[House Report 114-555]
[From the U.S. Government Publishing Office]


114th Congress    }                                      {      Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                      {     114-555

======================================================================



 
                               LALI'S LAW

                                _______
                                

  May 10, 2016.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

  Mr. Upton, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 4586]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
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, having considered the 
same, report favorably thereon with an amendment and recommend 
that the bill as amended do pass.










                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     3
Hearings.........................................................     4
Committee Consideration..........................................     4
Committee Votes..................................................     4
Committee Oversight Findings.....................................     4
Statement of General Performance Goals and Objectives............     4
New Budget Authority, Entitlement Authority, and Tax Expenditures     4
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     4
Committee Cost Estimate..........................................     4
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     6
Duplication of Federal Programs..................................     6
Disclosure of Directed Rule Makings..............................     6
Advisory Committee Statement.....................................     6
Applicability to Legislative Branch..............................     6
Section-by-Section Analysis of the Legislation...................     6
Changes in Existing Law Made by the Bill, as Reported............     7




    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

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

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

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

                     ``PART E--OPIOID USE DISORDER

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

  ``(a) Grants to States.--The Secretary may make grants to States 
for--
          ``(1) developing standing orders for pharmacies regarding 
        opioid overdose reversal medication;
          ``(2) encouraging pharmacies to dispense opioid overdose 
        reversal medication pursuant to a standing order;
          ``(3) implementing best practices for persons authorized to 
        prescribe medication regarding--
                  ``(A) prescribing opioids for the treatment of 
                chronic pain;
                  ``(B) co-prescribing opioid overdose reversal 
                medication with opioids; and
                  ``(C) discussing the purpose and administration of 
                opioid overdose reversal medication with patients;
          ``(4) developing or adapting training materials and methods 
        for persons authorized to prescribe or dispense medication to 
        use in educating the public regarding--
                  ``(A) when and how to administer opioid overdose 
                reversal medication; and
                  ``(B) steps to be taken after administering opioid 
                overdose reversal medication; and
          ``(5) educating the public regarding--
                  ``(A) the public health benefits of opioid overdose 
                reversal medication; and
                  ``(B) the availability of opioid overdose reversal 
                medication without a person-specific prescription.
  ``(b) Certain Requirement.--A grant may be made under this section 
only if the State involved has authorized standing orders regarding 
opioid overdose reversal medication.
  ``(c) Preference in Making Grants.--In making grants under this 
section, the Secretary shall give preference to States that--
          ``(1) have not issued standing orders regarding opioid 
        overdose reversal medication;
          ``(2) authorize standing orders that permit community-based 
        organizations, substance abuse programs, or other nonprofit 
        entities to acquire, dispense, or administer opioid overdose 
        reversal medication;
          ``(3) authorize standing orders that permit police, fire, or 
        emergency medical services agencies to acquire and administer 
        opioid overdose reversal medication;
          ``(4) have a higher per capita rate of opioid overdoses than 
        other applicant States; or
          ``(5) meet any other criteria deemed appropriate by the 
        Secretary.
  ``(d) Grant Terms.--
          ``(1) Number.--A State may not receive more than 1 grant 
        under this section.
          ``(2) Period.--A grant under this section shall be for a 
        period of 3 years.
          ``(3) Amount.--A grant under this section may not exceed 
        $500,000.
          ``(4) Limitation.--A State may use not more than 20 percent 
        of a grant under this section for educating the public pursuant 
        to subsection (a)(5).
  ``(e) Applications.--To be eligible to receive a grant under this 
section, a State shall submit an application to the Secretary in such 
form and manner and containing such information as the Secretary may 
require, including detailed proposed expenditures of grant funds.
  ``(f) Reporting.--Not later than 3 months after the Secretary 
disburses the first grant payment to any State under this section and 
every 6 months thereafter for 3 years, such State shall submit a report 
to the Secretary that includes the following:
          ``(1) The name and ZIP Code of each pharmacy in the State 
        that dispenses opioid overdose reversal medication under a 
        standing order.
          ``(2) The total number of opioid overdose reversal medication 
        doses dispensed by each such pharmacy, specifying how many were 
        dispensed with or without a person-specific prescription.
          ``(3) The number of pharmacists in the State who have 
        participated in training pursuant to subsection (a)(4).
  ``(g) Definitions.--In this section:
          ``(1) Opioid overdose reversal medication.--The term `opioid 
        overdose reversal medication' means any drug, including 
        naloxone, that--
                  ``(A) blocks opioids from attaching to, but does not 
                itself activate, opioid receptors; or
                  ``(B) inhibits the effects of opioids on opioid 
                receptors.
          ``(2) Standing order.--The term `standing order' means a 
        document prepared by a person authorized to prescribe 
        medication that permits another person to acquire, dispense, or 
        administer medication without a person-specific prescription.
  ``(h) Authorization of Appropriations.--
          ``(1) In general.--To carry out this section, there is 
        authorized to be appropriated $5,000,000 for the period of 
        fiscal years 2017 through 2019.
          ``(2) Administrative costs.--Not more than 3 percent of the 
        amounts made available to carry out this section may be used by 
        the Secretary for administrative expenses of carrying out this 
        section.''.

SEC. 3. CUT-GO COMPLIANCE.

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

                          Purpose and Summary

    H.R. 4586, ``Lali's Law,'' was introduced by Rep. Bob Dold 
(R-IL) and Rep. Katherine Clark (D-MA) on February 23, 2016. 
This legislation amends 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.

