[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2805 Introduced in House (IH)]
114th CONGRESS
1st Session
H. R. 2805
To address prescription opioid abuse and heroin use.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 17, 2015
Mrs. Brooks of Indiana (for herself, Mr. Kennedy, Mr. Carson of
Indiana, Mrs. Walorski, Mr. Whitfield, and Mr. Messer) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on the Judiciary, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To address prescription opioid abuse and heroin use.
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 the ``Heroin and Prescription Opioid Abuse
Prevention, Education, and Enforcement Act of 2015''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The Controlled Substances Act (21 U.S.C. 801 et seq.)
declares that many controlled substances have a useful and
legitimate medical purpose and are necessary to maintain the
health and general welfare of the people of the United States.
(2) Health care professionals, medical experts,
researchers, and scientists have found pain to be a major
national health problem.
(3) The responsible treatment of pain is a high priority
for our Nation and the needs of individuals with pain must be
taken into careful consideration when taking steps to prevent
prescription drug misuse and abuse.
(4) When no longer needed or wanted for legitimate pain
management or health treatment, prescription opioids are
susceptible to diversion. Prescription opioids also may be
abused by individuals who were not prescribed such drugs, or
misused by individuals not taking such drugs as directed.
(5) Approximately 4 out of 5 new heroin users report that
they became addicted to prescription opioids before they used
heroin for the first time.
(6) According to the National Institute on Drug Abuse,
heroin attaches to the same brain cell receptors as
prescription opioids.
(7) The low cost and high purity of currently available
heroin has contributed to an increase in heroin use across the
United States.
(8) More people are using heroin, and are using heroin at a
younger age. The National Survey on Drug Use and Health reports
that new heroin users numbered 142,000 in 2010, and increased
to 178,000 in 2011. In 2011, the average age at first use among
heroin abusers between 12 and 49 years was 22.1 years. In 2009,
the average age at first use among heroin abusers between 12
and 49 years was 25.5 years.
(9) According to the Department of Health and Human
Services, heroin use nationwide rose 79 percent between 2007
and 2012.
(10) Deaths from heroin overdose have significantly
increased in communities across the United States. According to
the Centers for Disease Control and Prevention, the number of
deaths involving heroin almost tripled between 2010 and 2013.
From 2010 to 2013, the number of heroin deaths rose from 3,036
to 8,257.
(11) The Edward Byrne Memorial Justice Assistance Grant
Program under part E of title I of the Omnibus Crime Control
and Safe Streets Act of 1968 (42 U.S.C. 3750 et seq.) is
critical to fighting the prescription opioid abuse and heroin
use epidemics, and should be reauthorized and fully funded.
SEC. 3. DEVELOPMENT OF BEST PRESCRIBING PRACTICES.
(a) Inter-Agency Task Force.--Not later than 120 days after the
date of enactment of this Act, the Secretary of Health and Human
Services (referred to in this section as 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
(referred to in this section as the ``task force'').
(b) Membership.--The task force shall be comprised of--
(1) representatives of--
(A) the Department of Health and Human Services,
including the Centers for Disease Control and
Prevention;
(B) the Department of Veterans Affairs;
(C) the Department of Defense;
(D) the Drug Enforcement Administration;
(E) the Office of National Drug Control Policy; and
(F) the Institute of Medicine; and
(2) the Director of the National Institutes of Health;
(3) physicians, dentists, and non-physician prescribers;
(4) pharmacists;
(5) experts in the fields of pain research and addiction
research;
(6) representatives of--
(A) pain management professional organizations;
(B) the mental health treatment community;
(C) the addiction treatment community; and
(D) pain advocacy groups;
(7) a person in recovery from addiction to medication for
chronic pain;
(8) a person with chronic pain; and
(9) other stakeholders, as the Secretary determines
appropriate.
(c) Duties.--The task force shall--
(1) not later than 180 days after the date on which the
task force is convened, develop best practices for pain
management and prescription pain medication prescribing
practices, taking into consideration--
(A) existing pain management research;
(B) recommendations from relevant conferences; and
(C) ongoing efforts at the State and local levels
and by medical professional organizations to develop
improved pain management strategies;
(2) solicit and take into consideration public comment on
the best practices developed under paragraph (1), amending such
best practices if appropriate; and
(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.
(d) Limitation.--The task force shall not have rulemaking
authority.
(e) Report.--Not later than 270 days after the date on which the
task force is convened under subsection (a), the task force shall
submit to Congress a report that includes--
(1) the strategy for disseminating best practices developed
under subsection (c);
(2) the results of a feasibility study on linking best
practices developed under paragraphs (1) and (2) of subsection
(c) to receiving and renewing registrations under section
303(f) of the Controlled Substances Act (21 U.S.C. 823(f)); and
(3) recommendations on how to apply such best practices to
improve prescribing practices at medical facilities, including
medical facilities of the Veterans Health Administration.
SEC. 4. 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).'';
(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 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 (m) through (o), as
redesignated by paragraph (7), as subsections (l) 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)--
(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.''.
SEC. 5. REAUTHORIZATION OF BYRNE JUSTICE ASSISTANCE GRANT PROGRAM.
Section 508 of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3758) is amended by striking ``2006
through 2012'' and inserting ``2016 through 2020''.
