of data on opioid use.--Not later
than 18 months after the date of the enactment of this Act,
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 on the feasibility
and advisability of improving the Opioid Therapy Risk Report
tool of the Department to allow for more advanced real-time
tracking of and access to data on--
(A) the key clinical indicators with respect to the
totality of opioid use by veterans;
(B) concurrent prescribing by health care providers of the
Department of opioids in different health care settings,
including data on concurrent prescribing of opioids to treat
mental health disorders other than opioid use disorder; and
(C) mail-order prescriptions of opioid prescribed to
veterans under the laws administered by the Secretary.
(e) Availability of Opioid Receptor Antagonists.--
(1) Increased availability and use.--
(A) In general.--The Secretary shall maximize the
availability of opioid receptor antagonists approved by the
Food and Drug Administration, including naloxone, to
veterans.
(B) Availability, training, and distributing.--In carrying
out subparagraph (A), not later than 90 days after the date
of the enactment of this Act, the Secretary shall--
(i) equip each pharmacy of the Department with opioid
receptor antagonists approved by the Food and Drug
Administration to be dispensed to outpatients as needed; and
(ii) expand the Overdose Education and Naloxone
Distribution program of the Department to ensure that all
veterans in receipt of health care under laws administered by
the Secretary who are at risk of opioid overdose may access
such opioid receptor antagonists and training on the proper
administration of such opioid receptor antagonists.
(C) Veterans who are at risk.--For purposes of subparagraph
(B), veterans who are at risk of opioid overdose include--
(i) veterans receiving long-term opioid therapy;
(ii) veterans receiving opioid therapy who have a history
of substance use disorder or prior instances of overdose; and
(iii) veterans who are at risk as determined by a health
care provider who is treating the veteran.
(2) Report.--Not later than 120 days after the date of the
enactment of this Act, 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 on carrying out paragraph (1),
including an assessment of any remaining steps to be carried
out by the Secretary to carry out such paragraph.
(f) Inclusion of Certain Information and Capabilities in
Opioid Therapy Risk Report Tool of the Department.--
(1) Information.--The Secretary shall include in the Opioid
Therapy Risk Report tool of the Department--
(A) information on the most recent time the tool was
accessed by a health care provider of the Department with
respect to each veteran; and
(B) information on the results of the most recent urine
drug test for each veteran.
(2) Capabilities.--The Secretary shall include in the
Opioid Therapy Risk Report tool the ability of the health
care providers of the Department to determine whether a
health care provider of the Department prescribed opioids to
a veteran without checking the information in the tool with
respect to the veteran.
(g) Notifications of Risk in Computerized Health Record.--
The Secretary shall modify the computerized patient record
system of the Department to ensure that any health care
provider that accesses the record of a veteran, regardless of
the reason the veteran seeks care
[[Page H2360]]
from the health care provider, will be immediately notified
whether the veteran--
(1) is receiving opioid therapy and has a history of
substance use disorder or prior instances of overdose;
(2) has a history of opioid abuse; or
(3) is at risk of becoming an opioid abuser as determined
by a health care provider who is treating the veteran.
(h) Definitions.--In this section:
(1) The term ``controlled substance'' has the meaning given
that term in section 102 of the Controlled Substances Act (21
U.S.C. 802).
(2) The term ``State'' means each of the several States,
territories, and possessions of the United States, the
District of Columbia, and the Commonwealth of Puerto Rico.
SEC. 303. STRENGTHENING OF JOINT WORKING GROUP ON PAIN
MANAGEMENT OF THE DEPARTMENT OF VETERANS
AFFAIRS AND THE DEPARTMENT OF DEFENSE.
(a) In General.--Not later than 90 days after the date of
enactment of this Act, the Secretary of Veterans Affairs and
the Secretary of Defense shall ensure that the Pain
Management Working Group of the Health Executive Committee of
the Department of Veterans Affairs-Department of Defense
Joint Executive Committee (Pain Management Working Group)
established under section 320 of title 38, United States
Code, includes a focus on the following:
(1) The opioid prescribing practices of health care
providers of each Department.
(2) The ability of each Department to manage acute and
chronic pain among individuals receiving health care from the
Department, including training health care providers with
respect to pain management.
(3) The use by each Department of complementary and
integrative health and complementary alternative medicines in
treating such individuals.
(4) The concurrent use by health care providers of each
Department of opioids and prescription drugs to treat mental
health disorders, including benzodiazepines.
(5) The practice by health care providers of each
Department of prescribing opioids to treat mental health
disorders.
(6) The coordination in coverage of and consistent access
to medications prescribed for patients transitioning from
receiving health care from the Department of Defense to
receiving health care from the Department of Veterans
Affairs.
(7) The ability of each Department to identify and treat
substance use disorders among individuals receiving health
care from that Department.
(b) Coordination and Consultation.--The Secretary of
Veterans Affairs and the Secretary of Defense shall ensure
that the working group described in subsection (a)--
(1) coordinates the activities of the working group with
other relevant working groups established under section 320
of title 38, United States Code;
(2) consults with other relevant Federal agencies with
respect to the activities of the working group; and
(3) consults with the Department of Veterans Affairs and
the Department of Defense with respect to, reviews, and
comments on the VA/DOD Clinical Practice Guideline for
Management of Opioid Therapy for Chronic Pain, or any
successor guideline, before any update to the guideline is
released.
(c) Clinical Practice Guidelines.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs
and the Secretary of Defense shall issue an update to the VA/
DOD Clinical Practice Guideline for Management of Opioid
Therapy for Chronic Pain.
(2) Matters included.--In conducting the update under
subsection (a), the Pain Management Working Group, in
coordination with the Clinical Practice Guideline VA/DOD
Management of Opioid Therapy for Chronic Pain Working Group,
shall examine whether the Clinical Practical Guideline should
include the following:
(A) Enhanced guidance with respect to--
(i) the coadministration of an opioid and other drugs,
including benzodiazepines, that may result in life-limiting
drug interactions;
(ii) the treatment of patients with current acute
psychiatric instability or substance use disorder or patients
at risk of suicide; and
(iii) the use of opioid therapy to treat mental health
disorders other than opioid use disorder.
(B) Enhanced guidance with respect to the treatment of
patients with behaviors or comorbidities, such as post-
traumatic stress disorder or other psychiatric disorders, or
a history of substance abuse or addiction, that requires a
consultation or comanagement of opioid therapy with one or
more specialists in pain management, mental health, or
addictions.
(C) Enhanced guidance with respect to health care
providers--
(i) conducting an effective assessment for patients
beginning or continuing opioid therapy, including
understanding and setting realistic goals with respect to
achieving and maintaining an expected level of pain relief,
improved function, or a clinically appropriate combination of
both; and
(ii) effectively assessing whether opioid therapy is
achieving or maintaining the established treatment goals of
the patient or whether the patient and health care provider
should discuss adjusting, augmenting, or discontinuing the
opioid therapy.
(D) Guidelines to govern the methodologies used by health
care providers of the Department of Veterans Affairs and the
Department of Defense to taper opioid therapy when adjusting
or discontinuing the use of opioid therapy.
(E) Guidelines with respect to appropriate case management
for patients receiving opioid therapy who transition between
inpatient and outpatient health care settings, which may
include the use of care transition plans.
(F) Guidelines with respect to appropriate case management
for patients receiving opioid therapy who transition from
receiving care during active duty to post-military health
care networks.
(G) Guidelines with respect to providing options, before
initiating opioid therapy, for pain management therapies
without the use of opioids and options to augment opioid
therapy with other clinical and complementary and integrative
health services to minimize opioid dependence.
(H) Guidelines with respect to the provision of evidence-
based non-opioid treatments within the Department of Veterans
Affairs and the Department of Defense, including medical
devices and other therapies approved or cleared by the Food
and Drug Administration for the treatment of chronic pain as
an alternative to or to augment opioid therapy.
SEC. 304. REVIEW, INVESTIGATION, AND REPORT ON USE OF OPIOIDS
IN TREATMENT BY DEPARTMENT OF VETERANS AFFAIRS.
(a) Comptroller General Report.--
(1) In general.--Not later than 2 years after the date of
the enactment of this Act, the Comptroller General of the
United States shall submit to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a report on the Opioid Safety
Initiative of the Department of Veterans Affairs and the
opioid prescribing practices of health care providers of the
Department.
(2) Elements.--The report submitted under paragraph (1)
shall include the following:
(A) Recommendations on such improvements to the Opioid
Safety Initiative of the Department as the Comptroller
General considers appropriate.
(B) Information with respect to--
(i) deaths resulting from sentinel events involving
veterans prescribed opioids by a health care provider of the
Department;
(ii) overall prescription rates and prescriptions
indications of opioids to treat non-cancer, non-palliative,
and non-hospice care patients;
(iii) the prescription rates and prescriptions indications
of benzodiazepines and opioids concomitantly by health care
providers of the Department;
(iv) the practice by health care providers of the
Department of prescribing opioids to treat patients without
any pain, including to treat patients with mental health
disorders other than opioid use disorder; and
(v) the effectiveness of opioid therapy for patients
receiving such therapy, including the effectiveness of long-
term opioid therapy.
(C) An evaluation of processes of the Department in place
to oversee opioid use among veterans, including procedures to
identify and remedy potential over-prescribing of opioids by
health care providers of the Department.
(D) An assessment of the implementation by the Secretary of
the VA/DOD Clinical Practice Guideline for Management of
Opioid Therapy for Chronic Pain.
(b) Quarterly Progress Report on Implementation of
Comptroller General Recommendations.--Not later than 2 years
after the date of the enactment of this Act, and not later
than 30 days after the end of each quarter thereafter, the
Secretary of Veterans Affairs shall submit to the Committee
on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a progress
report detailing the actions by the Secretary during the
period covered by the report to address any outstanding
findings and recommendations by the Comptroller General of
the United States under subsection (a) with respect to the
Veterans Health Administration.
(c) Annual Review of Prescription Rates.--Not later than 1
year after the date of the enactment of this Act, and not
less frequently than annually for the following 5 years, 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, with respect to each
medical facility of the Department of Veterans Affairs, to
collect and review information on opioids prescribed by
health care providers at the facility to treat non-cancer,
non-palliative, and non-hospice care patients that contains,
for the 1-year period preceding the submission of the report,
the following:
(1) The number of patients and the percentage of the
patient population of the Department who were prescribed
benzodiazepines and opioids concurrently by a health care
provider of the Department.
(2) The number of patients and the percentage of the
patient population of the Department without any pain who
were prescribed opioids by a health care provider of the
Department, including those who were prescribed
benzodiazepines and opioids concurrently.
(3) The number of non-cancer, non-palliative, and non-
hospice care patients and the percentage of such patients who
were treated with opioids by a health care provider of the
Department on an inpatient-basis and who also received
prescription opioids by mail from the Department while being
treated on an inpatient-basis.
(4) The number of non-cancer, non-palliative, and non-
hospice care patients and the percentage of such patients who
were prescribed opioids concurrently by a health care
provider of the Department and a health care provider that is
not health care provider of the Department.
(5) With respect to each medical facility of the
Department, information on opioids prescribed by health care
providers at the facility to treat non-cancer, non-
palliative, and non-hospice care patients, including
information on--
[[Page H2361]]
(A) the prescription rate at which each health care
provider at the facility prescribed benzodiazepines and
opioids concurrently to such patients and the aggregate such
prescription rate for all health care providers at the
facility;
(B) the prescription rate at which each health care
provider at the facility prescribed benzodiazepines or
opioids to such patients to treat conditions for which
benzodiazepines or opioids are not approved treatment and the
aggregate such prescription rate for all health care
providers at the facility;
(C) the prescription rate at which each health care
provider at the facility prescribed or dispensed mail-order
prescriptions of opioids to such patients while such patients
were being treated with opioids on an inpatient-basis and the
aggregate of such prescription rate for all health care
providers at the facility; and
(D) the prescription rate at which each health care
provider at the facility prescribed opioids to such patients
who were also concurrently prescribed opioids by a health
care provider that is not a health care provider of the
Department and the aggregate of such prescription rates for
all health care providers at the facility.
(6) With respect to each medical facility of the
Department, the number of times a pharmacist at the facility
overrode a critical drug interaction warning with respect to
an interaction between opioids and another medication before
dispensing such medication to a veteran.
(d) Investigation of Prescription Rates.--If the Secretary
determines that a prescription rate with respect to a health
care provider or medical facility of the Department conflicts
with or is otherwise inconsistent with the standards of
appropriate and safe care, the Secretary shall--
(1) immediately notify the Committee on Veterans' Affairs
of the Senate and the Committee on Veterans' Affairs of the
House of Representatives of such determination, including
information relating to such determination, prescription
rate, and health care provider or medical facility, as the
case may be; and
(2) through the Office of the Medical Inspector of the
Veterans Health Administration, conduct a full investigation
of the health care provider or medical facility, as the case
may be.
(e) Prescription Rate Defined.--In this section, the term
``prescription rate'' means, with respect to a health care
provider or medical facility of the Department, each of the
following:
(1) The number of patients treated with opioids by the
health care provider or at the medical facility, as the case
may be, divided by the total number of pharmacy users of that
health care provider or medical facility.
(2) The average number of morphine equivalents per day
prescribed by the health care provider or at the medical
facility, as the case may be, to patients being treated with
opioids.
(3) Of the patients being treated with opioids by the
health care provider or at the medical facility, as the case
may be, the average number of prescriptions of opioids per
patient.
SEC. 305. MANDATORY DISCLOSURE OF CERTAIN VETERAN INFORMATION
TO STATE CONTROLLED SUBSTANCE MONITORING
PROGRAMS.
Section 5701(l) of title 38, United States Code, is amended
by striking ``may'' and inserting ``shall''.
SEC. 306. MODIFICATION TO LIMITATION ON AWARDS AND BONUSES.
Section 705 of the Veterans Access, Choice, and
Accountability Act of 2014 (Public Law 113-146; 38 U.S.C. 703
note) is amended to read as follows:
``SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO
EMPLOYEES OF DEPARTMENT OF VETERANS AFFAIRS.
``The Secretary of Veterans Affairs shall ensure that the
aggregate amount of awards and bonuses paid by the Secretary
in a fiscal year under chapter 45 or 53 of title 5, United
States Code, or any other awards or bonuses authorized under
such title or title 38, United States Code, does not exceed
the following amounts:
``(1) With respect to each of fiscal years 2017 through
2021, $230,000,000.
``(2) With respect to each of fiscal years 2022 through
2024, $360,000,000.''.
TITLE IV--KINGPIN DESIGNATION IMPROVEMENT ACT
SEC. 401. SHORT TITLE.
This title may be cited as the ``Kingpin Designation
Improvement Act of 2016''.