                  Background and Need for Legislation

    In 1999, there were 6.1 overdose deaths per 100,000 
Americans involving opioid analgesics and heroin. By 2014, that 
number more than doubled to 14.7 overdose deaths. The rate of 
overdose for individuals aged 24 to 34 nearly tripled, going 
from 8.1 overdose deaths per 100,000 to 23.1 overdose 
deaths.\1\ Naloxone is an opioid antagonist that can prevent 
opioid overdose deaths by binding to the opioid receptors in 
the body and preventing the overdose. The World Health 
Organization estimated that if naloxone was more widely 
available in the United States, 20,000 overdose deaths could be 
prevented annually.\2\ 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 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.
---------------------------------------------------------------------------
    \1\http://www.cdc.gov/nchs/data/hus/hus15.pdf.
    \2\http://www.reuters.com/article/us-health-who-naloxone-
idUSKBN0IO12420141104.
---------------------------------------------------------------------------

                                Hearings

    The Committee on Energy and Commerce has not held hearings 
on the legislation.

                        Committee Consideration

    On April 20, 2016, the Subcommittee on Health met in open 
markup session and forwarded H.R. 4586, as amended, to the full 
Committee, by a voice vote. On April 26, 27, and 28, 2016, the 
full Committee on Energy and Commerce met in open markup 
session and ordered H.R. 4586 reported to the House, as 
amended, by a voice vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no record votes taken in connection with ordering 
H.R. 4586 reported.

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee has not held hearings 
on this legislation.

         Statement of General Performance Goals and Objectives

    The goal of this legislation is 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.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
4586 would result in no new or increased budget authority, 
entitlement authority, or tax expenditures or revenues.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

    In compliance with clause 9(e), 9(f), and 9(g) of rule XXI 
of the Rules of the House of Representatives, the Committee 
finds that H.R. 4586 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                       Washington, DC, May 9, 2016.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 4586, Lali's Law.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Rebecca Yip.
            Sincerely,
                                                        Keith Hall.
    Enclosure.

H.R. 4586--Lali's Law

    H.R. 4586 would allow the Centers for Disease Control and 
Prevention (CDC) to provide grants to states to enable and 
encourage pharmacies to dispense medications that reverse 
opioid overdoses pursuant to a standing order. A standing order 
is a prescription that permits another person to acquire, 
dispense, or administer medication without the prescription 
specifying who will be treated with the medication. The grants 
would be limited to $500,000 per state. The bill also would 
allow states to use the grant funds to implement best practices 
and to develop training materials on the purpose, 
administration, and availability of those medications. H.R. 
4586 would authorize the appropriation of a total of $5 million 
of fiscal years 2017 through 2019 to carry out these 
activities. Assuming the availability of appropriated funds, 
CBO estimates those funds would be spent over the 2017-2021 
period.
    Under current law, an authorization of appropriations 
totaling $138 million exists for 2017 for CDC for activities 
related to bioterrorism and public health emergencies. H.R. 
4586 would reduce the amount authorized by $5 million in 2017. 
Assuming appropriation actions consistent with the bill, CBO 
estimates that implementing this provision would result in $5 
million less in discretionary outlays for that program over the 
2017-2021 period.
    On net, CBO estimates that implementing H.R. 4586 would not 
affect discretionary costs over the 2017-2021 period. Enacting 
H.R. 4586 would not affect direct spending or revenues; 
therefore, pay-as-you-go procedures do not apply. CBO estimates 
that enacting H.R. 4586 would not increase net direct spending 
or on-budget deficits in any of the four consecutive 10-year 
periods beginning in 2027.
    H.R. 4586 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act. Any 
costs incurred by states that apply for grants authorized by 
the bill would be incurred voluntarily as a condition of 
assistance.
    The CBO staff contact for this estimate is Rebecca Yip. The 
estimate was approved by Holly Harvey, Deputy Assistant 
Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                    Duplication of Federal Programs

    No provision of H.R. 4586 establishes or reauthorizes a 
program of the Federal Government known to be duplicative of 
another Federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                  Disclosure of Directed Rule Makings

    The Committee estimates that enacting H.R. 4586 
specifically directs to be completed 0 rule makings within the 
meaning of 5 U.S.C. 551.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 states that the legislation may be cited as 
``Lali's Law.''

Section 2. Opioid overdose reversal medication access and education 
        grant programs

    Under section 2, the Secretary of Health and Human Services 
is authorized to make grants for: developing standing orders 
for pharmacies regarding opioid overdose reversal medication; 
encouraging pharmacies to dispense opioid overdose reversal 
medication pursuant to a standing order; implementing best 
practices; and developing or adapting training materials.
    Grantees must report on a number of metrics including: the 
name and ZIP codes of each pharmacy dispensing opioid overdose 
reversal drugs under a standing order, the total number of 
opioid overdose reversal medication doses dispensed by each 
pharmacy, and the number of pharmacists in the State who have 
participated in training also funded by the grant.
    Finally, this section authorizes an appropriation of $5 
million over the period of fiscal years 2017 through 2019.

Section 3. Cut-go compliance

    Section 3 reduces the authorization of Section 319D of the 
Public Health Service Act for $5,000,000 for fiscal year 2017 
to bring the legislation into compliance with Cut-Go. This 
reduction in authorization is equal to the authorization of 
appropriations in section 2.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, and existing law in which no 
change is proposed is shown in roman):

                     CHILDREN'S HEALTH ACT OF 2000




           *       *       *       *       *       *       *
DIVISION B--YOUTH DRUG AND MENTAL HEALTH SERVICES

           *       *       *       *       *       *       *


TITLE XXXIV--PROVISIONS RELATING TO FLEXIBILITY AND ACCOUNTABILITY

           *       *       *       *       *       *       *


SEC. 3405. REPEAL OF OBSOLETE ADDICT REFERRAL PROVISIONS.

