[Congressional Record (Bound Edition), Volume 162 (2016), Part 4]
[House]
[Pages 5711-5714]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1800
                               LALI'S LAW

  Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4586) to amend the Public Health Service Act to authorize 
grants to States for developing standing orders and educating health 
care professionals regarding the dispensing of opioid overdose reversal 
medication without person-specific prescriptions, and for other 
purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4586

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as ``Lali's Law''.

     SEC. 2. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND 
                   EDUCATION GRANT PROGRAMS.

       (a) Technical Clarification.--Effective as if included in 
     the enactment of the Children's Health Act of 2000 (Public 
     Law 106-310), section 3405(a) of such Act (114 Stat. 1221) is 
     amended by striking ``Part E of title III'' and inserting 
     ``Part E of title III of the Public Health Service Act''.
       (b) Amendment.--Title III of the Public Health Service Act 
     is amended by inserting after part D of such title (42 U.S.C. 
     254b et seq.) the following new part E:

                     ``PART E--OPIOID USE DISORDER

     ``SEC. 341. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND 
                   EDUCATION GRANT PROGRAMS.

       ``(a) Grants to States.--The Secretary may make grants to 
     States for--
       ``(1) developing standing orders for pharmacies regarding 
     opioid overdose reversal medication;
       ``(2) encouraging pharmacies to dispense opioid overdose 
     reversal medication pursuant to a standing order;
       ``(3) implementing best practices for persons authorized to 
     prescribe medication regarding--
       ``(A) prescribing opioids for the treatment of chronic 
     pain;
       ``(B) co-prescribing opioid overdose reversal medication 
     with opioids; and
       ``(C) discussing the purpose and administration of opioid 
     overdose reversal medication with patients;
       ``(4) developing or adapting training materials and methods 
     for persons authorized to prescribe or dispense medication to 
     use in educating the public regarding--
       ``(A) when and how to administer opioid overdose reversal 
     medication; and
       ``(B) steps to be taken after administering opioid overdose 
     reversal medication; and
       ``(5) educating the public regarding--
       ``(A) the public health benefits of opioid overdose 
     reversal medication; and
       ``(B) the availability of opioid overdose reversal 
     medication without a person-specific prescription.
       ``(b) Certain Requirement.--A grant may be made under this 
     section only if the State involved has authorized standing 
     orders regarding opioid overdose reversal medication.
       ``(c) Preference in Making Grants.--In making grants under 
     this section, the Secretary shall give preference to States 
     that--
       ``(1) have not issued standing orders regarding opioid 
     overdose reversal medication;
       ``(2) authorize standing orders that permit community-based 
     organizations, substance abuse programs, or other nonprofit 
     entities to acquire, dispense, or administer opioid overdose 
     reversal medication;
       ``(3) authorize standing orders that permit police, fire, 
     or emergency medical services agencies to acquire and 
     administer opioid overdose reversal medication;
       ``(4) have a higher per capita rate of opioid overdoses 
     than other applicant States; or
       ``(5) meet any other criteria deemed appropriate by the 
     Secretary.
       ``(d) Grant Terms.--
       ``(1) Number.--A State may not receive more than 1 grant 
     under this section.
       ``(2) Period.--A grant under this section shall be for a 
     period of 3 years.
       ``(3) Amount.--A grant under this section may not exceed 
     $500,000.
       ``(4) Limitation.--A State may use not more than 20 percent 
     of a grant under this section for educating the public 
     pursuant to subsection (a)(5).
       ``(e) Applications.--To be eligible to receive a grant 
     under this section, a State shall submit an application to 
     the Secretary in such form and manner and containing such 
     information as the Secretary may require, including detailed 
     proposed expenditures of grant funds.
       ``(f) Reporting.--Not later than 3 months after the 
     Secretary disburses the first grant payment to any State 
     under this section and every 6 months thereafter for 3 years, 
     such State shall submit a report to the Secretary that 
     includes the following:
       ``(1) The name and ZIP Code of each pharmacy in the State 
     that dispenses opioid overdose reversal medication under a 
     standing order.
       ``(2) The total number of opioid overdose reversal 
     medication doses dispensed by each such pharmacy, specifying 
     how many were dispensed with or without a person-specific 
     prescription.
       ``(3) The number of pharmacists in the State who have 
     participated in training pursuant to subsection (a)(4).
       ``(g) Definitions.--In this section:
       ``(1) Opioid overdose reversal medication.--The term 
     `opioid overdose reversal medication' means any drug, 
     including naloxone, that--
       ``(A) blocks opioids from attaching to, but does not itself 
     activate, opioid receptors; or
       ``(B) inhibits the effects of opioids on opioid receptors.
       ``(2) Standing order.--The term `standing order' means a 
     document prepared by a person authorized to prescribe 
     medication that permits another person to acquire, dispense, 
     or administer medication without a person-specific 
     prescription.

