June 12, 2018 - Issue: Vol. 164, No. 97 — Daily Edition115th Congress (2017 - 2018) - 2nd Session
PREVENTING OVERDOSES WHILE IN EMERGENCY ROOMS ACT OF 2018; Congressional Record Vol. 164, No. 97
(House of Representatives - June 12, 2018)
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[Pages H5047-H5049] From the Congressional Record Online through the Government Publishing Office [www.gpo.gov] PREVENTING OVERDOSES WHILE IN EMERGENCY ROOMS ACT OF 2018 Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5176) to require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non- fatal overdose after emergency room discharge, and for other purposes, as amended. The Clerk read the title of the bill. The text of the bill is as follows: H.R. 5176 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 ``Preventing Overdoses While in Emergency Rooms Act of 2018''. SEC. 2. PROGRAM TO SUPPORT EMERGENCY ROOM DISCHARGE AND CARE COORDINATION FOR DRUG OVERDOSE PATIENTS. (a) In General.--The Secretary of Health and Human Services shall establish a program (in this Act referred to as the ``Program'') to develop protocols for discharging patients who have presented with a drug overdose and enhance the integration and coordination of care and treatment options for individuals with substance use disorder after discharge. (b) Grant Establishment and Participation.-- (1) In general.--In carrying out the Program, the Secretary shall award grants on a competitive basis to not more than 20 eligible entities described in paragraph (2). (2) Eligibility.-- (A) In general.--To be eligible for a grant under this subsection, an entity shall be-- (i) a health care site described in subparagraph (B); or (ii) a health care site coordinator described in subparagraph (C). (B) Health care sites.--To be eligible for a grant under this section, a health care site shall-- (i) submit an application to the Secretary at such time, in such manner, and containing such information as specified by the Secretary; (ii) have an emergency department; (iii)(I) have a licensed health care professional onsite who has a waiver under section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) to dispense or prescribe covered drugs; or [[Page H5048]] (II) have a demonstrable plan to hire a sufficient number of full-time licensed health care professionals who have waivers described in subclause (I) to administer such treatment onsite; (iv) have in place an agreement with a sufficient number and range of entities certified under applicable State and Federal law, such as pursuant to registration or a waiver under section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) or certification as described in section 8.2 of title 42 of the Code of Federal Regulations, to provide treatment for substance use disorder such that the entity or the resulting network of entities with an agreement with the hospital cumulatively are capable of providing all evidence- based services for the treatment of substance use disorder, as medically appropriate for the individual involved, including-- (I) medication-assisted treatment; (II) withdrawal and detoxification services that include patient evaluation, stabilization, and readiness for and entry into treatment; and (III) counseling; (v) deploy onsite peer recovery specialists to help connect patients with treatment and recovery support services; and (vi) include the provision of overdose reversal medication in discharge protocols for opioid overdose patients. (C) Health care site coordinators.--To be eligible for a grant under this section, a health care site coordinator shall-- (i) be an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 (and exempt from tax under section 501(a) of such Code) or a State, local, or Tribal government; (ii) submit an application to the Secretary at such time, in such manner, and containing such information as specified by the Secretary; and (iii) have an agreement with multiple eligible health care sites described in subparagraph (B). (3) Preference.--In awarding grants under this section, the Secretary may give preference to eligible entities described in paragraph (2) that meet either or both of the following criteria: (A) The eligible health care site is, or the eligible health care site coordinator has an agreement described in paragraph (2)(C)(iii) with a site that is, a critical access hospital (as defined in section 1861(mm)(1) of the Social Security Act (42 U.S.C. 1395x(mm)(1))), a low-volume hospital (as defined in section 1886(d)(12)(C)(i) of such Act (42 U.S.C. 1395ww(d)(12)(C)(i))), or a sole community hospital (as defined in section 1886(d)(5)(D)(iii) of such Act (42 U.S.C. 1395ww(d)(5)(D)(iii))). (B) The eligible health care site or the eligible health care site coordinator is located in a geographic area with a drug overdose rate that is higher than the national rate, or in a geographic area with a rate of emergency department visits for overdoses that is higher than the national rate, as determined by the Secretary based on the most recent data from the Centers for Disease Control and Prevention. (4) Medication-assisted treatment defined.--For purposes of this section, the term ``medication-assisted treatment'' means the use of a drug approved under section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355) or a biological product licensed under section 351 of the Public Health Service Act (42 U.S.C. 262), in combination with behavioral health services, to provide an individualized approach to the treatment of substance use disorders, including opioid use disorders. (c) Period of Grant.