  (a) Repeal of Obsolete Public Health Service Act 
Authorities.--[Part E of title III] Part E of title III of the 
Public Health Service Act (42 U.S.C. 257 et seq.) is repealed.
  (b) Repeal of Obsolete NARA Authorities.--Titles III and IV 
of the Narcotic Addict Rehabilitation Act of 1966 (Public Law 
89-793) are repealed.
  (c) Repeal of Obsolete Title 28 Authorities.--
          (1) In general.--Chapter 175 of title 28, United 
        States Code, is repealed.
          (2) Table of contents.--The table of contents to part 
        VI of title 28, United States Code, is amended by 
        striking the items relating to chapter 175.

           *       *       *       *       *       *       *

                              ----------                              


                       PUBLIC HEALTH SERVICE ACT


TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



SEC. 319D. REVITALIZING THE CENTERS FOR DISEASE CONTROL AND PREVENTION.

  (a) Facilities; Capacities.--
          (1) Findings.--Congress finds that the Centers for 
        Disease Control and Prevention has an essential role in 
        defending against and combatting public health threats 
        domestically and abroad and requires secure and modern 
        facilities, and expanded and improved capabilities 
        related to bioterrorism and other public health 
        emergencies, sufficient to enable such Centers to 
        conduct this important mission.
          (2) Facilities.--
                  (A) In general.--The Director of the Centers 
                for Disease Control and Prevention may design, 
                construct, and equip new facilities, renovate 
                existing facilities (including laboratories, 
                laboratory support buildings, scientific 
                communication facilities, transshipment 
                complexes, secured and isolated parking 
                structures, office buildings, and other 
                facilities and infrastructure), and upgrade 
                security of such facilities, in order to better 
                conduct the capacities described in section 
                319A, and for supporting public health 
                activities.
                  (B) Multiyear contracting authority.--For any 
                project of designing, constructing, equipping, 
                or renovating any facility under subparagraph 
                (A), the Director of the Centers for Disease 
                Control and Prevention may enter into a single 
                contract or related contracts that collectively 
                include the full scope of the project, and the 
                solicitation and contract shall contain the 
                clause ``availability of funds'' found at 
                section 52.232-18 of title 48, Code of Federal 
                Regulations.
          (3) Improving the capacities of the centers for 
        disease control and prevention.--The Secretary shall 
        expand, enhance, and improve the capabilities of the 
        Centers for Disease Control and Prevention relating to 
        preparedness for and responding effectively to 
        bioterrorism and other public health emergencies. 
        Activities that may be carried out under the preceding 
        sentence include--
                  (A) expanding or enhancing the training of 
                personnel;
                  (B) improving communications facilities and 
                networks, including delivery of necessary 
                information to rural areas;
                  (C) improving capabilities for public health 
                surveillance and reporting activities, taking 
                into account the integrated system or systems 
                of public health alert communications and 
                surveillance networks under subsection (b); and
                  (D) improving laboratory facilities related 
                to bioterrorism and other public health 
                emergencies, including increasing the security 
                of such facilities.
  (b) National Communications and Surveillance Networks.--
          (1) In general.--The Secretary, directly or through 
        awards of grants, contracts, or cooperative agreements, 
        shall provide for the establishment of an integrated 
        system or systems of public health alert communications 
        and surveillance networks between and among--
                  (A) Federal, State, and local public health 
                officials;
                  (B) public and private health-related 
                laboratories, hospitals, poison control 
                centers, and other health care facilities; and
                  (C) any other entities determined appropriate 
                by the Secretary.
          (2) Requirements.--The Secretary shall ensure that 
        networks under paragraph (1) allow for the timely 
        sharing and discussion, in a secure manner, of 
        essential information concerning bioterrorism or 
        another public health emergency, or recommended methods 
        for responding to such an attack or emergency, allowing 
        for coordination to maximize all-hazards medical and 
        public health preparedness and response and to minimize 
        duplication of effort.
          (3) Standards.--Not later than one year after the 
        date of the enactment of the Public Health Security and 
        Bioterrorism Preparedness and Response Act of 2002, the 
        Secretary, in cooperation with health care providers 
        and State and local public health officials, shall 
        establish any additional technical and reporting 
        standards (including standards for interoperability) 
        for networks under paragraph (1) and update such 
        standards as necessary.
  (c) Modernizing Public Health Situational Awareness and 
Biosurveillance.--
          (1) In general.--Not later than 2 years after the 
        date of enactment of the Pandemic and All-Hazards 
        Preparedness Reauthorization Act of 2013, the 
        Secretary, in collaboration with State, local, and 
        tribal public health officials, shall establish a near 
        real-time electronic nationwide public health 
        situational awareness capability through an 
        interoperable network of systems to share data and 
        information to enhance early detection of rapid 
        response to, and management of, potentially 
        catastrophic infectious disease outbreaks, novel 
        emerging threats, and other public health emergencies 
        that originate domestically or abroad. Such network 
        shall be built on existing State situational awareness 
        systems or enhanced systems that enable such 
        connectivity.
          (2) Strategy and implementation plan.--Not later than 
        180 days after the date of enactment of the Pandemic 
        and All-Hazards Preparedness Reauthorization Act of 
        2013, the Secretary shall submit to the appropriate 
        committees of Congress a coordinated strategy and an 
        accompanying implementation plan that identifies and 
        demonstrates the measurable steps the Secretary will 
        carry out to--
                  (A) develop, implement, and evaluate the 
                network described in paragraph (1), utilizing 
                the elements described in paragraph (3);
                  (B) modernize and enhance biosurveillance 
                activities; and
                  (C) improve information sharing, 
                coordination, and communication among disparate 
                biosurveillance systems supported by the 
                Department of Health and Human Services.
          (3) Elements.--The network described in paragraph (1) 
        shall include data and information transmitted in a 
        standardized format from--
                  (A) State, local, and tribal public health 
                entities, including public health laboratories;
                  (B) Federal health agencies;
                  (C) zoonotic disease monitoring systems;
                  (D) public and private sector health care 
                entities, hospitals, pharmacies, poison control 
                centers or professional organizations in the 
                field of poison control, community health 
                centers, health centers and clinical 
                laboratories, to the extent practicable and 
                provided that such data are voluntarily 
                provided simultaneously to the Secretary and 
                appropriate State, local, and tribal public 
                health agencies; and
                  (E) such other sources as the Secretary may 
                deem appropriate.
          (4) Rule of construction.--Paragraph (3) shall not be 
        construed as requiring separate reporting of data and 
        information from each source listed.
          (5) Required activities.--In establishing and 
        operating the network described in paragraph (1), the 
        Secretary shall--
                  (A) utilize applicable interoperability 
                standards as determined by the Secretary, and 
                in consultation with the Office of the National 
                Coordinator for Health Information Technology, 
                through a joint public and private sector 
                process;
                  (B) define minimal data elements for such 
                network;
                  (C) in collaboration with State, local, and 
                tribal public health officials, integrate and 
                build upon existing State, local, and tribal 
                capabilities, ensuring simultaneous sharing of 
                data, information, and analyses from the 
                network described in paragraph (1) with State, 
                local, and tribal public health agencies; and
                  (D) in collaboration with State, local, and 
                tribal public health officials, develop 
                procedures and standards for the collection, 
                analysis, and interpretation of data that 
                States, regions, or other entities collect and 
                report to the network described in paragraph 
                (1).
          (6) Consultation with the national biodefense science 
        board.--In carrying out this section and consistent 
        with section 319M, the National Biodefense Science 
        Board shall provide expert advice and guidance, 