[[Page 5712]]

       ``(h) Authorization of Appropriations.--
       ``(1) In general.--To carry out this section, there is 
     authorized to be appropriated $5,000,000 for the period of 
     fiscal years 2017 through 2019.
       ``(2) Administrative costs.--Not more than 3 percent of the 
     amounts made available to carry out this section may be used 
     by the Secretary for administrative expenses of carrying out 
     this section.''.

     SEC. 3. CUT-GO COMPLIANCE.

       Subsection (f) of section 319D of the Public Health Service 
     Act (42 U.S.C. 247d-4) is amended by inserting before the 
     period at the end the following: ``(except such dollar amount 
     shall be reduced by $5,000,000 for fiscal year 2017)''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Kentucky (Mr. Guthrie) and the gentleman from Texas (Mr. Gene Green) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Kentucky.


                             General Leave

  Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Kentucky?
  There was no objection.
  Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4586, Lali's Law, 
introduced by my colleagues in the House, the gentleman from Illinois 
(Mr. Dold) and the gentlewoman from Massachusetts (Ms. Clark).
  The rate of overdose for individuals age 24 to 34 has nearly tripled, 
going from 8.1 overdose deaths per 100,000 to 23.1 overdose deaths per 
100,000. Families across the country are losing loved ones to 
reversible opioid overdose. Naloxone is an opioid antagonist that can 
prevent opioid overdose deaths by binding to the opioid receptors in 
the body and preventing the overdose.
  H.R. 4586 amends the Public Health Service Act to authorize grants to 
States for developing standing orders and educating healthcare 
professionals regarding the dispensing of opioid overdose reversal 
medication without person-specific prescriptions.
  This legislation is a first step in promoting wider access of 
naloxone or other opioid overdose reversal drugs that may come to 
market. Standing orders are prescriptions that are not person-specific. 
If a pharmacy has a standing order, anyone needing the medication may 
come and fill a prescription for it.
  Naloxone, while incredibly effective at stopping opioid overdose, 
does not have severe side effects if used incorrectly or if used when 
not needed. Many States have standing order laws in place but need help 
bridging the gap between law and a functioning program. The grants 
funded by this legislation will help aid that process.
  Mr. Speaker, I urge my colleagues to support this legislation.
  I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume. I rise in support of H.R. 4586, Lali's Law.
  Mr. Speaker, between 2001 and 2014, there was a threefold increase in 
prescription drug overdoses and a sixfold increase in heroin overdoses 
in the United States. We must do more to prevent drug misuse and abuse 
to avoid these tragedies in the first place. We must also ensure that 
those suffering from addiction to prescription and nonprescription 
drugs have access to potentially lifesaving treatments when and where 
they need it.
  Naloxone has proven to be a successful lifesaving intervention for 
patients presenting with overdose if administered quickly. When used, 
naloxone helps restore breathing that has been stopped by the overdose 
and has potential for saving thousands of lives each year.
  H.R. 4586 would create a competitive grant program to help States 
increase access to overdose reversal medications. The primary purpose 
of the grant is to fund State programs that allow pharmacists to 
distribute overdose reversal drugs without a person-prescription to 
qualified individuals or entities.
  To be effective, overdose reversal drugs must be given to the patient 
almost immediately. In an emergency situation, the ability for 
emergency medical technicians, law enforcement, substance abuse 
treatment providers, and qualified individuals to have such medications 
on hand can make the difference between life and death. Qualified 
individuals and entities often need to possess treatment before a 
specific patient is identified.
  Many States have established and use these programs to allow local 
law enforcement officers or emergency medical technicians to carry and 
use the overdose reversal drug naloxone. H.R. 4586 would expand these 
programs by helping States develop standing orders and educate 
healthcare professionals about dispensing these medications without 
person-specific prescriptions.
  I want to thank the bill's sponsors, the gentlewoman from 
Massachusetts (Ms. Clark) and the gentleman from Illinois (Mr. Dold), 
for introducing this legislation. I urge my colleagues to join me in 
supporting H.R. 4586.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Georgia (Mr. Carter), my friend.
  Mr. CARTER of Georgia. Mr. Speaker, I rise today in support of H.R. 
4586 because it is critical that we educate healthcare professionals 
about opioid overdose reversal medications.
  This bill allows the CDC to authorize grants to States based on their 
ability to educate healthcare professionals in dispensing opioid 
reversal medication. Specifically, this opioid reversal medication, 
called naloxone, can be used in emergency situations to stop an opioid 
overdose death.
  Also, through this bill, pharmacists will be able to dispense 
naloxone to patients without a prescription, increasing access to this 
lifesaving antidote. This access will help save lives in emergency 
situations when patients do not have the time or ability to seek or 
receive professional medical care. The World Health Organization states 
that this increased access will save up to 200,000 lives.
  As a lifelong pharmacist, I believe it is our duty to always educate 
Americans about the lifesaving tools available to them. I encourage my 
colleagues to support H.R. 4586 so more people can be educated and have 
access to lifesaving medication related to opioid overdose.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield 3 minutes to the 
gentlewoman from Massachusetts (Ms. Clark), a cosponsor of the bill.
  Ms. CLARK of Massachusetts. Mr. Speaker, I thank Representative Dold 
for joining me in this legislation, and I also thank the family of Alex 
Laliberte for sharing their story. We offer our deepest sympathies.
  Mr. Speaker, across Massachusetts and the Nation, too many parents 
are desperately trying to save their child from the deadly grip of the 
opioid crisis. In the past year alone, this public health crisis has 
claimed nearly 1,400 lives in the Commonwealth of Massachusetts. The 
bill before us today, Lali's Law, is a critical part of addressing this 
crisis.
  Naloxone, commonly known as Narcan, is a lifesaving drug. It stops 
the effect of heroin within minutes after it is administered, and it 
allows breathing to resume. But it is critical that it is widely 
available.
  Under this bill, States that have authorized a standing order that 
allows anyone to obtain naloxone from a pharmacist would be eligible 
for a grant that can be used for public education campaigns and 
training for healthcare providers and pharmacists.
  I want to share the story of a family from my district that 
illustrates the difference training and the availability of Narcan can 
make.
  One night, a 9-1-1 call came in, a desperate and frantic new mother 
with a very young baby who was unresponsive. The first responders 
arrived at the scene, but despite their best efforts, this baby was not 
reviving. A responding firefighter relied on his training and quick 
thinking to save this child's life by administering Narcan. It worked.