SEC. 402. PROTECTION OF CLASSIFIED INFORMATION IN FEDERAL
COURT CHALLENGES RELATING TO DESIGNATIONS UNDER
THE NARCOTICS KINGPIN DESIGNATION ACT.
Section 804 of the Foreign Narcotics Kingpin Designation
Act (21 U.S.C. 1903) is amended by adding at the end the
following:
``(i) Protection of Classified Information in Federal Court
Challenges Relating to Designations.--In any judicial review
of a determination made under this section, if the
determination was based on classified information (as defined
in section 1(a) of the Classified Information Procedures Act)
such information may be submitted to the reviewing court ex
parte and in camera. This subsection does not confer or imply
any right to judicial review.''.
TITLE V--GOOD SAMARITAN ASSESSMENT ACT
SEC. 501. SHORT TITLE.
This title may be cited as the ``Good Samaritan Assessment
Act of 2016''.
SEC. 502. FINDING.
The Congress finds that the executive branch, including the
Office of National Drug Control Policy, has a policy focus on
preventing and addressing prescription drug misuse and heroin
use, and has worked with States and municipalities to enact
Good Samaritan laws that would protect caregivers, law
enforcement personnel, and first responders who administer
opioid overdose reversal drugs or devices.
SEC. 503. GAO STUDY ON GOOD SAMARITAN LAWS PERTAINING TO
TREATMENT OF OPIOID OVERDOSES.
The Comptroller General of the United States shall submit
to the Committee on the Judiciary of the House of
Representatives, the Committee on Oversight and Government
Reform of the House of Representatives, the Committee on the
Judiciary of the Senate, and the Committee on Homeland
Security and Governmental Affairs of the Senate a report on--
(1) the extent to which the Director of National Drug
Control Policy has reviewed Good Samaritan laws, and any
findings from such a review, including findings related to
the potential effects of such laws, if available;
(2) efforts by the Director to encourage the enactment of
Good Samaritan laws; and
(3) a compilation of Good Samaritan laws in effect in the
States, the territories, and the District of Columbia.
SEC. 504. DEFINITIONS.
In this title--
(1) the term ``Good Samaritan law'' means a law of a State
or unit of local government that exempts from criminal or
civil liability any individual who administers an opioid
overdose reversal drug or device, or who contacts emergency
services providers in response to an overdose; and
(2) the term ``opioid'' means any drug, including heroin,
having an addiction-forming or addiction-sustaining liability
similar to morphine or being capable of conversion into a
drug having such addiction-forming or addiction-sustaining
liability.
TITLE VI--OPEN ACT
SEC. 601. SHORT TITLE.
This title may be cited as the ``Opioid Program Evaluation
Act'' or the ``OPEN Act''.
SEC. 602. EVALUATION OF PERFORMANCE OF DEPARTMENT OF JUSTICE
PROGRAM.
(a) Evaluation of Justice Department Comprehensive Opioid
Abuse Grant Program.--Not later than 5 years after the date
of enactment of this Act, the Attorney General shall complete
an evaluation of the effectiveness of the Comprehensive
Opioid Abuse Grant Program under part LL of the Omnibus Crime
Control and Safe Streets Act of 1968 administered by the
Department of Justice based upon the information reported
under subsection (d) of this section.
(b) Interim Evaluation.--Not later than 3 years after the
date of enactment of this Act, the Attorney General shall
complete an interim evaluation assessing the nature and
extent of the incidence of opioid abuse and illegal opioid
distribution in the United States.
(c) Metrics and Outcomes for Evaluation.--Not later than
180 days after the date of enactment of this Act, the
Attorney General shall identify outcomes that are to be
achieved by activities funded by the Comprehensive Opioid
Grant Abuse Program and the metrics by which the achievement
of such outcomes shall be determined.
(d) Metrics Data Collection.--The Attorney General shall
require grantees under the Comprehensive Opioid Abuse Grant
Program (and those receiving subawards under section 3021(b)
of part LL of the Omnibus Crime Control and Safe Streets Act
of 1968) to collect and annually report to the Department of
Justice data based upon the metrics identified under
subsection (c).
(e) Publication of Data and Findings.--
(1) Publication of outcomes and metrics.--The Attorney
General shall, not later than 30 days after completion of the
requirement under subsection (c), publish the outcomes and
metrics identified under that subsection.
(2) Publication of evaluation.--In the case of the interim
evaluation under subsection (b), and the final evaluation
under subsection (a), the National Academy of Sciences shall,
not later than 90 days after such an evaluation is completed,
publish the results of such evaluation and issue a report on
such evaluation to the Committee on the Judiciary of the
House of Representatives and the Committee on the Judiciary
of the Senate. Such report shall also be published along with
the data used to make such evaluation.
(f) Arrangement With the National Academy of Sciences.--For
purposes of subsections (a), (b), and (c), the Attorney
General shall enter into an arrangement with the National
Academy of Sciences.
SEC. 603. EVALUATION OF PERFORMANCE OF DEPARTMENT OF HEALTH
AND HUMAN SERVICES PROGRAM.
(a) Evaluation of Department of Health and Human Services
Programs.--Not later than 5 years after the date of enactment
of this Act, except as otherwise provided in this section,
the Secretary of Health and Human Services shall complete an
evaluation of any program administered by the Secretary that
provides grants for the primary purpose of providing
assistance in addressing problems pertaining to opioid abuse
based upon the information reported under subsection (d) of
this section.
(b) Interim Evaluation.--Not later than 3 years after the
date of enactment of this Act, the Secretary shall complete
an interim evaluation assessing the nature and extent of the
incidence of opioid abuse and illegal opioid distribution in
the United States.
(c) Metrics and Outcomes for Evaluation.--Not later than
180 days after the date of enactment of this Act, the
Secretary shall identify outcomes that are to be achieved by
activities funded by the programs described in subsection (a)
and the metrics by which the achievement of such outcomes
shall be determined.
(d) Metrics Data Collection.--The Secretary shall require
grantees under the programs
[[Page H2362]]
described in subsection (a) to collect and annually report to
the Department of Health and Human Services data based upon
the metrics identified under subsection (c).
(e) Publication of Data and Findings.--
(1) Publication of outcomes and metrics.--The Secretary
shall, not later than 30 days after completion of the
requirement under subsection (c), publish the outcomes and
metrics identified under that subsection.
(2) Publication of evaluation.--In the case of the interim
evaluation under subsection (b), and each final evaluation
under subsection (a), the National Academy of Sciences shall,
not later than 90 days after such an evaluation is completed,
publish the results of such evaluation and issue a report on
such evaluation to the Committee on Energy and Commerce of
the House of Representatives and the Committee on Health,
Education, Labor, and Pensions of the Senate. Such report
shall also be published along with the data used to make such
evaluation.
(f) Arrangement With the National Academy of Sciences.--For
purposes of subsections (a), (b), and (c), the Secretary
shall--
(1) enter into an arrangement with the National Academy of
Sciences; or
(2) enter into a contract or cooperative agreement with an
entity that is not an agency of the Federal Government.
(g) Exception.--If a program described under subsection (a)
is subject to an evaluation substantially similar to the
evaluation under subsection (a) pursuant to another provision
of law, the Secretary may opt not to conduct an evaluation
under subsection (a) of such program.
SEC. 604. DEFINITION.
In this title, the term ``opioid'' has the meaning given
the term ``opiate'' in section 102 of the Controlled
Substances Act (21 U.S.C. 802).
SEC. 605. NO ADDITIONAL FUNDS AUTHORIZED.
No additional funds are authorized to be appropriated to
carry out this Act.
SEC. 606. MATTERS REGARDING CERTAIN FEDERAL LAW ENFORCEMENT
ASSISTANCE.
Section 609Y of the Justice Assistance Act of 1984 (42
U.S.C. 10513) is amended--
(1) in subsection (a), by striking ``There is'' and
inserting ``Except as provided in subsection (c), there is'';
and
(2) by adding at the end the following:
``(c) For fiscal year 2022, there is authorized to be
appropriated $16,000,000, to provide under this chapter
Federal law enforcement assistance in the form of funds.''.
TITLE VII--INFANT PLAN OF SAFE CARE IMPROVEMENT ACT
SEC. 701. SHORT TITLE.
This title may be cited as the ``Infant Plan of Safe Care
Improvement Act''.
SEC. 702. BEST PRACTICES FOR DEVELOPMENT OF PLANS OF SAFE
CARE.
Section 103(b) of the Child Abuse Prevention and Treatment
Act (42 U.S.C. 5104(b)) is amended--
(1) by redesignating paragraphs (5) through (8) as
paragraphs (6) through (9), respectively; and
(2) by inserting after paragraph (4), the following:
``(5) maintain and disseminate information about the
requirements of section 106(b)(2)(B)(iii) and best practices
relating to the development of plans of safe care as
described in such section for infants born and identified as
being affected by illegal substance abuse or withdrawal
symptoms, or a Fetal Alcohol Spectrum Disorder;''.
SEC. 703. STATE PLANS.
Section 106(b)(2)(B)(iii) of the Child Abuse Prevention and
Treatment Act (42 U.S.C. 5106a(b)(2)(B)(iii)) is amended by
inserting before the semicolon at the end the following: ``to
ensure the safety and well-being of such infant following
release from the care of healthcare providers, including
through--''
``(I) addressing the health and substance use disorder
treatment needs of the infant and affected family or
caregiver; and
``(II) the development and implementation by the State of
monitoring systems regarding the implementation of such plans
to determine whether and in what manner local entities are
providing, in accordance with State requirements, referrals
to and delivery of appropriate services for the infant and
affected family or caregiver''.
SEC. 704. DATA REPORTS.
(a) In General.--Section 106(d) of the Child Abuse
Prevention and Treatment Act (42 U.S.C. 5106a(d)) is amended
by adding at the end of the following:
``(17)(A) The number of infants identified under subsection
(b)(2)(B)(ii).
``(B) The number of infants for whom a plan of safe care
was developed under subsection (b)(2)(B)(iii).
``(C) The number of infants for whom a referral was made
for appropriate services, including services for the affected
family or caregiver, under subsection (b)(2)(B)(iii).''.
(b) Redesignation.--Effective on May 29, 2017, section
106(d) of the Child Abuse Prevention and Treatment Act (42
U.S.C. 5106a(d)) is amended by redesignating paragraph (17)
(as added by subsection (a)) as paragraph (18).
SEC. 705. MONITORING AND OVERSIGHT.
(a) Amendment.--Title I of the Child Abuse Prevention and
Treatment Act (42 U.S.C. 5101 et seq.) is further amended by
adding at the end the following:
``SEC. 114. MONITORING AND OVERSIGHT.
``The Secretary shall conduct monitoring to ensure that
each State that receives a grant under section 106 is in
compliance with the requirements of section 106(b), which--
``(1) shall--
``(A) be in addition to the review of the State plan upon
its submission under section 106(b)(1)(A); and
``(B) include monitoring of State policies and procedures
required under clauses (ii) and (iii) of section
106(b)(2)(B); and
``(2) may include--
``(A) a comparison of activities carried out by the State
to comply with the requirements of section 106(b) with the
State plan most recently approved under section 432 of the
Social Security Act;
``(B) a review of information available on the Website of
the State relating to its compliance with the requirements of
section 106(b);
``(C) site visits, as may be necessary to carry out such
monitoring; and
``(D) a review of information available in the State's
Annual Progress and Services Report most recently submitted
under section 1357.16 of title 45, Code of Federal
Regulations (or successor regulations).''.
(b) Table of Contents.--The table of contents in section
1(b) of the Child Abuse Prevention and Treatment Act (42
U.S.C. 5101 note) is amended by inserting after the item
relating to section 113, the following:
``Sec. 114. Monitoring and oversight.''.
SEC. 706. RULE OF CONSTRUCTION.
Nothing in this Act, or the amendments made by this Act,
shall be construed to authorize the Secretary of Health and
Human Services or any other officer of the Federal Government
to add new requirements to section 106(b) of the Child Abuse
Prevention and Treatment Act (42 U.S.C. 5106a(b)), as amended
by this Act.
TITLE VIII--NAS HEALTHY BABIES ACT
SEC. 801. SHORT TITLE.
This title may be cited as the ``Nurturing And Supporting
Healthy Babies Act'' or as the ``NAS Healthy Babies Act''.
SEC. 802. GAO REPORT ON NEONATAL ABSTINENCE SYNDROME (NAS).
(a) In General.--Not later than 1 year after the date of
the enactment of this Act, the Comptroller General of the
United States shall submit to the Committee on Energy and
Commerce of the House of Representatives and the Committee on
Finance and the Committee on Health, Education, Labor and
Pensions of the Senate a report on neonatal abstinence
syndrome (in this section referred to as ``NAS'') in the
United States.
(b) Information To Be Included in Report.--Such report
shall include information on the following:
(1) The prevalence of NAS in the United States, including
the proportion of children born in the United States with NAS
who are eligible for medical assistance under State Medicaid
programs under title XIX of the Social Security Act at birth
and the costs associated with NAS through such programs.
(2) The services for which coverage is available under
State Medicaid programs for treatment of infants with NAS.
(3) The settings (including inpatient, outpatient,
hospital-based, and other settings) for the treatment of
infants with NAS and the reimbursement methodologies and
costs associated with such treatment in such settings.
(4) The prevalence of utilization of various care settings
under State Medicaid programs for treatment of infants with
NAS and any Federal barriers to treating such infants under
such programs, particularly in non-hospital-based settings.
(5) What is known about best practices for treating infants
with NAS.
(c) Recommendations.--Such report also shall include such
recommendations as the Comptroller General determines
appropriate for improvements that will ensure access to
treatment for infants with NAS under State Medicaid programs.
SEC. 803. EXCLUDING ABUSE-DETERRENT FORMULATIONS OF
PRESCRIPTION DRUGS FROM THE MEDICAID ADDITIONAL
REBATE REQUIREMENT FOR NEW FORMULATIONS OF
PRESCRIPTION DRUGS.
(a) In General.--The last sentence of section 1927(c)(2)(C)
of the Social Security Act (42 U.S.C. 1396r-8(c)(2)(C)) is
amended by inserting before the period at the end the
following: ``, but does not include an abuse-deterrent
formulation of the drug (as determined by the Secretary),
regardless of whether such abuse-deterrent formulation is an
extended release formulation''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply to drugs that are paid for by a State in calendar
quarters beginning on or after the date of the enactment of
this Act.
SEC. 804. LIMITING DISCLOSURE OF PREDICTIVE MODELING AND
OTHER ANALYTICS TECHNOLOGIES TO IDENTIFY AND
PREVENT WASTE, FRAUD, AND ABUSE.