        including recommendations, regarding the measurable 
        steps the Secretary should take to modernize and 
        enhance biosurveillance activities pursuant to the 
        efforts of the Department of Health and Human Services 
        to ensure comprehensive, real-time, all-hazards 
        biosurveillance capabilities. In complying with the 
        preceding sentence, the National Biodefense Science 
        Board shall--
                  (A) identify the steps necessary to achieve a 
                national biosurveillance system for human 
                health, with international connectivity, where 
                appropriate, that is predicated on State, 
                regional, and community level capabilities and 
                creates a networked system to allow for two-way 
                information flow between and among Federal, 
                State, and local government public health 
                authorities and clinical health care providers;
                  (B) identify any duplicative surveillance 
                programs under the authority of the Secretary, 
                or changes that are necessary to existing 
                programs, in order to enhance and modernize 
                such activities, minimize duplication, 
                strengthen and streamline such activities under 
                the authority of the Secretary, and achieve 
                real-time and appropriate data that relate to 
                disease activity, both human and zoonotic; and
                  (C) coordinate with applicable existing 
                advisory committees of the Director of the 
                Centers for Disease Control and Prevention, 
                including such advisory committees consisting 
                of representatives from State, local, and 
                tribal public health authorities and 
                appropriate public and private sector health 
                care entities and academic institutions, in 
                order to provide guidance on public health 
                surveillance activities.
  (d) State and Regional Systems To Enhance Situational 
Awareness in Public Health Emergencies.--
          (1) In general.--To implement the network described 
        in subsection (c), the Secretary may award grants to 
        States or consortia of States to enhance the ability of 
        such States or consortia of States to establish or 
        operate a coordinated public health situational 
        awareness system for regional or Statewide early 
        detection of, rapid response to, and management of 
        potentially catastrophic infectious disease outbreaks 
        and public health emergencies, in collaboration with 
        appropriate public health agencies, sentinel hospitals, 
        clinical laboratories, pharmacies, poison control 
        centers, other health care organizations, and animal 
        health organizations within such States.
          (2) Eligibility.--To be eligible to receive a grant 
        under paragraph (1), the State or consortium of States 
        shall submit to the Secretary an application at such 
        time, in such manner, and containing such information 
        as the Secretary may require, including an assurance 
        that the State or consortium of States will submit to 
        the Secretary--
                  (A) reports of such data, information, and 
                metrics as the Secretary may require;
                  (B) a report on the effectiveness of the 
                systems funded under the grant; and
                  (C) a description of the manner in which 
                grant funds will be used to enhance the 
                timelines and comprehensiveness of efforts to 
                detect, respond to, and manage potentially 
                catastrophic infectious disease outbreaks and 
                public health emergencies.
          (3) Use of funds.--A State or consortium of States 
        that receives an award under this subsection--
                  (A) shall establish, enhance, or operate a 
                coordinated public health situational awareness 
                system for regional or Statewide early 
                detection of, rapid response to, and management 
                of potentially catastrophic infectious disease 
                outbreaks and public health emergencies;
                  (B) may award grants or contracts to entities 
                described in paragraph (1) within or serving 
                such State to assist such entities in improving 
                the operation of information technology 
                systems, facilitating the secure exchange of 
                data and information, and training personnel to 
                enhance the operation of the system described 
                in subparagraph (A); and
                  (C) may conduct a pilot program for the 
                development of multi-State telehealth network 
                test beds that build on, enhance, and securely 
                link existing State and local telehealth 
                programs to prepare for, monitor, respond to, 
                and manage the events of public health 
                emergencies, facilitate coordination and 
                communication among medical, public health, and 
                emergency response agencies, and provide 
                medical services through telehealth initiatives 
                within the States that are involved in such a 
                multi-State telehealth network test bed.
          (4) Limitation.--Information technology systems 
        acquired or implemented using grants awarded under this 
        section must be compliant with--
                  (A) interoperability and other technological 
                standards, as determined by the Secretary; and
                  (B) data collection and reporting 
                requirements for the network described in 
                subsection (c).
          (5) Independent evaluation.--Not later than 3 years 
        after the date of enactment of the Pandemic and All-
        Hazards Preparedness Reauthorization Act of 2013, the 
        Government Accountability Office shall conduct an 
        independent evaluation, and submit to the Secretary and 
        the appropriate committees of Congress a report 
        concerning the activities conducted under this 
        subsection and subsection (c).
  (e) Telehealth Enhancements for Emergency Response.--
          (1) Evaluation.--The Secretary, in consultation with 
        the Federal Communications Commission and other 
        relevant Federal agencies, shall--
                  (A) conduct an inventory of telehealth 
                initiatives in existence on the date of 
                enactment of the Pandemic and All-Hazards 
                Preparedness Act, including--
                          (i) the specific location of network 
                        components;
                          (ii) the medical, technological, and 
                        communications capabilities of such 
                        components;
                          (iii) the functionality of such 
                        components; and
                          (iv) the capacity and ability of such 
                        components to handle increased volume 
                        during the response to a public health 
                        emergency;
                  (B) identify methods to expand and 
                interconnect the regional health information 
                networks funded by the Secretary, the State and 
                regional broadband networks funded through the 
                rural health care support mechanism pilot 
                program funded by the Federal Communications 
                Commission, and other telehealth networks;
                  (C) evaluate ways to prepare for, monitor, 
                respond rapidly to, or manage the events of, a 
                public health emergency through the enhanced 
                use of telehealth technologies, including 
                mechanisms for payment or reimbursement for use 
                of such technologies and personnel during 
                public health emergencies;
                  (D) identify methods for reducing legal 
                barriers that deter health care professionals 
                from providing telemedicine services, such as 
                by utilizing State emergency health care 
                professional credentialing verification 
                systems, encouraging States to establish and 
                implement mechanisms to improve interstate 
                medical licensure cooperation, facilitating the 
                exchange of information among States regarding 
                investigations and adverse actions, and 
                encouraging States to waive the application of 
                licensing requirements during a public health 
                emergency;
                  (E) evaluate ways to integrate the practice 
                of telemedicine within the National Disaster 
                Medical System; and
                  (F) promote greater coordination among 
                existing Federal interagency telemedicine and 
                health information technology initiatives.
          (2) Report.--Not later than 12 months after the date 
        of enactment of the Pandemic and All-Hazards 
        Preparedness Act, the Secretary shall prepare and 
        submit a report to the Committee on Health, Education, 
        Labor, and Pensions of the Senate and the Committee on 
        Energy and Commerce of the House of Representatives 
        regarding the findings and recommendations pursuant to 
        subparagraphs (A) through (F) of paragraph (1).
  (f) Authorization of Appropriations.--There are authorized to 
be appropriated to carry out this section, $138,300,000 for 
each of fiscal years 2014 through 2018 (except such dollar 
amount shall be reduced by $5,000,000 for fiscal year 2017).
  (g) Definition.--For purposes of this section the term 
``biosurveillance'' means the process of gathering near real-
time biological data that relates to human and zoonotic disease 
activity and threats to human or animal health, in order to 
achieve early warning and identification of such health 
threats, early detection and prompt ongoing tracking of health 
events, and overall situational awareness of disease activity.