[[Page 5713]]

  Even though the mom had not revealed that she was addicted to 
prescription painkillers, the first responder knew the symptoms and 
made the right guess and saved this child's life. If he had not been 
trained to administer Narcan and not had the lifesaving drug with him 
that night, that baby would not be alive. But the man was, and now the 
baby and mom have a future.
  This crisis presents an urgent calling for all of us, Democrats and 
Republicans alike, to put aside our differences and do what we can to 
save lives. That is what we are talking about here: increasing the 
availability of Narcan will save lives.
  I am happy to join with my friend from Illinois to offer this 
important bill. I urge all of my colleagues to support this 
legislation.
  Mr. GUTHRIE. Mr. Speaker, I yield 5 minutes to the gentleman from 
Illinois (Mr. Dold), my good friend.
  Mr. DOLD. Mr. Speaker, I want to thank my good friend for yielding. I 
want to thank my friend from Massachusetts for her work on this 
legislation. Representative Clark sharing that story is extremely 
powerful.
  In the suburbs of Chicago, Mr. Speaker, somebody dies from using 
heroin every 3 days. Nationally, that statistic is 1 every 19 minutes. 
Every single one of them leaves behind a family in grief.
  Today, Mr. Speaker, I am joined in the Chamber by Chelsea Laliberte, 
Jody Daitchman, and Gary Laliberte, the family of a young man from 
Buffalo Grove named Alex.
  Alex graduated from Stevenson High School. He played sports. He got 
good grades and made a lot of friends. He was a typical teenager who 
had his whole life ahead of him. But behind his happy exterior, Alex 
was sick. He was struggling with escalating drug abuse.
  During Alex's sophomore year in college, he came down with an unknown 
illness. He would go to the hospital, and he would get better--at least 
for a while. But then a few months later he would get sick. He would be 
admitted to the hospital and again would repeat the cycle. His family 
didn't know it then, but Alex was dependent on prescription drugs and 
was suffering from withdrawal.
  Alex continued this pattern until just a few days before his final 
exams. At that point in time, Alex actually overdosed on prescription 
drugs and heroin and, at the age of 20, passed away. His family never 
even had the chance to seek help for his dependency.
  Unfortunately, this story is far too common across our country.
  As a father, I can't even imagine the pain of losing a child to a 
drug overdose; but sadly, too many families like the Lalibertes have 
experienced this loss. Heroin and heroin abuse have become an epidemic 
in our country.
  During my work as the co-chair of the Suburban Anti-Heroin Task 
Force, I have met countless families who have been affected by drug 
abuse--literally torn apart. This is not an isolated issue. It affects 
every community, every ZIP Code, regardless of your socioeconomic 
status, regardless of your educational status.
  I talk to parents who say, ``It is not in my community.'' It is. It 
is in your community, let me just assure you.
  My work with Live4Lali and the Lake County Opioid Initiative inspired 
me to introduce this law with Representative Clark. Our bipartisan bill 
is named in Alex Laliberte's memory.
  Lali's Law increases access to a lifesaving antidote called naloxone, 
which, in Lake County, Illinois, has already saved nearly 100 lives 
since first responders and the police force requested the opportunity 
to be able to use this lifesaving antidote. The police officers 
actually would respond, would get there before the paramedics--often 5 
to 7, sometimes 9 minutes faster--and refused to sit by idly as they 
watched these young people die from an overdose.
  When used properly, naloxone helps restore breathing that has been 
stopped by an overdose. You have heard the statistics, but the World 
Health Organization predicts that increased access to naloxone could 
save another 20,000 lives each and every year.
  Lali's Law is a decisive step to not only save young people like Alex 
Laliberte from falling victim to drug abuse, but also to help those in 
our communities struggling to get their lives back on track. Our bill--
and, frankly, the work that has been done here in this body today, and 
I think we have got some 18 different bipartisan bills coming together 
to try to solve this prescription drug epidemic, this heroin epidemic 
that is sweeping our country--is proof of what is possible when we set 
aside partisanship and get to work for the people that we all 
represent.
  Lali's Law has already brought Alex's story to the United States 
Congress and has amplified the lifesaving benefit of Live4Lali's 
amazing work. Now, by passing this overwhelming bipartisan bill, we can 
ensure that Alex's lasting legacy includes helping countless others get 
a second chance at recovery and saving their families from the 
unbearable heartbreak.
  Mr. Speaker, together, we truly can save lives.
  Again, I want to thank Representative Clark. I want to thank the 
Laliberte family. I want to thank the first responders, the 
stakeholders back in Lake County, and all those here in this body who 
are working to try to create an environment, create the opportunity for 
us to be able to take a huge step forward in combating this 
prescription drug and heroin epidemic.
  I thank the gentleman for yielding the time.