(a) In General.--Title XI of the Social Security Act is
amended by inserting after section 1128J (42 U.S.C. 1320a-7k)
the following new section:
``SEC. 1128K. DISCLOSURE OF PREDICTIVE MODELING AND OTHER
ANALYTICS TECHNOLOGIES TO IDENTIFY AND PREVENT
WASTE, FRAUD, AND ABUSE.
``(a) Reference to Predictive Modeling Technologies
Requirements.--For provisions relating to the use of
predictive modeling and other analytics technologies to
identify and prevent waste, fraud, and abuse with respect to
the Medicare program under title XVIII, the Medicaid program
under title XIX, and the Children's Health Insurance Program
under title XXI, see section 4241 of the Small Business Jobs
Act of 2010 (42 U.S.C. 1320a-7m).
``(b) Limiting Disclosure of Predictive Modeling
Technologies.--In implementing
[[Page H2363]]
such provisions under such section 4241 with respect to
covered algorithms (as defined in subsection (c)), the
following shall apply:
``(1) Nonapplication of foia.--The covered algorithms used
or developed for purposes of such section (including by the
Secretary or a State (or an entity operating under a contract
with a State)) shall be exempt from disclosure under section
552(b)(3) of title 5, United States Code.
``(2) Limitation with respect to use and disclosure of
information by state agencies.--
``(A) In general.--A State agency may not use or disclose
covered algorithms used or developed for purposes of such
section except for purposes of administering the State plan
(or a waiver of the plan) under the Medicaid program under
title XIX or the State child health plan (or a waiver of the
plan) under the Children's Health Insurance Program under
title XXI, including by enabling an entity operating under a
contract with a State to assist the State to identify or
prevent waste, fraud, and abuse with respect to such
programs.
``(B) Information security.--A State agency shall have in
effect data security and control policies that the Secretary
finds adequate to ensure the security of covered algorithms
used or developed for purposes of such section 4241 and to
ensure that access to such information is restricted to
authorized persons for purposes of authorized uses and
disclosures described in subparagraph (A).
``(C) Procedural requirements.--State agencies to which
information is disclosed pursuant to such section 4241 shall
adhere to uniform procedures established by the Secretary.
``(c) Covered Algorithm Defined.--In this section, the term
`covered algorithm'--
``(1) means a predictive modeling or other analytics
technology, as used for purposes of section 4241(a) of the
Small Business Jobs Act of 2010 (42 U.S.C. 1320a-7m(a)) to
identify and prevent waste, fraud, and abuse with respect to
the Medicare program under title XVIII, the Medicaid program
under title XIX, and the Children's Health Insurance Program
under title XXI; and
``(2) includes the mathematical expressions utilized in the
application of such technology and the means by which such
technology is developed.''.
(b) Conforming Amendments.--
(1) Medicaid state plan requirement.--Section 1902(a) of
the Social Security Act (42 U.S.C. 1396a(a)) is amended--
(A) in paragraph (80), by striking ``and'' at the end;
(B) in paragraph (81), by striking the period at the end
and inserting ``; and''; and
(C) by inserting after paragraph (81) the following new
paragraph:
``(82) provide that the State agency responsible for
administering the State plan under this title provides
assurances to the Secretary that the State agency is in
compliance with subparagraphs (A), (B), and (C) of section
1128K(b)(2).''.
(2) State child health plan requirement.--Section
2102(a)(7) of the Social Security Act (42 U.S.C.
1397bb(a)(7)) is amended--
(A) in subparagraph (A), by striking ``, and'' at the end
and inserting a semicolon;
(B) in subparagraph (B), by striking the period at the end
and inserting ``; and''; and
(C) by adding at the end the following new subparagraph:
``(C) to ensure that the State agency involved is in
compliance with subparagraphs (A), (B), and (C) of section
1128K(b)(2).''.
SEC. 805. MEDICAID IMPROVEMENT FUND.
Section 1941(b)(1) of the Social Security Act (42 U.S.C.
1396w-1(b)(1)) is amended to read as follows:
``(1) In general.--There shall be available to the Fund,
for expenditures from the Fund for fiscal year 2021 and
thereafter, $5,000,000.''.
TITLE IX--CO-PRESCRIBING TO REDUCE OVERDOSES ACT
SEC. 901. SHORT TITLE.
This title may be cited as the ``Co-Prescribing to Reduce
Overdoses Act of 2016''.
SEC. 902. OPIOID OVERDOSE REVERSAL DRUGS PRESCRIBING GRANT
PROGRAM.
(a) Establishment.--
(1) In general.--Not later than 6 months after the date of
the enactment of this Act, the Secretary of Health and Human
Services may establish, in accordance with this section, a 5-
year opioid overdose reversal drugs prescribing grant program
(in this Act referred to as the ``grant program'').
(2) Maximum grant amount.--A grant made under this section
may not be for more than $200,000 per grant year.
(3) Eligible entity.--For purposes of this section, the
term ``eligible entity'' means a federally qualified health
center (as defined in section 1861(aa) of the Social Security
Act (42 U.S.C. 1395x(aa)), an opioid treatment program under
part 8 of title 42, Code of Federal Regulations, any
practitioner dispensing narcotic drugs pursuant to section
303(g) of the Controlled Substances Act (21 U.S.C. 823(g)),
or any other entity that the Secretary deems appropriate.
(4) Prescribing.--For purposes of this section and section
3, the term ``prescribing'' means, with respect to an opioid
overdose reversal drug, such as naloxone, the practice of
prescribing such drug--
(A) in conjunction with an opioid prescription for patients
at an elevated risk of overdose;
(B) in conjunction with an opioid agonist approved under
section 505 of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355) for the treatment of opioid abuse disorder;
(C) to the caregiver or a close relative of patients at an
elevated risk of overdose from opioids; or
(D) in other circumstances, as identified by the Secretary,
in which a provider identifies a patient is at an elevated
risk for an intentional or unintentional drug overdose from
heroin or prescription opioid therapies.
(b) Application.--To be eligible to receive a grant under
this section, an eligible entity shall submit to the
Secretary of Health and Human Services, in such form and
manner as specified by the Secretary, an application that
describes--
(1) the extent to which the area to which the entity will
furnish services through use of the grant is experiencing
significant morbidity and mortality caused by opioid abuse;
(2) the criteria that will be used to identify eligible
patients to participate in such program; and
(3) how such program will work to try to identify State,
local, or private funding to continue the program after
expiration of the grant.
(c) Use of Funds.--An eligible entity receiving a grant
under this section may use the grant for any of the following
activities, but may use not more than 20 percent of the grant
funds for activities described in paragraphs (4) and (5):
(1) To establish a program for prescribing opioid overdose
reversal drugs, such as naloxone.
(2) To train and provide resources for health care
providers and pharmacists on the prescribing of opioid
overdose reversal drugs, such as naloxone.
(3) To establish mechanisms and processes for tracking
patients participating in the program described in paragraph
(1) and the health outcomes of such patients.
(4) To purchase opioid overdose reversal drugs, such as
naloxone, for distribution under the program described in
paragraph (1).
(5) To offset the co-pays and other cost sharing associated
with opioid overdose reversal drugs, such as naloxone, to
ensure that cost is not a limiting factor for eligible
patients.
(6) To conduct community outreach, in conjunction with
community-based organizations, designed to raise awareness of
prescribing practices, and the availability of opioid
overdose reversal drugs, such as naloxone.
(7) To establish protocols to connect patients who have
experienced a drug overdose with appropriate treatment,
including medication assisted treatment and appropriate
counseling and behavioral therapies.
(d) Evaluations by Recipients.--As a condition of receipt
of a grant under this section, an eligible entity shall, for
each year for which the grant is received, submit to the
Secretary of Health and Human Services information on
appropriate outcome measures specified by the Secretary to
assess the outcomes of the program funded by the grant,
including--
(1) the number of prescribers trained;
(2) the number of prescribers who have co-prescribed an
opioid overdose reversal drug, such as naloxone, to at least
one patient;
(3) the total number of prescriptions written for opioid
overdose reversal drugs, such as naloxone;
(4) the percentage of patients at elevated risk who
received a prescription for an opioid overdose reversal drug,
such as naloxone;
(5) the number of patients reporting use of an opioid
overdose reversal drug, such as naloxone; and
(6) any other outcome measures that the Secretary deems
appropriate.
(e) Reports by Secretary.--For each year of the grant
program under this section, the Secretary of Health and Human
Services shall submit to the appropriate committees of the
House of Representatives and of the Senate a report
aggregating the information received from the grant
recipients for such year under subsection (d) and evaluating
the outcomes achieved by the programs funded by grants made
under this section.
SEC. 903. PROVIDING INFORMATION TO PRESCRIBERS IN CERTAIN
FEDERAL HEALTH CARE AND MEDICAL FACILITIES ON
BEST PRACTICES FOR PRESCRIBING OPIOID OVERDOSE
REVERSAL DRUGS.
(a) In General.--Not later than 180 days after the date of
enactment of this Act, the Secretary of Health and Human
Services (in this section referred to as the ``Secretary'')
may, as appropriate, provide information to prescribers
within federally qualified health centers (as defined in
paragraph (4) of section 1861(aa) of the Social Security Act
(42 U.S.C. 1395x(aa))), and the health care facilities of the
Indian Health Service, on best practices for prescribing
opioid overdose reversal drugs, such as naloxone, for
patients receiving chronic opioid therapy, patients being
treated for opioid use disorders, and other patients that a
provider identifies as having an elevated risk of overdose
from heroin or prescription opioid therapies.
(b) Not Establishing a Medical Standard of Care.--The
information on best practices provided under this section
shall not be construed as constituting or establishing a
medical standard of care for prescribing opioid overdose
reversal drugs, such as naloxone, for patients described in
subsection (a).
(c) Elevated Risk of Overdose Defined.--In this section,
the term ``elevated risk of overdose'' has the meaning given
such term by the Secretary, which--
(1) may be based on the criteria provided in the Opioid
Overdose Toolkit published by the Substance Abuse and Mental
Health Services Administration (SAMHSA); and
(2) may include patients on a first course opioid
treatment, patients using extended-release and long-acting
opioid analgesics, and patients with a respiratory disease or
other co-morbidities.
SEC. 904. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out this
title $5,000,000 for the period of fiscal years 2017 through
2021.
[[Page H2364]]
SEC. 905. 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 2018)''.
TITLE X--IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM WOMEN ACT
SEC. 1001. SHORT TITLE.
This title may be cited as the ``Improving Treatment for
Pregnant and Postpartum Women Act of 2016''.
SEC. 1002. REAUTHORIZATION OF RESIDENTIAL TREATMENT PROGRAMS
FOR PREGNANT AND POSTPARTUM WOMEN.
Section 508 of the Public Health Service Act (42 U.S.C.
290bb-1) is amended--
(1) in subsection (p), in the first sentence, by inserting
``(other than subsection (r))'' after ``section''; and
(2) in subsection (r), by striking ``such sums'' and all
that follows through ``2003'' and inserting ``$16,900,000 for
each of fiscal years 2017 through 2021''.
SEC. 1003. PILOT PROGRAM GRANTS FOR STATE SUBSTANCE ABUSE
AGENCIES.
(a) In General.--Section 508 of the Public Health Service
Act (42 U.S.C. 290bb-1) is amended--
(1) by redesignating subsection (r), as amended by section
2, as subsection (s); and
(2) by inserting after subsection (q) the following new
subsection:
``(r) Pilot Program for State Substance Abuse Agencies.--
``(1) In general.--From amounts made available under
subsection (s), the Director of the Center for Substance
Abuse Treatment shall carry out a pilot program under which
competitive grants are made by the Director to State
substance abuse agencies to--
``(A) enhance flexibility in the use of funds designed to
support family-based services for pregnant and postpartum
women with a primary diagnosis of a substance use disorder,
including opioid use disorders;
``(B) help State substance abuse agencies address
identified gaps in services furnished to such women along the
continuum of care, including services provided to women in
nonresidential based settings; and
``(C) promote a coordinated, effective, and efficient State
system managed by State substance abuse agencies by
encouraging new approaches and models of service delivery.
``(2) Requirements.--In carrying out the pilot program
under this subsection, the Director shall--
``(A) require State substance abuse agencies to submit to
the Director applications, in such form and manner and
containing such information as specified by the Director, to
be eligible to receive a grant under the program;
``(B) identify, based on such submitted applications, State
substance abuse agencies that are eligible for such grants;
``(C) require services proposed to be furnished through
such a grant to support family-based treatment and other
services for pregnant and postpartum women with a primary
diagnosis of a substance use disorder, including opioid use
disorders;
``(D) not require that services furnished through such a
grant be provided solely to women that reside in facilities;
``(E) not require that grant recipients under the program
make available through use of the grant all services
described in subsection (d); and
``(F) consider not applying requirements described in
paragraphs (1) and (2) of subsection (f) to applicants,
depending on the circumstances of the applicant.
``(3) Required services.--
``(A) In general.--The Director shall specify a minimum set
of services required to be made available to eligible women
through a grant awarded under the pilot program under this
subsection. Such minimum set--
``(i) shall include requirements described in subsection
(c) and be based on the recommendations submitted under
subparagraph (B); and
``(ii) may be selected from among the services described in
subsection (d) and include other services as appropriate.
``(B) Stakeholder input.--The Director shall convene and
solicit recommendations from stakeholders, including State
substance abuse agencies, health care providers, persons in
recovery from substance abuse, and other appropriate
individuals, for the minimum set of services described in
subparagraph (A).
``(4) Duration.--The pilot program under this subsection
shall not exceed 5 years.
``(5) Evaluation and report to congress.--The Director of
the Center for Behavioral Health Statistics and Quality shall
fund an evaluation of the pilot program at the conclusion of
the first grant cycle funded by the pilot program. The
Director of the Center for Behavioral Health Statistics and
Quality, in coordination with the Director of the Center for
Substance Abuse Treatment shall submit to the relevant
committees of jurisdiction of the House of Representatives
and the Senate a report on such evaluation. The report shall
include at a minimum outcomes information from the pilot
program, including any resulting reductions in the use of
alcohol and other drugs; engagement in treatment services;
retention in the appropriate level and duration of services;
increased access to the use of medications approved by the
Food and Drug Administration for the treatment of substance
use disorders in combination with counseling; and other
appropriate measures.
``(6) State substance abuse agencies defined.--For purposes
of this subsection, the term `State substance abuse agency'
means, with respect to a State, the agency in such State that
manages the Substance Abuse Prevention and Treatment Block
Grant under part B of title XIX.''.