           *       *       *       *       *       *       *


            [Part E--Narcotic Addicts and Other Drug Abusers


                          [care and treatment

  [Sec. 341. (a) The Surgeon General is authorized to provide 
for the confinement, care, protection, treatment, and 
discipline of persons addicted to the use of habit-forming 
narcotic drugs who are civilly committed to treatment under the 
Narcotic Addict Rehabilitation Act of 1966, addicts and other 
persons with drug abuse and drug dependence problems who 
voluntarily submit themselves for treatment, and addicts 
convicted of offenses against the United States, including 
persons convicted by general courts-martial and consular 
courts. Such care and treatment shall be provided at hospitals 
of the Service especially equipped for the accommodation of 
such patients or elsewhere where authorized under other 
provisions of law, and shall be designed to rehabilitate such 
persons, to restore them to health, and, where necessary, to 
train them to be self-supporting and self-reliant; but nothing 
in this section or in this part shall be construed to limit the 
authority of the Surgeon General under other provisions of law 
to provide for the conditional release of patients and for 
aftercare under supervision. In carrying out this subsection, 
the Secretary shall establish in each hospital and other 
appropriate medical facility of the Service a treatment and 
rehabilitation program for drug addicts and other persons with 
drug abuse and drug dependence problems who are in the area 
served by such hospital or other facility; except that the 
requirement of this sentence shall not apply in the case of any 
such hospital or other facility with respect to which the 
Secretary determines that there is not sufficient need for such 
a program in such hospital or other facility.
  [(b) Upon the admittance to, and departure from, a hospital 
of the Service of a person who voluntarily submitted himself 
for treatment pursuant to the provisions of this section, and 
who at the time of his admittance to such hospital was a 
resident of the District of Columbia, the Surgeon General shall 
furnish to the Commissioners of the District of Columbia or 
their designated agent, the name, address, and such other 
pertinent information as may be useful in the rehabilitation to 
society of such person.
  [(c) The Secretary may enter into agreements with the 
Secretary of Veterans Affairs, the Secretary of Defense, and 
the head of any other department or agency of the Government 
under which agreements hospitals and other appropriate medical 
facilities of the Service may be used in treatment and 
rehabilitation programs provided by such department or agency 
for drug addicts and other persons with drug abuse and other 
drug dependence problems who are in areas served by such 
hospitals or other facilities.