                              {time}  1815

  Mr. GENE GREEN of Texas. Mr. Speaker, I yield back the balance of my 
time.
  Mr. GUTHRIE. Mr. Speaker, I encourage my colleagues to vote for H.R. 
4586.
  I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 4586, also 
known as Lali's Law.
  Sadly, Lali's Law was named after Alex Laliberte: a Buffalo Grove, 
Illinois resident who tragically passed away seven years ago from a 
drug overdose.
  Alex was a good kid. He was an athlete during high school, and also 
did well academically.
  During his sophomore year in college, he began being hospitalized for 
a mysterious illness.
  Unknown to his friends and family, Alex soon developed an addiction 
to the prescription drugs and was being hospitalized for withdrawal.
  He would stay in the hospital until his symptoms subsided only to 
leave the hospital and repeat the cycle.
  Alex continued this cycle until he died of an opioid overdose a few 
days before his final exams.
  He was only 20 years old.
  Our lack of education on opioids and harm reduction contributed to 
Alex's early death, and we must act to prevent a repeat of this 
tragedy.
  Lali's Law is an important piece of legislation that would authorize 
grants to states to develop standing orders and educate health care 
professionals about the dispensing of opioid overdose reversal 
medication without person-specific prescriptions.
  In addition, this bill would encourage pharmacies to dispense opioid 
overdose reversal medication pursuant to a standing order.
  According to the National Institute on Drug Abuse, 2.1 million people 
nationwide abuse opioids.
  Mr. Speaker, Lali's Law is instrumental in helping these victims 
reverse their addiction.
  Lali's Law would also implement the following guidelines and 
practices for those people authorized to prescribe the medication:
  Only prescribe opioids for chronic pain
  Opioid overdose reversal medication must be co-prescribed with 
opioids; and
  the purpose and administration of opioid overdose reversal medication 
must be discussed with the patients.
  Furthermore, H.R. 4586 would require the development and adaptation 
of training materials and methods for the people authorized to 
prescribe or dispense the medication to use in educating the public, 
which includes:
  When and how to administer opioid overdose reversal medication, and
  The steps that should be taken after administering the opioid 
overdose reversal medication.
  Lastly, Lali's Law would educate the public regarding the health 
benefits of the opioid reversal medication and the availability of the 
medication without a person-specific prescription.
  In 2014, rates of opioid overdose deaths jumped significantly, from 
7.9 per 100,000 in

[[Page 5714]]

2013 to 9.0 per 100,000, which is a 14 percent increase.
  Mr. Speaker, I join my colleagues in support of H.R. 4586.
  This legislation is vital for reducing opioid-related deaths across 
our nation, protecting the lives of those at risk to opioid abuse.
  It is our job to make sure that Alex's lasting legacy includes 
helping others get a second chance at recovery and a second chance at 
life.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules 
and pass the bill, H.R. 4586, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. GUTHRIE. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

                          ____________________