(b) Funding.--Subsection (s) of section 508 of the Public
Health Service Act (42 U.S.C. 290bb-1), as amended by section
1002 and redesignated by subsection (a), is further amended
by adding at the end the following new sentence: ``Of the
amounts made available for a year pursuant to the previous
sentence to carry out this section, not more than 25 percent
of such amounts shall be made available for such year to
carry out subsection (r), other than paragraph (5) of such
subsection. Notwithstanding the preceding sentence, no funds
shall be made available to carry out subsection (r) for a
fiscal year unless the amount made available to carry out
this section for such fiscal year is more than the amount
made available to carry out this section for fiscal year
2016.''.
SEC. 1004. CUT-GO COMPLIANCE.
Subsection (f) of section 319D of the Public Health Service
Act (42 U.S.C. 247d-4) is amended by striking ``through
2018'' and inserting ``through 2016, $133,300,000 for fiscal
year 2017, and $138,300,000 for fiscal year 2018''.
TITLE XI--VETERAN EMERGENCY MEDICAL TECHNICIAN SUPPORT ACT
SEC. 1101. SHORT TITLE.
This title may be cited as the ``Veteran Emergency Medical
Technician Support Act of 2016''.
SEC. 1102. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL
TRAINING TO MEET REQUIREMENTS FOR BECOMING
CIVILIAN EMERGENCY MEDICAL TECHNICIANS.
Part B of title III of the Public Health Service Act (42
U.S.C. 243 et seq.) is amended by inserting after section 314
the following:
``SEC. 315. ASSISTING VETERANS WITH MILITARY EMERGENCY
MEDICAL TRAINING TO MEET REQUIREMENTS FOR
BECOMING CIVILIAN EMERGENCY MEDICAL
TECHNICIANS.
``(a) Program.--The Secretary shall establish a program
consisting of awarding demonstration grants to States to
streamline State requirements and procedures in order to
assist veterans who completed military emergency medical
technician training while serving in the Armed Forces of the
United States to meet certification, licensure, and other
requirements applicable to becoming an emergency medical
technician in the State.
``(b) Use of Funds.--Amounts received as a demonstration
grant under this section shall be used to prepare and
implement a plan to streamline State requirements and
procedures as described in subsection (a), including by--
``(1) determining the extent to which the requirements for
the education, training, and skill level of emergency medical
technicians in the State are equivalent to requirements for
the education, training, and skill level of military
emergency medical technicians; and
``(2) identifying methods, such as waivers, for military
emergency medical technicians to forgo or meet any such
equivalent State requirements.
``(c) Eligibility.--To be eligible for a grant under this
section, a State shall demonstrate that the State has a
shortage of emergency medical technicians.
``(d) Report.--The Secretary shall submit to the Congress
an annual report on the program under this section.
``(e) Funding.--No additional funds are authorized to be
appropriated for the purpose of carrying out this section.
This section shall be carried out using amounts otherwise
available for such purpose.''.
TITLE XII--JOHN THOMAS DECKER ACT
SEC. 1201. SHORT TITLE.
This title may be cited as the ``John Thomas Decker Act of
2016''.
SEC. 1202. INFORMATION MATERIALS AND RESOURCES TO PREVENT
ADDICTION RELATED TO YOUTH SPORTS INJURIES.
(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. INFORMATION MATERIALS AND RESOURCES TO PREVENT
ADDICTION RELATED TO YOUTH SPORTS INJURIES.
``(a) Report.--The Secretary shall--
``(1) not later than 24 months after the date of the
enactment of this section, make publicly available a report
determining the extent to which informational materials and
resources described in subsection (b) are available to
teenagers and adolescents who play youth sports, families of
such teenagers and adolescents, nurses, youth sports groups,
and relevant health care provider groups; and
``(2) for purposes of educating and preventing addiction in
teenagers and adolescents who are injured playing youth
sports and are subsequently prescribed an opioid, not later
than 12 months after such report is made publicly available
and taking into consideration the findings of such report,
develop and, in coordination with youth sports groups,
disseminate informational materials and resources described
in subsection (b) for teenagers and adolescents who play
youth sports, families of such teenagers and adolescents,
nurses, youth sports groups, and relevant health care
provider groups.
``(b) Materials and Resources Described.--For purposes of
this section, the informational materials and resources
described in this subsection are informational materials and
resources with respect to youth sports injuries for which
opioids are potentially prescribed and
[[Page H2365]]
subsequently potentially lead to addiction, including
materials and resources focused on the dangers of opioid use
and misuse, treatment options for such injuries that do not
involve the use of opioids, and how to seek treatment for
addiction.
``(c) No Additional Funds.--No additional funds are
authorized to be appropriated for the purpose of carrying out
this section. This section shall be carried out using amounts
otherwise available for such purpose.''.
TITLE XIII--LALI'S LAW
SEC. 1301. SHORT TITLE.
This title may be cited as ``Lali's Law''.
SEC. 1302. 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 one 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. 1303. 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)''.
TITLE XIV--REDUCING UNUSED MEDICATIONS ACT
SEC. 1401. SHORT TITLE.
This title may be cited as the ``Reducing Unused
Medications Act of 2016''.
SEC. 1402. PARTIAL FILLS OF SCHEDULE II CONTROLLED
SUBSTANCES.
(a) In General.--Section 309 of the Controlled Substances
Act (21 U.S.C. 829) is amended by adding at the end the
following:
``(f) Partial Fills of Schedule II Controlled Substances.--
``(1) Partial fills.--
``(A) In general.--A prescription for a controlled
substance in schedule II may be partially filled if--
``(i) it is not prohibited by State law;
``(ii) the prescription is written and filled in accordance
with the Controlled Substances Act (21 U.S.C. 801 et seq.),
regulations prescribed by the Attorney General, and State
law;
``(iii) the partial fill is requested by the patient or the
practitioner that wrote the prescription; and
``(iv) the total quantity dispensed in all partial fillings
does not exceed the total quantity prescribed.
``(B) Other circumstances.--A prescription for a controlled
substance in schedule II may be partially filled in
accordance with section 1306.13 of title 21, Code of Federal
Regulations (as in effect on the date of enactment of the
Reducing Unused Medications Act).
``(2) Remaining portions.--
``(A) In general.--Except as provided in subparagraph (B),
remaining portions of a partially filled prescription for a
controlled substance in schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 30 days after the
date on which the prescription is written.
``(B) Emergency situations.--In emergency situations, as
described in subsection (a), the remaining portions of a
partially filled prescription for a controlled substance in
schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 72 hours after the
prescription is issued.''.
(b) Rule of Construction.--Nothing in this section shall be
construed to affect the authority of the Attorney General to
allow a prescription for a controlled substance in schedule
III, IV, or V of section 202(c) of the Controlled Substances
Act (21 U.S.C. 812(c)) to be partially filled.
TITLE XV--OPIOID REVIEW MODERNIZATION ACT
SEC. 1501. SHORT TITLE.
This title may be cited as the ``Opioid Review
Modernization Act of 2016''.
SEC. 1502. FDA OPIOID ACTION PLAN.
Chapter V of the Federal Food, Drug, and Cosmetic Act is
amended by inserting after section 569 of such Act (21 U.S.C.
350bbb-8) the following:
``SEC. 569-1. OPIOID ACTION PLAN.
``(a) New Drug Application.--
``(1) In general.--Subject to paragraph (2), prior to the
approval pursuant to an application under section 505(b) of a
new drug that is an opioid and does not have abuse-deterrent
properties, the Secretary shall refer the application to an
advisory committee of the Food and Drug Administration to
seek recommendations from such advisory committee.
``(2) Public health exemption.--A referral to an advisory
committee under paragraph (1) is not required with respect to
a new drug if the Secretary--
``(A) finds that such a referral is not in the interest of
protecting and promoting public health;
``(B) finds that such a referral is not necessary based on
a review of the relevant scientific information; and
``(C) submits a notice containing the rationale for such
findings to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and
Commerce of the House of Representatives.
``(b) Pediatric Opioid Labeling.--The Secretary shall
convene the Pediatric Advisory Committee of the Food and Drug
Administration to seek recommendations from such Committee
regarding a framework for the inclusion of information in the
labeling of drugs that are opioids relating to the use of
such drugs in pediatric populations before the Secretary
approves any labeling or change to labeling for any drug that
is an opioid intended for use in a pediatric population.
``(c) Sunset.--The requirements of subsections (a) and (b)
shall cease to be effective on October 1, 2022.''.
SEC. 1503. PRESCRIBER EDUCATION.
Not later than 1 year after the date of the enactment of
this Act, the Secretary of Health and Human Services, acting
through the Commissioner of Food and Drugs, as part of the
Food and Drug Administration's evaluation of the Extended-
Release/Long-Acting Opioid Analgesics Risk Evaluation and
Mitigation Strategy, and in consultation with relevant
stakeholders, shall develop recommendations regarding
education programs for prescribers of opioids pursuant to
section 505-1 of the Federal Food, Drug,
[[Page H2366]]
and Cosmetic Act (21 U.S.C. 355-1), including recommendations
on--
(1) which prescribers should participate in such programs;
and
(2) how often participation in such programs is necessary.
SEC. 1504. GUIDANCE ON EVALUATING THE ABUSE DETERRENCE OF
GENERIC SOLID ORAL OPIOID DRUG PRODUCTS.
Not later than 2 years after the end of the period for
public comment on the draft guidance entitled ``General
Principals for Evaluating the Abuse Deterrence of Generic
Solid Oral Opioid Drug Products'' issued by the Center for
Drug Evaluation and Research of the Food and Drug
Administration in March 2016, the Commissioner of Food and
Drugs shall publish in the Federal Register a final version
of such guidance.
TITLE XVI--EXAMINING OPIOID TREATMENT INFRASTRUCTURE ACT
SEC. 1601. SHORT TITLE.
This title may be cited as the ``Examining Opioid Treatment
Infrastructure Act of 2016''.
SEC. 1602. STUDY ON TREATMENT INFRASTRUCTURE.
Not later than 24 months after the date of enactment of
this Act, the Comptroller General of the United States shall
initiate an evaluation, and submit to Congress a report, of
the inpatient and outpatient treatment capacity,
availability, and needs of the United States, which shall
include, to the extent data are available--
(1) the capacity of acute residential or inpatient
detoxification programs;
(2) the capacity of inpatient clinical stabilization
programs, transitional residential support services, and
residential rehabilitation programs;
(3) the capacity of demographic specific residential or
inpatient treatment programs, such as those designed for
pregnant women or adolescents;
(4) geographical differences of the availability of
residential and outpatient treatment and recovery options for
substance use disorders across the continuum of care;
(5) the availability of residential and outpatient
treatment programs that offer treatment options based on
reliable scientific evidence of efficacy for the treatment of
substance use disorders, including the use of Food and Drug
Administration-approved medicines and evidence-based
nonpharmacological therapies;
(6) the number of patients in residential and specialty
outpatient treatment services for substance use disorders;
(7) an assessment of the need for residential and
outpatient treatment for substance use disorders across the
continuum of care;
(8) the availability of residential and outpatient
treatment programs to American Indians and Alaska Natives
through an Indian health program (as defined by section 4 of
the Indian Health Care Improvement Act (25 U.S.C. 1603)); and
(9) the barriers (including technological barriers) at the
Federal, State, and local levels to real-time reporting of
de-identified information on drug overdoses and ways to
overcome such barriers.
TITLE XVII--OPIOID USE DISORDER TREATMENT EXPANSION AND MODERNIZATION
ACT
SEC. 1701. SHORT TITLE.
This title may be cited as the ``Opioid Use Disorder
Treatment Expansion and Modernization Act''.
SEC. 1702. FINDING.
The Congress finds that opioid use disorder has become a
public health epidemic that must be addressed by increasing
awareness and access to all treatment options for opioid use
disorder, overdose reversal, and relapse prevention.
SEC. 1703. OPIOID USE DISORDER TREATMENT MODERNIZATION.
(a) In General.--Section 303(g)(2) of the Controlled
Substances Act (21 U.S.C. 823(g)(2)) is amended--
(1) in subparagraph (B), by striking clauses (i), (ii), and
(iii) and inserting the following:
``(i) The practitioner is a qualifying practitioner (as
defined in subparagraph (G)).
``(ii) With respect to patients to whom the practitioner
will provide such drugs or combinations of drugs, the
practitioner has the capacity to provide directly, by
referral, or in such other manner as determined by the
Secretary--
``(I) all schedule III, IV, and V drugs, as well as
unscheduled medications approved by the Food and Drug
Administration, for the treatment of opioid use disorder,
including such drugs and medications for maintenance,
detoxification, overdose reversal, and relapse prevention, as
available; and
``(II) appropriate counseling and other appropriate
ancillary services.
``(iii)(I) The total number of such patients of the
practitioner at any one time will not exceed the applicable
number. Except as provided in subclause (II), the applicable
number is 30.
``(II) The applicable number is 100 if, not sooner than 1
year after the date on which the practitioner submitted the
initial notification, the practitioner submits a second
notification to the Secretary of the need and intent of the
practitioner to treat up to 100 patients.
``(III) The Secretary may by regulation change such total
number.
``(IV) The Secretary may exclude from the applicable number
patients to whom such drugs or combinations of drugs are
directly administered by the qualifying practitioner in the
office setting.
``(iv) If the Secretary by regulation increases the total
number of patients which a qualifying practitioner is
permitted to treat pursuant to clause (iii)(II), the
Secretary shall require such a practitioner to obtain a
written agreement from each patient, including the patient's
signature, that the patient--
``(I) will receive an initial assessment and treatment plan
and periodic assessments and treatment plans thereafter;
``(II) will be subject to medication adherence and
substance use monitoring;
``(III) understands available treatment options, including
all drugs approved by the Food and Drug Administration for
the treatment of opioid use disorder, including their
potential risks and benefits; and
``(IV) understands that receiving regular counseling
services is critical to recovery.