   [employment of addicts or other persons with drug abuse and drug 
                          dependence problems

  [Sec. 342. Narcotic addicts or other persons with drug abuse 
and drug dependence problems in hospitals of the Service 
designated for their care shall be employed in such manner and 
under such conditions as the Surgeon General may direct. In 
such hospitals the Surgeon General may, in his discretion, 
establish industries, plants, factories, or shops for the 
production and manufacture of articles, commodities, and 
supplies for the United States Government. The Secretary of the 
Treasury may require any Government department, establishment, 
or other institution, for whom appropriations are made directly 
or indirectly by the Congress of the United States, to purchase 
at current market prices, as determined by him or his 
authorized representative, such of the articles, commodities, 
or supplies so produced or manufactured as meet their 
specifications; and the Surgeon General shall provide for 
payment to the inmates or their dependents of such pecuniary 
earnings as he may deem proper. The Secretary shall establish a 
working-capital fund for such industries, plants, factories, 
and shops out of any funds appropriated for Public Health 
Service hospitals at which addicts or other persons with drug 
abuse and drug dependence problems are treated and cared for; 
and such fund shall be available for the purchase, repair, or 
replacement of machinery or equipment, for the purchase of raw 
materials and supplies, for the purchase of uniforms and other 
distinctive wearing apparel of employees in the performance of 
their official duties, and for the employment of necessary 
civilian officers and employees. The Surgeon General may 
provide for the disposal of products of the industrial 
activities conducted pursuant to this section, and the proceeds 
of any sales thereof shall be covered into the Treasury of the 
United States to the credit of the working-capital fund.

                               [convicts

  [Sec. 343. (a) The authority vested with the power to 
designate the place of confinement of a prisoner shall transfer 
to hospitals of the Service especially equipped for the 
accommodation of addicts or other persons with drug abuse and 
drug dependence problems, if accommodations are available, all 
addicts or other persons with drug abuse and drug dependence 
problems who have been or are hereafter sentenced to 
confinement, or who are now or shall hereafter be confined, in 
any penal, correctional, disciplinary, or reformatory 
institution of the United States, including those addicts or 
other persons with drug abuse and drug dependence problems 
convicted of offenses against the United States who are 
confined in State and Territorial prisons, penitentiaries, and 
reformatories, except that no addict or other person with a 
drug abuse or other drug dependence problem shall be 
transferred to a hospital of the Service who, in the opinion of 
the officer authorized to direct the transfer, is not a proper 
subject for confinement in such an institution either because 
of the nature of the crime he has committed or because of his 
apparent incorrigibility. The authority vested with the power 
to designate the place of confinement of a prisoner shall 
transfer from a hospital of the Service to the institution from 
which he was received, or to such other institution as may be 
designated by the proper authority, any addict or other person 
with a drug abuse or other drug dependence problem whose 
presence at a hospital of the Service is detrimental to the 
well-being of the hospital or who does not continue to be a 
narcotic addict or other person with a drug abuse or other drug 
dependence problem. All transfers of such prisoners to or from 
a hospital of the Service shall be accompanied by necessary 
attendants as directed by the officer in charge of such 
hospital and the actual and necessary expenses incident to such 
transfers shall be paid from the appropriation for the 
maintenance of such Service hospital except to the extent that 
other Federal agencies are authorized or required by law to pay 
expenses incident to such transfers. When sentence is 
pronounced against any person whom the prosecuting officer 
believes to be an addict or other person with a drug abuse or 
other drug dependence problem such officer shall report to the 
authority vested with the power to designate the place of 
confinement, the name of such person, the reasons for his 
belief, all pertinent facts bearing on such addiction, drug 
abuse, or drug dependence and the nature of the offense 
committed. Whenever an alien addict or other person with a drug 
abuse or other drug dependence problem transferred to a Service 
hospital pursuant to this subsection is entitled to his 
discharge but is subject to deportation, in lieu of being 
returned to the penal institution from which he came he shall 
be deported by the authority vested by law with power over 
deportation.
  [(c) Not later than one month prior to the expiration of the 
sentence of any addict or other person with a drug abuse or 
other drug dependence problem confined in a Service hospital, 
he shall be examined by the Surgeon General or his authorized 
representative. If the Surgeon General believes the person to 
be discharged is still an addict or other person with a drug 
abuse or other drug dependence problem and that he may by 
further treatment in a Service hospital be cured of his 
addiction, drug abuse, or drug dependence the addict or other 
person with a drug abuse or other drug dependence problem shall 
be informed, in accordance with regulations, of the 
advisability of his submitting himself to further treatment. 
The addict or other person with a drug abuse or other drug 
dependence problem may then apply in writing to the Surgeon 
General for further treatment in a Service hospital for a 
period not exceeding the maximum length of time considered 
necessary by the Surgeon General. Upon approval of the 
application by the Surgeon General or his authorized agent, the 
addict or other person with a drug abuse or other drug 
dependence problem may be given such further treatment as is 
necessary to cure him of his addiction, drug abuse, or drug 
dependence.
  [(d) Every person convicted of an offense against the United 
States, upon discharge, or upon release on parole or supervised 
release from a hospital of the Service, shall be furnished with 
the gratuities and transportation authorized by law to be 
furnished to prisoners upon release from a penal, correctional, 
disciplinary, or reformatory institution.
  [(e) Any court of the United States having the power to 
suspend the imposition or execution of sentence and to place a 
defendant on probation under any existing laws may impose as 
one of the conditions of such probation that the defendant, if 
an addict, or other person with a drug abuse or other drug 
dependence problem shall submit himself for treatment at a 
hospital of the Service especially equipped for the 
accommodation of addicts or other persons with drug abuse and 
drug dependence problems until discharged therefrom as cured 
and that he shall be admitted thereto for such purpose. Upon 
the discharge of any such probationer from a hospital of the 
Service, he shall be furnished with the gratuities and 
transportation authorized by law to be furnished to prisoners 
upon release from a penal, correctional, disciplinary, or 
reformatory institution. The actual and necessary expense 
incident to transporting such probationer to such hospital and 
to furnishing such transportation and gratuities shall be paid 
from the appropriation for the maintenance of such hospital 
except to the extent that other Federal agencies are authorized 
or required by law to pay the cost of such transportation: 
Provided, That where existing law vests a discretion in any 
officer as to the place to which transportation shall be 
furnished or as to the amount of clothing and gratuities to be 
furnished, such discretion shall be exercised by the Surgeon 
General with respect to addicts or other persons with drug 
abuse and drug dependence problems discharged from hospitals of 
the Service.