SEC. 6. AWARENESS CAMPAIGNS.
(a) In General.--The Secretary of Health and Human Services shall
advance the education and awareness of the public, providers, patients,
and other appropriate stakeholders regarding the risk of abuse of
prescription opioid drugs if such products are not taken as prescribed.
(b) Drug-Free Media Campaign.--
(1) In general.--The Office of National Drug Control
Policy, in coordination with the Secretary of Health and Human
Services and the Attorney General, shall establish a national
drug awareness campaign.
(2) Requirements.--The national drug awareness campaign
under paragraph (1) shall--
(A) take into account the association between
prescription opioid abuse and heroin use;
(B) emphasize the similarities between heroin and
prescription opioids and the effects of heroin and
prescription opioids on the human body; and
(C) bring greater public awareness to the dangerous
effects of fentanyl when mixed with heroin or abused in
a similar manner.
(3) Available funds.--Funds for the national drug awareness
campaign may be derived from amounts appropriated to the Office
of National Drug Control Policy and otherwise available for
obligation and expenditure.
SEC. 7. NALOXONE DEMONSTRATION GRANTS.
(a) Definitions.--In this section--
(1) the term ``eligible entity'' means a State, a unit of
local government, or a tribal government;
(2) the term ``first responder'' includes firefighters, law
enforcement officers, paramedics, emergency medical
technicians, and other individuals (including employees of
legally organized and recognized volunteer organizations,
whether compensated or not), who, in the course of professional
duties, respond to fire, medical, hazardous material, or other
similar emergencies; and
(3) the term ``opioid overdose reversal drug'' means a drug
that, when administered, reverses in whole or part the
pharmacological effects of an opioid overdose in the human
body.
(b) Program Authorized.--The Attorney General, in coordination with
the Secretary of Health and Human Services and the Director of the
Office of National Drug Control Policy, may make grants to eligible
entities to create not more than 8 demonstration programs to allow
properly trained first responders to prevent prescription opioid and
heroin overdose death by administering an opioid overdose reversal drug
to an individual who has experienced overdose or who has been
determined to have likely experienced overdose.
(c) Application.--
(1) In general.--To be eligible to receive a grant under
this section, an entity shall submit an application to the
Attorney General, at such time, in such manner, and accompanied
by such information as the Attorney General shall require,
and--
(A) that meets the criteria for selection under
paragraph (2); and
(B) that describes--
(i) the evidence-based methodology and
outcome measures that will be used to evaluate
the program funded with a grant under this
section, and specifically explain how such
measurements will provide valid measures of the
impact of the program;
(ii) how the program could be broadly
replicated if demonstrated to be effective;
(iii) how the eligible entity will
coordinate with their corresponding State
substance abuse agency to identify protocols
and resources that are available to victims and
families, including information on treatment
and recovery resources; and
(iv) how the demonstration program will
continue with State, local, or private funding
after the expiration of the grant.
(2) Criteria for selection.--The Attorney General may award
grants to eligible entities that demonstrate an institutional
need for technical support and lack existing infrastructure in
order to implement and train first responders to carry out a
demonstration program under paragraph (b).
(3) Priority consideration.--In awarding grants under this
section, the Attorney General shall give priority to an
eligible entity located in a State that provides civil
liability protection for first responders administering an
opioid overdose reversal drug to counteract opioid overdoses
by--
(A) enacting legislation that provides such civil
liability protection; and
(B) providing a certification by the attorney
general of the State that the attorney general has--
(i) reviewed any applicable civil liability
protection law to determine the applicability
of the law with respect to first responders who
may administer an opioid overdose reversal drug
to individuals reasonably believed to be
suffering from opioid overdose; and
(ii) concluded that the law described in
subparagraph (A) provides adequate civil
liability protection applicable to such
persons.
(d) Use of Funds.--An eligible entity shall use a grant received
under this section to--
(1) make an opioid overdose reversal drug, which may
include naloxone, available to be carried and administered by
first responders;
(2) train and provide resources for first responders, on
carrying and administrating such opioid overdose reversal drug
for the prevention of prescription opioid and heroin overdose
deaths; and
(3) establish processes, protocols, and mechanisms for
referral to treatment.
(e) Technical Support.--The Attorney General shall provide
individualized technical support, as requested, to grant recipients
under this section to assist with implementation of the demonstration
program.
(f) Grant Duration.--A demonstration project grant shall be for a
period of 3 years.
(g) Evaluation.--Following the first grant year, a recipient of a
grant awarded under this section shall report to the Attorney General
on an annual basis --
(1) the number of first responders equipped with an opioid
overdose reversal drug for the prevention of fatal prescription
opioid and heroin overdose;
(2) the number of prescription opioid and heroin overdoses
reversed by first responders;
(3) the number of calls for service related to prescription
opioid and heroin overdose; and
(4) the extent to which overdose victims and families
receive information about treatment services and available data
describing treatment admissions.
(h) Report to Congress.--The Attorney General shall submit an
annual report to the appropriate committees of Congress aggregating the
data received from the grant recipients and evaluating the outcomes
achieved by the demonstration projects funded under this section.
SEC. 8. OFFSET.
It is the sense of Congress that the amounts expended to carry out
this Act and the amendments made by this Act should be offset by a
corresponding reduction in Federal non-defense discretionary spending.
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