``(v) The practitioner will comply with the reporting
requirements of subparagraph (D)(i)(IV).'';
(2) in subparagraph (D)--
(A) in clause (i), by adding at the end the following:
``(IV) The practitioner reports to the Secretary, at such
times and in such manner as specified by the Secretary, such
information and assurances as the Secretary determines
necessary to assess whether the practitioner continues to
meet the requirements for a waiver under this paragraph.'';
(B) in clause (ii), by striking ``Upon receiving a
notification under subparagraph (B)'' and inserting ``Upon
receiving a determination from the Secretary under clause
(iii) finding that a practitioner meets all requirements for
a waiver under subparagraph (B)''; and
(C) in clause (iii)--
(i) by inserting ``and shall forward such determination to
the Attorney General'' before the period at the end of the
first sentence; and
(ii) by striking ``physician'' and inserting
``practitioner'';
(3) in subparagraph (G)--
(A) by amending clause (ii)(IV) to read as follows:
``(IV) The physician has, with respect to the treatment and
management of opiate-dependent patients, completed not less
than 8 hours of training (through classroom situations,
seminars at professional society meetings, electronic
communications, or otherwise) that is provided by the
American Society of Addiction Medicine, the American Academy
of Addiction Psychiatry, the American Medical Association,
the American Osteopathic Association, the American
Psychiatric Association, or any other organization that the
Secretary determines is appropriate for purposes of this
subclause. Such training shall address--
``(aa) opioid maintenance and detoxification;
``(bb) appropriate clinical use of all drugs approved by
the Food and Drug Administration for the treatment of opioid
use disorder;
``(cc) initial and periodic patient assessments (including
substance use monitoring);
``(dd) individualized treatment planning; overdose
reversal; relapse prevention;
``(ee) counseling and recovery support services;
``(ff) staffing roles and considerations;
``(gg) diversion control; and
``(hh) other best practices, as identified by the
Secretary.''; and
(B) by adding at the end the following:
``(iii) The term `qualifying practitioner' means--
``(I) a qualifying physician, as defined in clause (ii); or
``(II) during the period beginning on the date of the
enactment of the Opioid Use Disorder Treatment Expansion and
Modernization Act and ending on the date that is 3 years
after such date of enactment, a qualifying other
practitioner, as defined in clause (iv).
``(iv) The term `qualifying other practitioner' means a
nurse practitioner or physician assistant who satisfies each
of the following:
``(I) The nurse practitioner or physician assistant is
licensed under State law to prescribe schedule III, IV, or V
medications for the treatment of pain.
``(II) The nurse practitioner or physician assistant
satisfies one or more of the following:
``(aa) Has completed not fewer than 24 hours of initial
training addressing each of the topics listed in clause
(ii)(IV) (through classroom situations, seminars at
professional society meetings, electronic communications, or
otherwise) provided by the American Society of Addiction
Medicine, the American Academy of Addiction Psychiatry, the
American Medical Association, the American Osteopathic
Association, the American Nurses Credentialing Center, the
American Psychiatric Association, the American Association of
Nurse Practitioners, the American Academy of Physician
Assistants, or any other organization that the Secretary
determines is appropriate for purposes of this subclause.
``(bb) Has such other training or experience as the
Secretary determines will demonstrate the ability of the
nurse practitioner or physician assistant to treat and manage
opiate-dependent patients.
``(III) The nurse practitioner or physician assistant is
supervised by or works in collaboration with a qualifying
physician, if the nurse practitioner or physician assistant
is required by State law to prescribe medications for the
treatment of opioid use disorder in collaboration with or
under the supervision of a physician
.The Secretary may review and update the requirements for
being a qualifying other practitioner under this clause.'';
and
(4) in subparagraph (H)--
(A) in clause (i), by inserting after subclause (II) the
following:
``(III) Such other elements of the requirements under this
paragraph as the Secretary determines necessary for purposes
of implementing such requirements.''; and
(B) by amending clause (ii) to read as follows:
``(ii) Not later than 1 year after the date of enactment of
the Opioid Use Disorder Treatment Expansion and Modernization
Act, the Secretary shall update the treatment improvement
[[Page H2367]]
protocol containing best practice guidelines for the
treatment of opioid-dependent patients in office-based
settings. The Secretary shall update such protocol in
consultation with experts in opioid use disorder research and
treatment.''.
(b) Recommendation of Revocation or Suspension of
Registration in Case of Substantial Noncompliance.--The
Secretary of Health and Human Services may recommend to the
Attorney General that the registration of a practitioner be
revoked or suspended if the Secretary determines, according
to such criteria as the Secretary establishes by regulation,
that a practitioner who is registered under section 303(g)(2)
of the Controlled Substances Act (21 U.S.C. 823(g)(2)) is not
in substantial compliance with the requirements of such
section, as amended by this Act.
(c) Opioid Defined.--Section 102(18) of the Controlled
Substances Act (21 U.S.C. 802(18)) is amended by inserting
``or `opioid' '' after ``The term `opiate' ''.
(d) Reports to Congress.--
(1) In general.--Not later than 2 years after the date of
enactment of this Act and not less than over every 5 years
thereafter, the Secretary of Health and Human Services, in
consultation with the Drug Enforcement Administration and
experts in opioid use disorder research and treatment,
shall--
(A) perform a thorough review of the provision of opioid
use disorder treatment services in the United States,
including services provided in opioid treatment programs and
other specialty and nonspecialty settings; and
(B) submit a report to the Congress on the findings and
conclusions of such review.
(2) Contents.--Each report under paragraph (1) shall
include an assessment of--
(A) compliance with the requirements of section 303(g)(2)
of the Controlled Substances Act (21 U.S.C. 823(g)(2)), as
amended by this Act;
(B) the measures taken by the Secretary of Health and Human
Services to ensure such compliance;
(C) whether there is further need to increase or decrease
the number of patients a waivered practitioner is permitted
to treat, as provided for by the amendment made by subsection
(a)(1);
(D) the extent to which, and proportions with which, the
full range of Food and Drug Administration-approved
treatments for opioid use disorder are used in routine health
care settings and specialty substance use disorder treatment
settings;
(E) access to, and use of, counseling and recovery support
services, including the percentage of patients receiving such
services;
(F) changes in State or local policies and legislation
relating to opioid use disorder treatment;
(G) the use of prescription drug monitoring programs by
practitioners who are permitted to dispense narcotic drugs to
individuals pursuant to a waiver under section 303(g)(2) of
the Controlled Substances Act (21 U.S.C. 823(g)(2));
(H) the findings resulting from inspections by the Drug
Enforcement Administration of practitioners described in
subparagraph (G); and
(I) the effectiveness of cross-agency collaboration between
Department of Health and Human Services and the Drug
Enforcement Administration for expanding effective opioid use
disorder treatment.
SEC. 1704. SENSE OF CONGRESS.
It is the Sense of Congress that, with respect to the total
number of patients that a qualifying physician (as defined in
subparagraph (G)(iii) of section 303(g)(2) of the Controlled
Substances Act (21 U.S.C. 823(g)(2)) can treat at any one
time pursuant to such section, the Secretary of Health and
Human Services should consider raising such total number to
250 patients following a third notification to the Secretary
of the need and intent of the physician to treat up to 250
patients that is submitted to the Secretary not sooner than 1
year after the date on which the physician submitted to the
Secretary a second notification to treat up to 100 patients.
SEC. 1705. PARTIAL FILLS OF SCHEDULE II CONTROLLED
SUBSTANCES.
(a) In General.--Section 309 of the Controlled Substances
Act (21 U.S.C. 829) is amended by adding at the end the
following:
``(f) Partial Fills of Schedule II Controlled Substances.--
``(1) Partial fills.--
``(A) In general.--A prescription for a controlled
substance in schedule II may be partially filled if--
``(i) it is not prohibited by State law;
``(ii) the prescription is written and filled in accordance
with the Controlled Substances Act (21 U.S.C. 801 et seq.),
regulations prescribed by the Attorney General, and State
law;
``(iii) the partial fill is requested by the patient or the
practitioner that wrote the prescription; and
``(iv) the total quantity dispensed in all partial fillings
does not exceed the total quantity prescribed.
``(B) Other circumstances.--A prescription for a controlled
substance in schedule II may be partially filled in
accordance with section 1306.13 of title 21, Code of Federal
Regulations (as in effect on the date of enactment of the
Reducing Unused Medications Act of 2016).
``(2) Remaining portions.--
``(A) In general.--Except as provided in subparagraph (B),
remaining portions of a partially filled prescription for a
controlled substance in schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 30 days after the
date on which the prescription is written.
``(B) Emergency situations.--In emergency situations, as
described in subsection (a), the remaining portions of a
partially filled prescription for a controlled substance in
schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 72 hours after the
prescription is issued.''.
(b) Rule of Construction.--Nothing in this section shall be
construed to affect the authority of the Attorney General to
allow a prescription for a controlled substance in schedule
III, IV, or V of section 202(c) of the Controlled Substances
Act (21 U.S.C. 812(c)) to be partially filled.
TITLE XVIII--NATIONAL ALL SCHEDULES PRESCRIPTION ELECTRONIC REPORTING
REAUTHORIZATION ACT
SEC. 1801. SHORT TITLE.
This title may be cited as the ``National All Schedules
Prescription Electronic Reporting Reauthorization Act of
2015''.
SEC. 1802. AMENDMENT TO PURPOSE.
Paragraph (1) of section 2 of the National All Schedules
Prescription Electronic Reporting Act of 2005 (Public Law
109-60) is amended to read as follows:
``(1) foster the establishment of State-administered
controlled substance monitoring systems in order to ensure
that--
``(A) health care providers have access to the accurate,
timely prescription history information that they may use as
a tool for the early identification of patients at risk for
addiction in order to initiate appropriate medical
interventions and avert the tragic personal, family, and
community consequences of untreated addiction; and
``(B) appropriate law enforcement, regulatory, and State
professional licensing authorities have access to
prescription history information for the purposes of
investigating drug diversion and prescribing and dispensing
practices of errant prescribers or pharmacists; and''.
SEC. 1803. AMENDMENTS TO CONTROLLED SUBSTANCE MONITORING
PROGRAM.
Section 399O of the Public Health Service Act (42 U.S.C.
280g-3) is amended--
(1) in subsection (a)--
(A) in paragraph (1)--
(i) in subparagraph (A), by striking ``or'';
(ii) in subparagraph (B), by striking the period at the end
and inserting ``; or''; and
(iii) by adding at the end the following:
``(C) to maintain and operate an existing State-controlled
substance monitoring program.''; and
(B) in paragraph (3), by inserting ``by the Secretary''
after ``Grants awarded'';
(2) by amending subsection (b) to read as follows:
``(b) Minimum Requirements.--The Secretary shall maintain
and, as appropriate, supplement or revise (after publishing
proposed additions and revisions in the Federal Register and
receiving public comments thereon) minimum requirements for
criteria to be used by States for purposes of clauses (ii),
(v), (vi), and (vii) of subsection (c)(1)(A).'';
(3) in subsection (c)--
(A) in paragraph (1)(B)--
(i) in the matter preceding clause (i), by striking
``(a)(1)(B)'' and inserting ``(a)(1)(B) or (a)(1)(C)'';
(ii) in clause (i), by striking ``program to be improved''
and inserting ``program to be improved or maintained'';
(iii) by redesignating clauses (iii) and (iv) as clauses
(iv) and (v), respectively;
(iv) by inserting after clause (ii) the following:
``(iii) a plan to apply the latest advances in health
information technology in order to incorporate prescription
drug monitoring program data directly into the workflow of
prescribers and dispensers to ensure timely access to
patients' controlled prescription drug history;'';
(v) in clause (iv), as redesignated, by inserting before
the semicolon at the end ``and at least one health
information technology system such as an electronic health
records system, a health information exchange, or an e-
prescribing system''; and
(vi) in clause (v), as redesignated, by striking ``public
health'' and inserting ``public health or public safety'';
(B) in paragraph (3)--
(i) by striking ``If a State that submits'' and inserting
the following:
``(A) In general.--If a State that submits'';
(ii) by striking the period at the end and inserting ``and
include timelines for full implementation of such
interoperability. The State shall also describe the manner in
which it will achieve interoperability between its monitoring
program and health information technology systems, as
allowable under State law, and include timelines for
implementation of such interoperability.''; and
(iii) by adding at the end the following:
``(B) Monitoring of efforts.--The Secretary shall monitor
State efforts to achieve interoperability, as described in
subparagraph (A).''; and
(C) in paragraph (5)--
(i) by striking ``implement or improve'' and inserting
``establish, improve, or maintain''; and
(ii) by adding at the end the following: ``The Secretary
shall redistribute any funds that are so returned among the
remaining grantees under this section in accordance with the
formula described in subsection (a)(2)(B).'';
(4) in subsection (d)--
(A) in the matter preceding paragraph (1)--
(i) by striking ``In implementing or improving'' and all
that follows through ``(a)(1)(B)'' and inserting ``In
establishing, improving, or maintaining a controlled
substance monitoring program under this section, a State
shall comply, or with respect to a State that applies for a
grant under subparagraph (B) or (C) of subsection (a)(1)'';
and
(ii) by striking ``public health'' and inserting ``public
health or public safety''; and
(B) by adding at the end the following:
``(5) The State shall report to the Secretary on--
``(A) as appropriate, interoperability with the controlled
substance monitoring programs of Federal departments and
agencies;
``(B) as appropriate, interoperability with health
information technology systems such as
[[Page H2368]]
electronic health records systems, health information
exchanges, and e-prescribing systems; and
``(C) whether or not the State provides automatic, real-
time or daily information about a patient when a practitioner
(or the designee of a practitioner, where permitted) requests
information about such patient.'';
(5) in subsections (e), (f)(1), and (g), by striking
``implementing or improving'' each place it appears and
inserting ``establishing, improving, or maintaining'';
(6) in subsection (f)--
(A) in paragraph (1)--
(i) in subparagraph (B), by striking ``misuse of a schedule
II, III, or IV substance'' and inserting ``misuse of a
controlled substance included in schedule II, III, or IV of
section 202(c) of the Controlled Substance Act''; and
(ii) in subparagraph (D), by inserting ``a State substance
abuse agency,'' after ``a State health department,''; and
(B) by adding at the end the following:
``(3) Evaluation and reporting.--Subject to subsection (g),
a State receiving a grant under subsection (a) shall provide
the Secretary with aggregate data and other information
determined by the Secretary to be necessary to enable the
Secretary--
``(A) to evaluate the success of the State's program in
achieving its purposes; or
``(B) to prepare and submit the report to Congress required
by subsection (l)(2).
``(4) Research by other entities.--A department, program,
or administration receiving nonidentifiable information under
paragraph (1)(D) may make such information available to other
entities for research purposes.'';
(7) by redesignating subsections (h) through (n) as
subsections (j) through (p), respectively;
(8) in subsections (c)(1)(A)(iv) and (d)(4), by striking
``subsection (h)'' each place it appears and inserting
``subsection (j)'';
(9) by inserting after subsection (g) the following:
``(h) Education and Access to the Monitoring System.--A
State receiving a grant under subsection (a) shall take steps
to--
``(1) facilitate prescriber and dispenser use of the
State's controlled substance monitoring system;
``(2) educate prescribers and dispensers on the benefits of
the system both to them and society; and
``(3) facilitate linkage to the State substance abuse
agency and substance abuse disorder services.
