[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4429 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 4429

To require the Secretary of Health and Human Services to provide grants 
         to demonstrate pharmacy-based addiction care programs.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 23, 2024

  Mr. Booker (for himself, Mr. Braun, and Mr. Markey) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To require the Secretary of Health and Human Services to provide grants 
         to demonstrate pharmacy-based addiction care programs.

    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 ``Substance Use Prevention and 
Pharmacy Oriented Recovery Treatment Prescription Act'' or the 
``SUPPORT Rx Act''.

SEC. 2. PHARMACY-BASED ADDICTION CARE DEMONSTRATION PROGRAM.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall carry out a 3-
year demonstration program under which the Secretary shall award grants 
to eligible entities to establish, maintain, or improve a pharmacy-
based addiction care program.
    (b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall be--
            (1) a State, Tribal, or local health department;
            (2) a partnership between such a health department and 1 or 
        more other public entities or private entities located in a 
        State, the laws of which allow pharmacists to prescribe, or 
        enter into collaborative practice agreements with physicians 
        authorized to prescribe, a controlled substance that is listed 
        on schedule III of section 202(c) of the Controlled Substances 
        Act (21 U.S.C. 812(c)); or
            (3) a specialty addiction treatment practitioner in a 
        primary care setting or a specialty substance use disorder 
        treatment facility.
    (c) Applications.--An eligible entity desiring a grant under 
subsection (a) shall submit to the Secretary an application at such 
time, in such manner, and containing such information as the Secretary 
may require, including--
            (1) a plan to establish a collaborative practice 
        agreement--
                    (A) through which board certified addiction 
                medicine physicians or addiction psychiatrists shall 
                collaborate with pharmacists permitted to enter into 
                such agreements under applicable State law in order to 
                enable such pharmacists to provide drug therapy 
                management; and
                    (B) under which the prescriptive authority of a 
                pharmacist shall not exceed the authority that is 
                specified in the collaborative practice agreement;
            (2) a description of activities proposed to be carried out 
        pursuant to the grant; and
            (3) a plan to sustain activities described in such 
        application following the conclusion of the grant period.
    (d) Use of Funds.--
            (1) In general.--An eligible entity receiving a grant under 
        subsection (a) shall use the grant funds to establish, 
        maintain, or improve a comprehensive, pharmacy-based addiction 
        care program to support withdrawal, induction, ongoing care, 
        and rescue for individuals with opioid or other substance use 
        disorders, provided by and at community pharmacies, including 
        by--
                    (A) offering buprenorphine for opioid and other 
                substance use disorders, and managing withdrawal from 
                opioids and other substances when appropriate, 
                induction, and maintenance care;
                    (B) rendering same-day care services of low-barrier 
                treatment, with no or reduced requirements, including 
                no or reduced requirements for payment, insurance, age 
                limits (to the extent authorized under State or Federal 
                law), and identification; and
                    (C) training pharmacists on treating and managing 
                patients with opioid and other substance use disorders, 
                which training, at a minimum, shall be in accordance 
                with paragraph (1)(B) of the second subsection (l) of 
                section 303 of the Controlled Substances Act (21 U.S.C. 
                823) (as added by section 1263(a) of the Consolidated 
                Appropriations Act, 2023 (Public Law 117-328; 136 Stat. 
                5683)).
            (2) Additional uses.--In addition to uses described in 
        paragraph (1), an eligible entity receiving a grant under 
        subsection (a) shall use the grant funds--
                    (A) to provide compensation to staff for pharmacy 
                program and other program operations for which the 
                staff would not otherwise receive compensation;
                    (B) to provide payment for an individual to obtain 
                not more than a 30-day supply of buprenorphine 
                prescribed at any one time under the pharmacy-based 
                addiction care program supported by the grant;
                    (C) to provide care continuity fee payments to 
                providers or clinics the patients of which transfer 
                their maintenance care to the pharmacy-based addiction 
                care program supported by the grant to support good 
                recordkeeping, safe transfer, and transition in care;
                    (D) to provide telebehavioral health services;
                    (E) to provide construction to permit private or 
                semi-private spaces for counseling and administration 
                of medication;
                    (F) to provide secure technology that is in 
                compliance with HIPAA privacy regulations, as defined 
                in section 1180(b)(3) of the Social Security Act (42 
                U.S.C. 1320d-9(b)(3));
                    (G) to establish a collaborative practice agreement 
                described in subsection (c)(1);
                    (H) to pay for the costs of training staff in 
                administration of opioid reversal medications approved 
                by the Food and Drug Administration;
                    (I) to pay for other necessary staff training, 
                including the training described in paragraph (1)(C); 
                and
                    (J) to pay for registration fees in each applicable 
                State in accordance with section 302(e) of the 
                Controlled Substances Act (21 U.S.C. 822(e)).
            (3) Limitation.--No funds made available under a grant 
        under subsection (a) may be used to prescribe or dispense any 
        drug other than buprenorphine or an opioid overdose reversal 
        drug.
    (e) Pharmacy-Based Addiction Care Guidance.--Not later than 180 
days after the date of enactment of this Act, the Secretary shall issue 
guidance to provide eligible entities and pharmacists with technical 
assistance, recommendations, and best practices regarding treatment to 
support management of withdrawal from opioids and other substances when 
appropriate, induction, ongoing care, and rescue.
    (f) Report to the Secretary.--Each recipient of a grant under 
subsection (a) shall submit to the Secretary an annual evaluation of 
the progress of the pharmacy-based addiction care program supported by 
the grant, including information on--
            (1) the number of patients receiving treatment;
            (2) any changes in local rates of overdose over the course 
        of the grant; and
            (3) any other readily available information the Secretary 
        determines necessary, including--
                    (A) cost data;
                    (B) patient-reported outcomes;
                    (C) overdose data;
                    (D) hospitalization data;
                    (E) quality and safety measures;
                    (F) program retention data;
                    (G) data on the opioid prescriptions fill rates;
                    (H) the demographic characteristics of patients who 
                were treated by the program; and
                    (I) any other information the Secretary determines 
                necessary.
    (g) Report to Congress.--Not later than 120 days after completion 
of the demonstration program under this section, the Secretary shall 
submit to Congress a report that describes the results of the 
demonstration program, including--
            (1) the number of applications received for grants under 
        the demonstration program, and the number of grants awarded;
            (2) a summary of the evaluations submitted under subsection 
        (f), including standardized data; and
            (3) recommendations for broader implementation of pharmacy-
        based addiction models of care.
    (h) Funding.--The Secretary shall carry out the demonstration 
program under this section using amounts available to the Secretary, 
and not otherwise obligated, for the Harm Reduction Grant Program of 
the Substance Abuse and Mental Health Services Administration pursuant 
to section 516(a) of the Public Health Service Act (42 U.S.C. 290bb-
22(a)) and section 2706 of the American Rescue Plan Act of 2021 (42 
U.S.C. 290dd-3 note; Public Law 117-2).
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