                          [voluntary patients

  [Sec. 344. (a) Any addict, or other person with a drug abuse 
or other drug dependence problem whether or not he shall have 
been convicted of an offense against the United States, may 
apply to the Surgeon General for admission to a hospital of the 
Service especially equipped for the accommodation of addicts or 
other persons with drug abuse and drug dependence problems.
  [(b) Any applicant shall be examined by the Surgeon General 
who shall determine whether the applicant is an addict, or 
other person with a drug abuse or other drug dependence problem 
whether by treatment in a hospital of the Service he may 
probably be cured of his addiction, drug abuse, or drug 
dependence and the estimated length of time necessary to effect 
his cure. The Surgeon General may, in his discretion, admit the 
applicant to a Service hospital. No such addict or other person 
with drug abuse or other drug dependence problem shall be 
admitted unless he agrees to submit to treatment for the 
maximum amount of time estimated by the Surgeon General to be 
necessary to effect a cure, and unless suitable accommodations 
are available after all eligible addicts or other persons with 
drug abuse and drug dependence problems convicted of offenses 
against the United States have been admitted. Any such addict 
or other person with a drug abuse or other drug dependence 
problem may be required to pay for his subsistence, care, and 
treatment at rates fixed by the Surgeon General and amounts so 
paid shall be covered into the Treasury of the United States to 
the credit of the appropriation from which the expenditure for 
his subsistence, care, and treatment was made. Appropriations 
available for the care and treatment of addicts or other 
persons with drug abuse and drug dependence problems admitted 
to a hospital of the Service under this section shall be 
available, subject to regulations, for paying the cost of 
transportation to any place within the continental United 
States, including subsistence allowance while traveling, for 
any indigent addict or other person with a drug abuse or other 
drug dependence problem who is discharged as cured.
  [(c) Any addict or other person with a drug abuse or other 
drug dependence problem admitted for treatment under this 
section, including any addict, or other person with a drug 
abuse or other drug dependence problem not convicted of an 
offense, who voluntarily submits himself for treatment, may be 
confined in a hospital of the Service for a period not 
exceeding the maximum amount of time estimated by the Surgeon 
General as necessary to effect a cure of the addiction, drug 
abuse, or drug dependence or until such time as he ceases to be 
an addict or other person with a drug abuse or other drug 
dependence problem.
  [(d) Any addict or other person with a drug abuse or other 
drug dependence problem admitted for treatment under this 
section shall not thereby forfeit or abridge any of his rights 
as a citizen of the United States; nor shall such admission or 
treatment be used against him in any proceeding in any court; 
and the record of his voluntary commitment shall, except as 
otherwise provided by this Act, be confidential and shall not 
be divulged.

              [persons committed from district of columbia

  [Sec. 345. (a) The Surgeon General is authorized to admit for 
care and treatment in any hospital of the Service suitably 
equipped therefor, and thereafter to transfer between hospitals 
of the Service in accordance with section 321(b), any addict 
who is committed, under the provisions of the Act of June 24, 
1953 (Public Law 76, Eighty-third Congress), to the Service or 
to a hospital thereof for care and treatment and who the 
Surgeon General determines is a proper subject for care and 
treatment. No such addict shall be admitted unless (1) 
committed prior to July 1, 1958; and (2) at the time of 
commitment, the number of persons in hospitals of the Service 
who have been admitted pursuant to this subsection is less than 
100; and (3) suitable accommodations are available after all 
eligible addicts convicted of offenses against the United 
States have been admitted.
  [(b) Any person admitted to a hospital of the Service 
pursuant to subsection (a) shall be discharged therefrom (1) 
upon order of the Superior Court of the District of Columbia, 
or (2) when he is found by the Surgeon General to be cured and 
rehabilitated. When any such person is so discharged, the 
Surgeon General shall give notice thereof to the Superior Court 
of the District of Columbia and shall deliver such person to 
such court for such further action as such court may deem 
necessary and proper under the provisions of the Act of June 
24, 1953 (Public Law 76, Eighty-third Congress).
  [(c) With respect to the detention, transfer, parole, or 
discharge of any person committed to a hospital of the Service 
in accordance with subsection (a), the Surgeon General and the 
officer in charge of the hospital, in addition to authority 
otherwise vested in them, shall have such authority as may be 
conferred upon them, respectively, by the order of the 
committing court.
  [(d) The cost of providing care and treatment for persons 
admitted to a hospital of the Service pursuant to subsection 
(a) shall be a charge upon the District of Columbia and shall 
be paid by the District of Columbia to the Public Health 
Service, either in advance or otherwise, as may be determined 
by the Surgeon General. Such cost may be determined for each 
addict or on the basis of rates established for all or 
particular classes of patients, and shall include the cost of 
transportation to and from facilities of the Public Health 
Service. Moneys so paid to the Public Health Service shall be 
covered into the Treasury of the United States as miscellaneous 
receipts. Appropriations available for the care and treatment 
of addicts admitted to a hospital of the Service under this 
section shall be available, subject to regulations, for paying 
the cost of transportation to the District of Columbia, 
including subsistence allowance while traveling, for any such 
addict who is discharged.