``(i) Consultation With Attorney General.--In carrying out
this section, the Secretary shall consult with the Attorney
General of the United States and other relevant Federal
officials to--
``(1) ensure maximum coordination of controlled substance
monitoring programs and related activities; and
``(2) minimize duplicative efforts and funding.'';
(10) in subsection (l)(2)(A), as redesignated by paragraph
(7)--
(A) in clause (ii), by inserting ``; established or
strengthened initiatives to ensure linkages to substance use
disorder services;'' before ``or affected patient access'';
and
(B) in clause (iii), by inserting ``and between controlled
substance monitoring programs and health information
technology systems'' before ``, including an assessment'';
(11) by striking subsection (m) (relating to preference),
as redesignated by paragraph (7);
(12) by redesignating subsections (n) through (p), as
redesignated by paragraph (7), as subsections (m) through
(o), respectively;
(13) in subsection (m)(1), as redesignated by paragraph
(12), by striking ``establishment, implementation, or
improvement'' and inserting ``establishment, improvement, or
maintenance'';
(14) in subsection (n), as redesignated by paragraph (12)--
(A) in paragraph (5)--
(i) by striking ``means the ability'' and inserting the
following: ``means--
``(A) the ability'';
(ii) by striking the period at the end and inserting ``;
or''; and
(iii) by adding at the end the following:
``(B) sharing of State controlled substance monitoring
program information with a health information technology
system such as an electronic health records system, a health
information exchange, or an e-prescribing system.'';
(B) in paragraph (7), by striking ``pharmacy'' and
inserting ``pharmacist''; and
(C) in paragraph (8), by striking ``and the District of
Columbia'' and inserting ``, the District of Columbia, and
any commonwealth or territory of the United States''; and
(15) by amending subsection (o), as redesignated by
paragraph (12), to read as follows:
``(o) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $10,000,000
for each of fiscal years from 2016 through 2020.''.
The SPEAKER pro tempore. The bill shall be debatable for 1 hour,
equally divided among and controlled by the chair and ranking minority
member of the Committee on Energy and Commerce and the chair and
ranking minority member of the Committee on the Judiciary.
The gentlewoman from Indiana (Mrs. Brooks), the gentleman from New
Jersey (Mr. Pallone), the gentleman from Virginia (Mr. Goodlatte), and
the gentleman from Michigan (Mr. Conyers) each will control 15 minutes.
The Chair recognizes the gentlewoman from Indiana.
{time} 1045
General Leave
Mrs. BROOKS of Indiana. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and to insert extraneous material on S. 524.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Indiana?
There was no objection.
Mrs. BROOKS of Indiana. Mr. Speaker, I yield myself such time as I
may consume.
Mr. Speaker, this week in Congress, we passed 18 bills to address the
heroin and opioid crisis that is impacting every community in this
country.
I am thankful that my bill, H.R. 4641, which I worked on with
Representative Kennedy of Massachusetts, ensures that healthcare
professionals have access to up-to-date guidelines and best practices
for treating patients with acute and chronic pain.
Many of these proposals we considered this week enjoyed nearly
unanimous support, and I can't express to you how refreshing it was to
work with all of my colleagues on meaningful solutions to this public
health crisis.
As we learned from the multitude of Members this week that shared
their stories on the House floor, we are facing a public health crisis
that crosses every socioeconomic, every geographic, generational, and
ethnic boundary. It is a rural, urban, and suburban problem. It reaches
into our schools, our places of work, and our hospitals. It is tearing
apart and devastating families and people's lives.
However, in the midst of this crisis, as with many past crises faced
by our Nation, we, as Members of Congress, have set aside our political
differences and have crafted a package of thoughtful reforms that will
support our communities ravaged by this scourge.
I am proud of the work done by the Energy and Commerce Committee and
the strong, bipartisan leadership by Chairmen Upton and Pitts and
Ranking Members Pallone and Green. We cannot overlook the hard work and
countless hours spent by both the majority and the minority committee
staff on this effort, and I want to thank them for their hard work.
Members of the Energy and Commerce Committee have pursued answers to
this epidemic through roundtables and meetings with individuals and
families on the front lines of this crisis--health workers, first
responders, and community leaders seeking to guide their communities
through this crisis.
We, as Members, have visited neonatal intensive care units in
hospitals to see firsthand the devastating effects of infants born
addicted to opioids and who must already fight for survival through
their withdrawal in their very first days of life.
We have met with juvenile court judges and social workers whose
caseloads have doubled over the past few years as more and more
children are being removed from their parents' care because their
parents are more concerned about where to find their next high than the
welfare of their child and it is no longer safe for them to remain in
their homes.
It is important to note that it is National Police Week this week.
And it is our first responders, whom so many of us have talked to,
those we have heard from in Indiana, who keep naloxone in their police
cruisers because they are seeing this unprecedented increase in drug
overdoses, and they are saving lives each and every day.
In a minute, my colleague from the Judiciary Committee will highlight
all of the great work that their committee has also done to fight this
scourge, but I would like to take a moment to highlight the bills
rolled into this legislation that my colleagues from the Energy and
Commerce Committee have painstakingly crafted.
The Opioid Review Modernization Act, led by Representatives Carolyn
B. Maloney of New York and Lance, would require the FDA to work closely
with expert advisory committees before making critical opioid approval
and labeling decisions, develop recommendations regarding prescriber
education programs that address extended-release and long-acting
opioids, and encourage the development and approval of generic opioids
with abuse-deterrent properties.
[[Page H2369]]
Representative Sarbanes led the Co-Prescribing to Reduce Overdoses
Act, which would establish a grant program for co-prescribing of opioid
reversal drugs for patients who are at a high risk of overdose.
Representative Evan Jenkins and Representative Bustos crafted the
Nurturing and Supporting Healthy Babies Act, which will expand our
knowledge of care and treatment for babies with neonatal abstinence
syndrome and fixes an unintended consequence with the Medicaid drug
rebate program that discourages drug manufacturers from producing
opioids that are harder to abuse.
Representative Ben Ray Lujan of New Mexico led efforts to establish a
pilot program that will provide grants to State substance abuse
agencies to promote innovative service delivery models for pregnant
women who have a substance use disorder, such as opioid addiction.
Representative Kinzinger's Veteran Emergency Medical Technician
Support Act will improve the quality of care within our communities by
providing grants to States with emergency medical technician shortages
so as to help streamline State requirements for our veterans to enter
the EMT workforce without there being an unnecessary duplication of
their training.
Representatives Meehan, Kind, and Veasey led the legislation
directing the CDC to study what information and resources are available
to youth athletes and their families regarding the dangers of opioid
use.
Lali's Law, authored by Representative Dold and Representative
Katherine Clark of Massachusetts, would create a competitive grant
program to help States increase access to the overdose reversal
medications that save lives.
The Reducing Unused Medications Act, led again by Representatives
Clark of Massachusetts and Stivers, clarifies when Schedule II
controlled substances, including opioid pain medications, can be
partially filled.
Representatives Foster and Pallone spearheaded the Examining Opioid
Treatment Infrastructure Act, which requires the GAO to collect the
data necessary to assess the opioid infrastructure in our country,
looking at the numbers of hospital beds and treatment facilities.
Finally, my Hoosier colleague, Representative Bucshon, along with
Representative Tonko, championed a bill that will expand existing
opioid treatment capacity substantially by providers, all while
ensuring that the care that individuals receive is high-quality and
minimizes the risk of diversion.
Each approach that I have just set out has been a reflection of much
effort put into crafting this bipartisan, thoughtful, and comprehensive
package to give each of our communities, families, and individuals with
addictions the support they need.
Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from New
York (Mr. Engel).
Mr. ENGEL. Mr. Speaker, I thank the gentleman for yielding to me.
Mr. Speaker, my heart goes out to the thousands of American families
affected by the opioid epidemic. I am pleased the House is working in a
bipartisan manner to address this crisis. However, we could be doing
more.
The prescription opioid death rate has more than quadrupled since the
late 1990s. In 2014, prescription opioids played a role in more than
28,000 overdose deaths.
We must equip our communities with the resources needed to reverse
these trends. Yes, authorizing new grant programs, reports, and studies
is an important step, but without new funding, communities won't be
able to fully implement these initiatives.
On Wednesday, the majority blocked a Democratic substitute opioids
package which would have provided $600 million--paid for, I might add--
to fund the initiatives we have considered this week. I understand the
need to get our fiscal house in order, but I don't understand the
impulse to do so on the backs of millions of Americans grappling with
opioid abuse.
These bills are great, and I wholeheartedly support them, but we need
to put our money where our mouth is. This epidemic does not
discriminate. It has touched every corner of our Nation, from my
hometown of New York City to the shores of the Pacific.
So many Americans have already felt its impact. We need to do
everything we can to keep it from impacting more of our families, our
friends, and our constituents.
We are on the right path, but, again, without money, this becomes
irrelevant. We need to make sure that we have adequate funding so what
we all want to do on both sides of the aisle can become a reality.
Mrs. BROOKS of Indiana. Mr. Speaker, I yield 2 minutes to the
gentleman from Michigan (Mr. Benishek).
Mr. BENISHEK. Mr. Speaker, it is past time to give our healthcare
providers the tools they need to confront the growing epidemic of
opioid abuse in our country. This is an emergency.
As a doctor who has treated patients in northern Michigan for over 30
years, both in private practice and in the VA system, I know how urgent
the need for immediate action is.
The amendment to the Comprehensive Addiction and Recovery Act that we
are considering today will be a giant step forward in how we provide
treatment and care for those suffering from opioid addiction.
The bill will also improve the quality of care available to our
Nation's veterans. The rate of abuse for legal prescription drugs is
significantly higher among our veteran population than it is in the
general population, and this problem is only continuing to grow.
We have an opportunity today to take a first step in fixing a major
national problem and pass meaningful legislation that will help save
the lives of thousands and thousands of Americans.
Mr. Speaker, I urge my colleagues to support this legislation and
continue working together on bipartisan solutions for our Nation's
growing epidemic of substance abuse.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from New
York (Mr. Tonko).
Mr. TONKO. Mr. Speaker, this week, we have seen a number of well-
intentioned bills come to the floor with good ideas on how we can
address the Nation's opioid epidemic that is sweeping our entire
country.
I was proud to lead one of those efforts with my good friend
Representative Bucshon with a bill that endeavors to lift the cap on
the number of patients a provider may treat with buprenorphine to 250,
while expanding prescribing privileges to nurse practitioners and
physician assistants.
This is a good bill, and it would make a real, immediate difference
for individuals facing months-long waiting lists for effective
treatment, like the gentleman that I met last week when touring an
addiction clinic in my district. He had struggled with addiction for
decades and, after making the decision to try to get clean, was faced
with a closed door and a 7-month waiting list due to outdated Federal
rules that our bill would have fixed.
Unfortunately, when this bill came to the floor, we were told the cap
language had to be temporarily replaced with placeholder sense-of-
Congress language until we go to conference because our bill was going
to cost too much.
Now, when we talk about the cost of this bill, what we are really
talking about is the fact that more people will have access to
effective treatment and more lives--more lives--will be saved. It is an
unfortunate truth that, in the distorted budgetary terms of Washington,
dead people cost less than the living.
So we can talk all we want and we can pass all the bills we want, but
unless we put our money where our mouth is, we will simply be peddling
false hope. We will be condemning more of our brothers and sisters to
the death spiral of addiction when we could have done something to
help.
A sense of Congress won't end months-long waiting lists for effective
treatment. A sense of Congress won't get lifesaving overdose reversal
drugs out to our first responders. If this Congress has any sense, as
we move into conference committee, we will support this epidemic with
the robust resources this country deserves for a real and meaningful
response.
Mrs. BROOKS of Indiana. Mr. Speaker, I reserve the balance of my
time.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
California (Ms. Matsui).
Ms. MATSUI. Mr. Speaker, the opioid and heroin crisis has hit home
for everyone, impacting our coworkers, our
[[Page H2370]]
neighbors, and our friends in every corner of this country.
In Sacramento, my district, the deadly consequences of fentanyl are
devastating our families. The faces behind this tragedy are people like
28-year-old Jerome Butler, a young father whose life was cut short
because of a tainted pill.
The human toll of this crisis demands our leadership. This week, we
took a step forward by passing a number of bipartisan bills to address
the opioid epidemic, many of which we worked on in the Energy and
Commerce Committee.
{time} 1100
But we can and must do more. We need new funding to confront this
tragedy.
My Democratic colleagues and I are ready to fund the President's $1.1
billion request for this crisis. We need a real investment to meet the
challenges our committees are facing every day.
As we advance substance abuse legislation and continue our important
work on comprehensive behavioral health reform, I urge my colleagues to
focus on solutions that both adequately address the immediate crisis
and long-term community prevention strategies.
The families reeling from the tragedies of this epidemic deserve
nothing less than our swift action and full support.
Mrs. BROOKS of Indiana. Mr. Speaker, I reserve the balance of my
time.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
I rise this morning to speak in favor of the House amendment to S.
524.
Over the last 2 days of floor debate, we have heard heartfelt
speeches from Members of Congress about how the opioid epidemic is
affecting their constituents and, for some, their own families. We have
heard from both Democrats and Republicans, Members from urban
districts, suburban districts, and rural districts, as well as Members
from every region of the United States.
What is clear is that no community has been immune to this crisis,
including communities in my home State of New Jersey. About 256,000 New
Jersey residents are addicted to heroin and prescription opioids. That
is nearly the same as the entire population of Newark, the largest city
in New Jersey.
This is a serious crisis that demands an urgent response. A
comprehensive solution to the crisis will require real dollars and must
take an approach that targets the full spectrum of addiction:
prevention, crisis response, expanding access to treatment, and
providing support for lifelong recovery.
The approach must be guided by science and cannot be deterred because
of stigma or misperceptions about proven treatment and intervention
strategies.
I am pleased to support the package of opioid legislation that we are
considering today because it takes steps towards that approach.
This bill incorporates proven public health approaches to fight
against the heroin and prescription drug abuse crisis. It improves the
tools available to prescribers to prevent opioid abuse and the
development of opioid use disorder. It expands access to lifesaving
naloxone, an opioid overdose-reversal drug, to respond to those in an
acute opioid crisis. It expands access to evidence-based treatments to
help individuals with opioid use disorders enter recovery.
However, Mr. Speaker, I want to make clear we must go further to
ensure that the scale of our response is proportionate to the burden of
the crisis. We not only need to support individuals' entry into
recovery, we need to ensure that we provide access to the support and
services that lead to lifelong recovery. We must also further expand
access to bupe, or buprenorphine, an office-based, medication-assisted
treatment for opioid use disorders.
Currently, we do not have adequate treatment capacity to respond to
the unprecedented demand for opioid use disorder treatment. That is why
we need to expand upon the Opioid Use Disorder Treatment Expansion and
Modernization Act to significantly increase the number of patients a
physician can treat with this medication as well as permanently
allowing nurse practitioners and physician assistants to treat patients
with this medication.
In the committee, Democrats voted to raise the cap to 500 patients
for qualifying physicians with appropriate credentials. Additionally,
committee Democrats and Republicans voted unanimously to permanently
allow nurse practitioners and physician assistants to treat patients
with bupe.
I am committed to continuing to work with my colleagues as part of
our conference with the Senate to ensure that we lift the arbitrary and
harmful physician treatment cap and to ensure that nurse practitioners
and physician assistants in every community can permanently use their
skills and experience to serve those in need of opioid use disorder
treatments in their community.
Finally, Mr. Speaker, I want to be clear that we should not be under
the illusion that we can adequately respond to this crisis without
providing urgently needed resources. Waiting on the appropriation
process isn't suitable. Our States and communities urgently need money
now.
Additionally, we should not be forced to cut other discretionarily
funded public health programs to provide resources for substance abuse
programs. The discretionary funding caps have already left many of our
vital public health programs underfunded.
Forcing additional cuts to those programs in order to provide funding
to respond to the opioid epidemic will limit our ability to adequately
respond to the opioid crisis as well as to meet the remaining public
health needs of our communities.
We don't have to guess how it turns out if we fail to provide the
urgent, robust funding that is desperately needed. Sadly, the evidence
is already staring us in the face. There will be more lives lost to the
epidemic and will be thousands more Americans who will continue to be
left behind to battle without the treatment and recovery support
services they need.
We are losing now, we estimate, 78 Americans each day, and we can't
afford anything less than a comprehensive well-funded Federal response.
I urge my colleagues to vote ``yes'' to this legislation because I
believe it takes important steps in turning the tide on this crisis
that is taking the lives of 78 Americans every day.
But I also urge my colleagues to support providing the financial
resources and additional tools necessary to meet the burden of this
crisis.
I urge support for this package and once again stress that we are not
providing enough funding. As much as I believe that this package is
very important, I certainly would agree with my colleague on the
Republican side how important it is.
We are not providing enough resources. I hope that, when we go to
conference and before this package goes to the President, we can
provide the additional resources.
I urge everyone to support the bill.
I yield back the balance of my time.
Mrs. BROOKS of Indiana. Mr. Speaker, I yield myself such time as I
may consume.
In closing, I would like to emphasize that, as my colleague, the
ranking member from New Jersey, indicated, we have made real strides
this week in turning back the epidemic, but we agree it is not enough
and it is not over. This fight is not going to be over. There is still
more to be done.
But I do hope that this week's productivity will lead to more weeks
where we can continue to engage in a healthy and robust debate about
the issues that matter. This week has proven we are stronger as a body
when we focus on the things that unite us and bring us together.
Sadly, it shouldn't take an epidemic or a national crisis to bring us
together. This week has taught us that, with enough will and
dedication, we can get to yes.
The conference committee, which this bill will initiate, will need
similar fortitude to swiftly come to a resolution on the differences we
have with the Senate. That accomplishment is within our grasp.
We have come too far to turn back now rather than let this issue
languish. That is why I urge my colleagues to vote in favor of this
bill, support the motion to go to conference.
Beyond the 78 Americans who are dying every day, we have 1.9 million
Americans addicted to or abusing prescription opioid-based painkillers
across the country. Because of their lives and their families' lives,
we must pass this bill.
[[Page H2371]]
I yield back the balance of my time.
Mr. GOODLATTE. Mr. Speaker, I yield myself such time as I may
consume.
It has been quite a week. This week the House has passed 18 bills
designed to address various facets of America's opioid epidemic. Most
recently, yesterday, the House passed by an overwhelming 413-5 vote the
Judiciary Committee's flagship bill.
H.R. 5046, which was authored by Crime Subcommittee Chairman Jim
Sensenbrenner, creates a comprehensive Justice Department grant program
to provide States with the resources needed to fight opioid addiction.
It authorizes $103 million a year for 5 years for the grant program. It
allocates precious resources responsibly by leveraging and streamlining
existing programs and fully offsetting the legislation in compliance
with the House's CutGo protocol.
In addition to that bill, the House passed four other Judiciary
Committee bills this week to address drug abuse and protect American
people.
H.R. 5052, the OPEN Act, increases the transparency and
accountability of the comprehensive opioid abuse grant program in H.R.
5046 by requiring grantees to report on the use of grant funds and
requiring a publicly available analysis of whether the grants have
achieved their intended purposes.
H.R. 4985, the Kingpin Designation Improvement Act, protects
classified information from disclosure when a drug kingpin challenges
his designation as such in a Federal court.
H.R. 5048, the Good Samaritan Assessment Act, requires the GAO to
study State and local Good Samaritan laws that protect caregivers, law
enforcement personnel, and first responders who administer opioid
overdose reversal drugs or devices from criminal or civil liability as
well as those who contact emergency service providers in response to an
overdose.
Finally, S. 32, the Transnational Drug Trafficking Act, improves law
enforcement's ability to pursue international drug manufacturers,
brokers, and distributors in source nations. I am pleased that the
House took up the Senate version of this bill.
As a result, that legislation is on its way to the President's desk
to be signed into law so that Federal prosecutors can begin using that
tool to pursue foreign drug traffickers.
Along with the excellent legislation prepared by our sister
committees, spearheaded by Chairman Upton, Chairman Miller, and
Chairman Kline, four of the Judiciary Committee bills will be included
in the House amendment to S. 524, the Senate's Comprehensive Addiction
and Recovery Act.
As a package, these bills make substantial policy changes at the
Federal agencies responsible for fighting addiction. They take real
steps to address the opioid epidemic and provide real relief to a real
problem affecting real Americans. Members of this body should be proud
of these accomplishments.
In addition to the committee chairmen I mentioned, I also want to
thank Chairman Harold Rogers, who spoke in support of H.R. 5046
yesterday and is a strong ally in the fight against elicit opioid
abuse. I have no doubt that he will make every effort during this
Congress to provide the critical funding authorized by the bills that
have passed the House this week.
Mr. Speaker, I look forward to sending this legislation back to the
Senate and moving to conference expeditiously. Congressional action to
combat the opioid epidemic is sorely needed, and there is bipartisan,
bicameral support for these efforts.
I thank my colleagues for their support and hard work. I urge
everyone to support the House amendment to S. 524.
I thank my colleague, the ranking member of the committee, Mr.
Conyers, for his hard work on this as well. This truly is a bipartisan
effort.
I commend all to support this motion to go to conference.
I reserve the balance of my time.
Mr. CONYERS. Mr. Speaker, I yield myself such time as I may consume.
Members of the House, I rise in support of the House amendment to S.
524, the Comprehensive Addiction and Recovery Act.
Before starting out on the merits of the legislation, I want to
commend the Judiciary Committee chairman, Mr. Goodlatte, for
shepherding our committee's five bills to House passage.
I also commend the subcommittee chairman, Mr. Sensenbrenner of
Wisconsin, for authoring the legislation that is largely responsible
for bringing us together today.
I also want to recognize the leadership of the Crime Subcommittee
ranking member, Sheila Jackson Lee of Texas, who was an original
cosponsor of the primary Judiciary Committee bill and who has helped us
find common ground in addressing the issue of drug addiction and
treatment.
This week the House considered and passed a wide range of bills aimed
at combating the devastating impact of drug abuse and addiction that is
afflicting communities all across our Nation.
We must take this action because our Nation is in the midst of a
major public health crisis caused by an epidemic of prescription and
opioid abuse. It is a crisis that affects Americans of all ages, of all
races, and of all income levels. It has devastated communities across
the United States. It affects families, the workplace, and also our
Nation's economy.
{time} 1115
Drug overdoses are now the leading cause of injury-related deaths in
our Nation. In my State of Michigan, for example, there were 1,745 drug
overdose deaths in 2014, and more than half of those overdose deaths
were attributed to opioids and heroin. In fact, 78 Americans die from
an opioid overdose every single day. Without question, this is a crisis
that cries out for immediate relief.
Fortunately, there may be effective solutions. For example, several
States have undertaken various innovative measures to better respond to
the rapid increase of individuals who are addicted to prescription
opioids and heroin and to prevent individuals from dying as a result of
drug overdose.
As I mentioned only yesterday during debate with respect to our
consideration of H.R. 5046, which has been incorporated into the House
amendment to S. 524, this measure would fund new, innovative ways to
address the nationwide epidemic of opioid drug abuse addiction. These
innovations include, for instance, the Law Enforcement Assisted
Diversion approach, which has been utilized with great success in two
cities of which I know--in Seattle and in Santa Fe. Programs such as
this diversion approach underscore the fact that we cannot arrest our
way out of opioid abuse addiction. Treating addicts as criminals only
makes matters worse for them and also for the rest of us.
The diversion approach, which reduces, by the way, recidivism by 60
percent, is just one example of innovation at the State and local
levels that we must encourage through increased funding assistance, and
it is more evidence that treatment alternatives to incarceration work.
The funding authorized under this measure would establish a
competitive grant program to provide funds to State and local
governments to continue and improve their efforts to protect Americans
from the dangers of opioid abuse and heroin use; and it will help
ensure that addicts have access to the services that are provided.
These funds would support such initiatives as providing treatment
alternatives to incarceration; fostering better collaboration between
State criminal justice agencies and state substance abuse systems;
providing first responders with the ability to purchase naloxone and to
receive training on how to administer this lifesaving drug;
establishing medication-assisted treatment programs by criminal justice
agencies; in addition, investigating more of the illegal distribution
methods of opioids; creating Prescription Drug Monitoring Programs;
addressing juvenile opioid abuse, which is, unfortunately, increasing;
and establishing comprehensive opioid abuse response programs.
The House amendment to S. 524 also includes a number of important
provisions that have been added pursuant to a series of amendments that
were passed by the House only yesterday.
In sum, these additional provisions expand the range of allowed
purpose areas under the new program to more fully address the range of
problems and
[[Page H2372]]
solutions that are presented by opioid abuse. Whether we provide
separate, new grant programs for each of these approaches or whether we
consolidate them into one grant program, it is critical that we change
our ways of addressing addiction. The scourge of drug abuse and its
overwhelming impact on our communities requires us to address this
problem not only immediately, but effectively.
I thank all of the committees and individuals who have participated
in this effort. Accordingly, I support House amendment S. 524.
I reserve the balance of my time.
Mr. GOODLATTE. Mr. Speaker, I do not have any speakers remaining, and
I am prepared to close.
I reserve the balance of my time.
Mr. CONYERS. Mr. Speaker, I yield myself such time as I may consume.
I support the House amendment to S. 524 because it will help address
our Nation's crisis of opioid abuse and heroin use. My support for this
legislation is based, in part, on the fact that it includes H.R. 5046,
which is legislation that I have worked on with my colleagues on both
sides of the aisle, that would provide critical grants to States and
local governments, intended to prevent and treat opioid abuse
addiction. Most importantly, I support this legislation because it
would help save lives.
The House amendment to S. 524 provides a comprehensive approach to
the opioid substance abuse public health emergency that is currently
ravaging our Nation. Accordingly, I urge my colleagues to support this
measure.
Mr. Speaker, I yield the balance of my time to the gentlewoman from
Texas (Ms. Jackson Lee).
Ms. JACKSON LEE. Let me thank Mr. Goodlatte, Mr. Conyers, the
Judiciary Committee, and Mr. Sensenbrenner, who mentioned yesterday
that he had been working on this for 2 years. We have joined him as the
original cosponsors in supporting this on the Subcommittee on Crime,
Terrorism, Homeland Security, and Investigations, of which I am the
ranking member, along with Mr. Sensenbrenner, and this is a moment that
all of us are appreciative of.
Mr. Speaker, as I thought about this week, during which we are
honoring police and we are also acknowledging those who have fallen in
the line of duty, this bill, the Comprehensive Addiction and Recovery
Act, becomes even more important. This week, the House adopted a number
of bills that, together, are intended to provide a response to the
opioid crisis that is commensurate with the scope of the problem.
Yesterday the House passed, by an overwhelming vote, the primary
contribution of the Judiciary Committee's to this effort, H.R. 5046,
the Comprehensive Opioid Reduction Act. I am an original cosponsor of
that bill, and I was a cosponsor of the predecessor bill, both of which
were introduced by my colleague, Jim Sensenbrenner, the chairman of the
subcommittee.
I commend him for the years of work and persistence on this issue. I
also commend Chairman Goodlatte and Ranking Member Conyers for their
leadership, for it would not have been shepherded through the committee
if we had not all worked together to find common ground on this very
important issue.
That has been the trend of the Judiciary Committee's as we work on
criminal justice reform, which includes sentencing reduction and prison
reform--provocative, innovative bills that are going to change the
lives of many of those who are incarcerated for many, many years. We
are going to turn mass incarceration upside down and on its ears and
cause it to be extinct. This new approach to opioids is part of that.
This bill has no mandatory minimums. As we take the steps today which
will allow us to engage in discussions with the Senate so that we may
soon send a bill to the President for his signature, I am pleased of
the progress that has been made. I can only hope that our work on
sentencing reduction, prison reform, and juvenile justice will have the
same kind of impetus and will wind up on the President's desk. That is
the vision, I believe, of many Republicans and Democrats in and out of
this House. As well, it is the vision of the President's; but, more
importantly, it is the vision of suffering families' who do not have
their loved ones with them.
The reason we must work together is that the leading killer of
Americans today, which is drug overdose, started first by prescription
use in many instances. Between 2000 and 2014, almost half a million
people died from drug overdoses. That is a startling number. In 2014
alone, more than 47,000 people died of drug overdoses. The largest
percentage of overdose deaths in 2014 was attributed to opioids, like
prescription painkillers, methadone, morphine, and heroin.
Specifically, 28,647 people overdosed and died because of an opioid in
2014.
This is an emergency, and it is a combination of prescription
painkillers and heroin. Prescription painkillers abuse is the strongest
risk for the future use of heroin. That is our athletes or those who
have had surgery--just everyday Americans who find themselves caught in
the trap of addiction. Approximately three out of four new heroin users
report that their use began with the abuse of prescription drugs.
Heroin use becomes appealing to those who are addicted to prescription
drugs because it is cheaper and easier to obtain, and due to its
potency, heroin use tends to lead to addiction. We know that from the
1980s and 1990s with crack cocaine in that crack was a more potent
extraction of cocaine, and we saw many of those individuals not get
treatment. They actually only got incarceration. Heroin addiction is
often deadly just as crack cocaine was in leading to overdose or to
other chronic diseases.
The rate at which the occurrence of heroin overdose deaths has
increased is cause for alarm. In the 4 years between 2010 and 2014,
heroin overdoses more than tripled. In 2013, 11 million people admitted
to the improper use of prescription painkillers and, therefore, were at
a heightened risk of becoming addicted.