                               [penalties

  [Sec. 346. (a) Any person not authorized by law or by the 
Surgeon General who introduces or attempts to introduce into or 
upon the grounds of any hospital of the Service at which 
addicts or other persons with drug abuse and drug dependence 
problems are treated and cared for, any habit-forming narcotic 
drug, or substance controlled under the Controlled Substances 
Act, weapon, or any other contraband article or thing, or any 
contraband letter or message intended to be received by an 
inmate thereof, shall be guilty of a felony and, upon 
conviction thereof, shall be punished by imprisonment for not 
more than ten years.
  [(b) It shall be unlawful for any person properly committed 
thereto to escape or attempt to escape from a hospital of the 
Service at which addicts or other persons with drug abuse and 
drug dependence problems are treated and cared for, and any 
such person upon apprehension and conviction in a United States 
court shall be punished by imprisonment for not more than five 
years, such sentence to begin upon the expiration of the 
sentence for which such person was originally confined.
  [(c) Any person who procures the escape of any person 
admitted to a hospital of the Service at which addicts or other 
persons with drug abuse and drug dependence problems are 
treated and cared for, or who advises, connives at, aids, or 
assists in such escape, or who conceals any such inmate after 
such escape, shall be punished upon conviction in a United 
States court by imprisonment in the penitentiary for not more 
than three years.

                          [release of patients

  [Sec. 347. For purposes of this Act, an individual shall be 
deemed cured of his addiction, drug abuse, or drug dependence, 
and rehabilitated if the Surgeon General determines that he has 
received the maximum benefits of treatment and care by the 
Service for his addiction, drug abuse, or drug dependence, or 
if the Surgeon General determines that his further treatment 
and care for such purpose would be detrimental to the interests 
of the Service.]

                      PART E--OPIOID USE DISORDER

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

  (a) Grants to States.--The Secretary may make grants to 
States for--
          (1) developing standing orders for pharmacies 
        regarding opioid overdose reversal medication;
          (2) encouraging pharmacies to dispense opioid 
        overdose reversal medication pursuant to a standing 
        order;
          (3) implementing best practices for persons 
        authorized to prescribe medication regarding--
                  (A) prescribing opioids for the treatment of 
                chronic pain;
                  (B) co-prescribing opioid overdose reversal 
                medication with opioids; and
                  (C) discussing the purpose and administration 
                of opioid overdose reversal medication with 
                patients;
          (4) developing or adapting training materials and 
        methods for persons authorized to prescribe or dispense 
        medication to use in educating the public regarding--
                  (A) when and how to administer opioid 
                overdose reversal medication; and
                  (B) steps to be taken after administering 
                opioid overdose reversal medication; and
          (5) educating the public regarding--
                  (A) the public health benefits of opioid 
                overdose reversal medication; and
                  (B) the availability of opioid overdose 
                reversal medication without a person-specific 
                prescription.
  (b) Certain Requirement.--A grant may be made under this 
section only if the State involved has authorized standing 
orders regarding opioid overdose reversal medication.
  (c) Preference in Making Grants.--In making grants under this 
section, the Secretary shall give preference to States that--
          (1) have not issued standing orders regarding opioid 
        overdose reversal medication;
          (2) authorize standing orders that permit community-
        based organizations, substance abuse programs, or other 
        nonprofit entities to acquire, dispense, or administer 
        opioid overdose reversal medication;
          (3) authorize standing orders that permit police, 
        fire, or emergency medical services agencies to acquire 
        and administer opioid overdose reversal medication;
          (4) have a higher per capita rate of opioid overdoses 
        than other applicant States; or
          (5) meet any other criteria deemed appropriate by the 
        Secretary.
  (d) Grant Terms.--
          (1) Number.--A State may not receive more than 1 
        grant under this section.
          (2) Period.--A grant under this section shall be for 
        a period of 3 years.
          (3) Amount.--A grant under this section may not 
        exceed $500,000.
          (4) Limitation.--A State may use not more than 20 
        percent of a grant under this section for educating the 
        public pursuant to subsection (a)(5).
  (e) Applications.--To be eligible to receive a grant under 
this section, a State shall submit an application to the 
Secretary in such form and manner and containing such 
information as the Secretary may require, including detailed 
proposed expenditures of grant funds.
  (f) Reporting.--Not later than 3 months after the Secretary 
disburses the first grant payment to any State under this 
section and every 6 months thereafter for 3 years, such State 
shall submit a report to the Secretary that includes the 
following:
          (1) The name and ZIP Code of each pharmacy in the 
        State that dispenses opioid overdose reversal 
        medication under a standing order.
          (2) The total number of opioid overdose reversal 
        medication doses dispensed by each such pharmacy, 
        specifying how many were dispensed with or without a 
        person-specific prescription.
          (3) The number of pharmacists in the State who have 
        participated in training pursuant to subsection (a)(4).
  (g) Definitions.--In this section:
          (1) Opioid overdose reversal medication.--The term 
        ``opioid overdose reversal medication'' means any drug, 
        including naloxone, that--
                  (A) blocks opioids from attaching to, but 
                does not itself activate, opioid receptors; or
                  (B) inhibits the effects of opioids on opioid 
                receptors.
          (2) Standing order.--The term ``standing order'' 
        means a document prepared by a person authorized to 
        prescribe medication that permits another person to 
        acquire, dispense, or administer medication without a 
        person-specific prescription.
  (h) Authorization of Appropriations.--
          (1) In general.--To carry out this section, there is 
        authorized to be appropriated $5,000,000 for the period 
        of fiscal years 2017 through 2019.
          (2) Administrative costs.--Not more than 3 percent of 
        the amounts made available to carry out this section 
        may be used by the Secretary for administrative 
        expenses of carrying out this section.

           *       *       *       *       *       *       *


                                  [all]