That is why we have worked together this week on legislation to put
together something like an omnibus in order to reduce the risks of
addiction and to fund appropriate treatment responses for those who
abuse these drugs. The bill that was passed yesterday reflects the
strategy by proposing to establish a grant program to be administered
by the Department of Justice to assist States and local governments.
It is important to note these statistics: the rate of deaths from
heroin overdoses that account from the White population saw a 267
percent increase between 2010 and 2014; in African Americans, there was
an increase of 213 percent in 2010 to 2014; in Hispanics, there was a
137 percent increase from 2010 to 2014; and in Native Americans, there
was a 236 percent increase.
No aspect of American life has been uninfluenced by the devastation
of heroin overdoses and deaths--many of it impacting families whose
young, bright, talented, athletic, and, otherwise, young people have
fallen victim to this. This grant program is extremely helpful, for
which I am very pleased, because it deals with monitoring the
prescription drugs, and it deals with matching those who are committed
to working with police officers. It is truly an important bill.
Let me close by saying that we must have money to support all of
this, and I am hoping that this will not be the last stop we will make.
Mr. Speaker, I rise in support of this amendment to S. 524, the
Comprehensive Addiction and Recovery Act.
This week, the House adopted a number of bills that--together--are
intended to provide a response to the opioid crisis that is
commensurate with the scope of the problem.
Yesterday, the House passed--by an overwhelming vote--the primary
contribution of the Judiciary Committee to this effort, H.R. 5046, the
Comprehensive Opioid Abuse Reduction Act.
I am an original cosponsor of that bill, and I was a cosponsor of the
predecessor bill, both of which were introduced by my colleague, Jim
Sensenbrenner, the Chairman of the Subcommittee on Crime.
I commend him for his years of work and persistence on this issue,
and I also commend Chairman Goodlatte and Ranking Member Conyers for
their leadership and work to find common ground on this very important
issue.
As we take the steps today which will allow us to engage in
discussions with the Senate so that we may soon send a bill to the
President for signature, I am pleased at the progress we have made.
[[Page H2373]]
The reason we must work together is that a leading killer of
Americans today is drug overdose.
Between 2000 and 2014, almost half a million people died from drug
overdoses.
In 2014 alone, more than 47,000 people died of drug overdoses.
The largest percentage of overdose deaths in 2014 was attributed to
opioids--like prescription painkillers, methadone, morphine, and
heroin.
Specifically, 28,647 people overdosed and died because of an opioid
in 2014.
This emergency is compounded due to the perilous connection between
prescription painkillers and heroin.
Prescription painkiller abuse is the strongest risk factor for future
heroin use.
Approximately three out of four new heroin users report that their
use began with their abuse of prescription painkillers.
Heroin use becomes appealing to those addicted to prescription
painkillers because it is cheaper and easier to obtain.
Due to its potency, heroin use tends to lead to addiction.
Heroin addiction is often deadly, leading to overdose or other
chronic diseases.
The rate at which the occurrence of heroin overdose deaths increased
is cause for alarm.
In the four years between 2010 and 2014, heroin overdoses more than
tripled.
In 2013, 11 million people admitted to improper use of prescription
painkillers and therefore were at a heightened risk of becoming
addicted to heroin--with its attendant risks and dangers.
That is why we have worked together this week on legislation to
reduce the risks of addiction and to fund appropriate treatment
responses to those who abuse these drugs.
The bill we passed yesterday, H.R. 5046, reflects this strategy by
proposing to establish a grant program, to be administered by the
Department of Justice, to assist states and local governments,
particularly by helping criminal justice agencies to tackle the opioid
problem from a variety of angles.
This bill, included in this amendment, encourages the development of
alternatives to incarceration that provide treatment as a solution to
the underlying motivation for criminal behavior or conduct associated
with mental disorders.
We must make our best efforts to prevent individuals from moving from
painkillers to heroin by making treatment for addicts more accessible
by encouraging the use of evidence-based programs, such as medication-
assisted treatment.
Life-saving overdose reversal drugs, like naloxone, are most valuable
in the hands of trained individuals who regularly come in contact with
individuals who are prone to drug overdoses.
This legislation will increase the use and availability of naloxone
and other overdose reversal drugs to first responders.
Addiction is a disease that affects the brain and eventually changes
the behavior of addicts, causing them to experience mental health
issues and encounter legal problems.
Treatment is the most reasonable and effective approach to diverting
these individuals away from homelessness and prison.
There are also specific provisions we have proposed that allow for a
wide range of services to be offered to our veterans who tend to suffer
from mental health issues and addiction.
I support this legislation because I believe that it will help save
lives and prevent and treat opioid addiction.
The approach Congress is taking with the crisis of heroin and other
opioids is thoughtful and comprehensive.
I hope it signals a departure from some of the failed approaches
concerning other drug crises in the past.
For instance, our response to the surge in crack cocaine in the 1980s
was to enact draconian mandatory minimum penalties with vastly
disparate treatment for crack and powder cocaine.
At that time, we in Congress took action that we are still trying to
rectify.
At one point, more than 80% of the defendants sentenced for crack
offenses were African American, despite the fact that more than 66% of
crack users are white or Hispanic.
As we work on other legislation to address the enforcement and
sentencing disparities related to the crack issue, we must re-examine
our approach to that and other drug issues.
While law enforcement has an appropriate role and the bills recognize
that, the bills we adopted this week and that we put forth as an
amendment to the Senate bill today reflect a broader strategy that
reflects the fact that this is an addiction issue.
Accordingly, we are not raising sentences or impacting mandatory
minimums but we are funding anti-addiction mechanisms such as treatment
alternatives to incarceration.
We are not adding to mass incarceration--with all of the related and
devastating collateral consequences--but instead we are incentivizing
state and local governments to prevent, treat, and heal.
That is what we should be doing, and that is what we should have done
for crack and cocaine addicts.
With that history in mind and with the chance to take smarter and
more effective steps now, I look forward to continuing to work with my
colleagues in the House--and in the Senate--to apply this more
comprehensive approach, including treatment alternatives, to those
suffering from crack and cocaine addiction.
Yesterday, in my closing remarks on H.R. 5046, I stated my intention
to ensure that we make progress on addiction not only involving opioids
but drugs like crack and powder cocaine as well.
As I express my support for this legislation, I urge my colleagues to
work with me in this broader initiative as well as join me in voting
for this amendment to the Senate bill today.
Mr. CONYERS. Mr. Speaker, I yield back the balance of my time.
Mr. GOODLATTE. Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 725, the previous question is ordered on
the bill, as amended.
The question is on the third reading of the bill.
The bill was ordered to be read a third time, and was read the third
time.
The SPEAKER pro tempore. The question is on the passage of the bill.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. GOODLATTE. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The vote was taken by electronic device, and there were--yeas 400,
nays 5, not voting 28, as follows:
[Roll No. 193]
YEAS--400
Abraham
Aderholt
Aguilar
Allen
Amodei
Ashford
Babin
Barletta
Barr
Barton
Beatty
Becerra
Benishek
Bera
Beyer
Bilirakis
Bishop (GA)
Bishop (MI)
Bishop (UT)
Black
Blackburn
Blum
Blumenauer
Bonamici
Bost
Boustany
Boyle, Brendan F.
Brady (PA)
Brady (TX)
Brat
Brooks (IN)
Brown (FL)
Brownley (CA)
Buchanan
Buck
Bucshon
Bustos
Butterfield
Byrne
Calvert
Capps
Capuano
Carney
Carson (IN)
Carter (GA)
Carter (TX)
Cartwright
Castor (FL)
Castro (TX)
Chabot
Chaffetz
Chu, Judy
Cicilline
Clark (MA)
Clarke (NY)
Clawson (FL)
Clay
Cleaver
Clyburn
Coffman
Cohen
Cole
Collins (GA)
Collins (NY)
Comstock
Conaway
Connolly
Conyers
Cook
Cooper
Costa
Costello (PA)
Courtney
Cramer
Crawford
Crenshaw
Crowley
Cuellar
Culberson
Cummings
Curbelo (FL)
Davis (CA)
Davis, Danny
Davis, Rodney
DeFazio
DeGette
Delaney
DeLauro
DelBene
Denham
Dent
DeSantis
DeSaulnier
DesJarlais
Deutch
Diaz-Balart
Dingell
Doggett
Dold
Donovan
Doyle, Michael F.
Duckworth
Duffy
Duncan (SC)
Duncan (TN)
Edwards
Ellison
Ellmers (NC)
Emmer (MN)
Engel
Eshoo
Esty
Farenthold
Farr
Fitzpatrick
Fleischmann
Fleming
Flores
Fortenberry
Foster
Foxx
Frankel (FL)
Franks (AZ)
Frelinghuysen
Fudge
Gabbard
Gallego
Garrett
Gibbs
Gibson
Goodlatte
Gosar
Gowdy
Graham
Granger
Graves (GA)
Graves (LA)
Graves (MO)
Grayson
Green, Al
Green, Gene
Griffith
Grijalva
Grothman
Guinta
Guthrie
Gutierrez
Hahn
Hanna
Hardy
Harper
Harris
Hartzler
Heck (NV)
Heck (WA)
Hensarling
Hice, Jody B.
Higgins
Hill
Himes
Hinojosa
Holding
Honda
Hoyer
Hudson
Huelskamp
Huffman
Huizenga (MI)
Hultgren
Hunter
Hurd (TX)
Hurt (VA)
Issa
Jackson Lee
Jeffries
Jenkins (KS)
Jenkins (WV)
Johnson (GA)
Johnson (OH)
Johnson, E. B.
Johnson, Sam
Jolly
Jones
Jordan
Joyce
Kaptur
Katko
Keating
Kelly (IL)
Kelly (MS)
Kelly (PA)
Kildee
Kilmer
Kind
King (IA)
King (NY)
Kinzinger (IL)
Kline
Kuster
Labrador
LaHood
LaMalfa
Lamborn
Lance
Langevin
Larsen (WA)
Larson (CT)
Lawrence
Lee
Levin
Lewis
Lieu, Ted
Lipinski
LoBiondo
Loebsack
Lofgren
Long
Loudermilk
Love
Lowenthal
Lowey
Lucas
Luetkemeyer
Lujan Grisham (NM)
Lujan, Ben Ray (NM)
Lummis
Lynch
MacArthur
Maloney, Carolyn
Maloney, Sean
Marchant
Marino
Matsui
McCarthy
McCaul
McClintock
McCollum
McDermott
McGovern
McHenry
McKinley
McMorris Rodgers
McNerney
McSally
Meadows
Meehan
Meeks
Meng
Messer
Mica
Miller (FL)
Miller (MI)
Moolenaar
Mooney (WV)
Moore
Moulton
Mullin
Mulvaney
[[Page H2374]]
Murphy (FL)
Murphy (PA)
Nadler
Napolitano
Neal
Neugebauer
Newhouse
Noem
Nolan
Norcross
Nugent
Nunes
O'Rourke
Olson
Palazzo
Pallone
Palmer
Paulsen
Pearce
Pelosi
Perlmutter
Perry
Peters
Peterson
Pingree
Pittenger
Pocan
Poe (TX)
Poliquin
Polis
Pompeo
Posey
Price (NC)
Price, Tom
Quigley
Rangel
Ratcliffe
Reed
Reichert
Renacci
Ribble
Rice (NY)
Rice (SC)
Rigell
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rohrabacher
Rokita
Rooney (FL)
Ros-Lehtinen
Roskam
Ross
Rothfus
Rouzer
Roybal-Allard
Royce
Ruiz
Ruppersberger
Ryan (OH)
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Scalise
Schakowsky
Schiff
Schrader
Schweikert
Scott, Austin
Scott, David
Sensenbrenner
Serrano
Sessions
Sewell (AL)
Sherman
Shimkus
Shuster
Simpson
Sinema
Sires
Slaughter
Smith (MO)
Smith (NE)
Smith (NJ)
Smith (TX)
Smith (WA)
Stefanik
Stewart
Stivers
Swalwell (CA)
Takai
Takano
Thompson (CA)
Thompson (MS)
Thompson (PA)
Thornberry
Tiberi
Tipton
Tonko
Torres
Trott
Tsongas
Turner
Upton
Valadao
Van Hollen
Vargas
Veasey
Vela
Velazquez
Visclosky
Wagner
Walberg
Walden
Walker
Walorski
Walters, Mimi
Walz
Wasserman Schultz
Waters, Maxine
Watson Coleman
Weber (TX)
Webster (FL)
Welch
Wenstrup
Westerman
Westmoreland
Williams
Wilson (FL)
Wilson (SC)
Wittman
Womack
Woodall
Yarmuth
Yoder
Yoho
Young (AK)
Young (IA)
Young (IN)
Zeldin
Zinke
NAYS--5
Amash
Brooks (AL)
Gohmert
Massie
Scott (VA)
NOT VOTING--28
Adams
Bass
Bridenstine
Burgess
Cardenas
Fattah
Fincher
Forbes
Garamendi
Hastings
Herrera Beutler
Israel
Kennedy
Kirkpatrick
Knight
Latta
Pascrell
Payne
Pitts
Richmond
Rush
Russell
Salmon
Sanford
Speier
Stutzman
Titus
Whitfield
{time} 1151
Mr. SCOTT of Virginia changed his vote from ``yea'' to ``nay.''
So the bill was passed.
The result of the vote was announced as above recorded.
Pursuant to section 3 of House Resolution 725, the title of the bill
was amended so as to read: ``An Act to authorize the Attorney General
and Secretary of Health and Human Services to award grants to address
the national epidemics of prescription opioid abuse and heroin use, and
to provide for the establishment of an inter-agency task force to
review, modify, and update best practices for pain management and
prescribing pain medication, and for other purposes.''.
A motion to reconsider was laid on the table.
Stated for:
Mr. SCOTT of Virginia. Mr. Speaker, I inadvertently voted NAY on
passage of S. 524, as amended by the House. I strongly support S. 524,
as amended by the House.
Personal Explanation
Mr. SANFORD. Mr. Speaker, because I was in Nashville, Tennessee
attending my son Landon's graduation from Vanderbilt University today,
I was not present to vote. Had I been present, I would have voted
``yea'' on rollcall 190, ``aye'' on rollcall 191, ``yea'' on rollcall
192, and ``nay'' on rollcall 193.
Personal Explanation
Mr. KNIGHT. Mr. Speaker, on Friday, May 13th, I was absent due to
obligations in the district. Had I been present for the day's vote
series, I would have voted ``yea'' on rollcall No. 190, on ordering the
previous question; ``yea'' on rollcall No. 191, on the rule providing
for the consideration of S. 524; ``nay'' on rollcall No. 192, on
approval of the journal; and ``yea'' on rollcall No. 193, on passage of
S. 524 or the Comprehensive Addiction and Recovery Act of 2016, as
modified by the House amendment.
____________________