--A grant awarded to an eligible entity under this section shall be for a period of at least 2 years. (d) Grant Uses.-- (1) Required uses.--A grant awarded under this section to an eligible entity shall be used for both of the following purposes: (A) To establish policies and procedures that address the provision of overdose reversal medication, prescription and dispensing of medication-assisted treatment to an emergency department patient who has had a non-fatal overdose or who is at risk of a drug overdose, and the subsequent referral to evidence-based treatment upon discharge for patients who have experienced a non-fatal drug overdose or who are at risk of a drug overdose. (B) To develop best practices for treating non-fatal drug overdoses, including with respect to care coordination and integrated care models for long term treatment and recovery options for individuals who have experienced a non-fatal drug overdose. (2) Additional permissible uses.--A grant awarded under this section to an eligible entity may be used for any of the following purposes: (A) To hire emergency department peer recovery specialists; counselors; therapists; social workers; or other licensed medical professionals specializing in the treatment of substance use disorder. (B) To establish integrated models of care for individuals who have experienced a non-fatal drug overdose which may include patient assessment, follow up, and transportation to treatment facilities. (C) To provide for options for increasing the availability and access of medication-assisted treatment and other evidence-based treatment for individuals with substance use disorders. (D) To offer consultation with and referral to other supportive services that help in treatment and recovery. (e) Reporting Requirements.-- (1) Reports by grantees.--Each eligible entity awarded a grant under this section shall submit to the Secretary an annual report for each year for which the entity has received such grant that includes information on-- (A) the number of individuals treated at the site (or, in the case of an eligible health care site coordinator, at sites covered by the agreement referred to in subsection (b)(2)(C)(iii)) for non-fatal overdoses in the emergency department; (B) the number of individuals administered each medication- assisted treatment at such site or sites in the emergency department; (C) the number of individuals referred by such site or sites to other treatment facilities after a non-fatal overdose, the types of such other facilities, and the number of such individuals admitted to such other facilities pursuant to such referrals; (D) the frequency and number of patient readmissions for non-fatal overdoses and substance use disorder; (E) for what the grant funding was used; and (F) the effectiveness of, and any other relevant additional data regarding, having an onsite health care professional to administer and begin medication-assisted treatment for substance use disorders. (2) Report by secretary.--Not less than one year after the conclusion of the Program, the Secretary shall submit to Congress a report that includes-- (A) findings of the Program; (B) overall patient outcomes under the Program, such as with respect to hospital readmission; (C) what percentage of patients treated by a site funded through a grant under this section were readmitted to a hospital for non-fatal or fatal overdose; (D) an evaluation determining the effectiveness of having a practitioner onsite to administer and begin medication- assisted treatment for substance use disorder; and (E) a compilation of voluntary guidelines and best practices from the reports submitted under paragraph (1). (f) Authorization of Appropriations.--There is authorized to be appropriated to carry out this Act $50,000,000 for the period of fiscal years 2019 through 2023. The SPEAKER pro tempore. Pursuant to the rule, the gentleman from Oregon (Mr. Walden) and the gentleman from New Jersey (Mr. Pallone) each will control 20 minutes. The Chair recognizes the gentleman from Oregon. General Leave Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials into the Record on the bill. The SPEAKER pro tempore. Is there objection to the request of the gentleman from Oregon? There was no objection. Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today to express my strong support for H.R. 5176, the Preventing Overdoses While in Emergency Rooms Act, or the POWER Act. This legislation will provide needed resources to help hospitals, health departments, and health systems to develop discharge protocols for patients who have had an opioid overdose, such as the provision of naloxone upon discharge, and referrals to treatment and other services that best fit the patients' needs. By putting rapid referral systems in place, we can better place those presenting with an overdose in evidence-based treatment and get patients on the road to recovery. I want to thank my colleagues, Representatives David McKinley of West Virginia and Mike Doyle of Pennsylvania, for leading this initiative. I am going to yield to my colleague from West Virginia, but before I do, I just want to say what a leader David McKinley has been on this issue involving opioids. We have met on countless occasions. He has brought many initiatives to our committee. While he is the lead on this bill, he has been instrumental on nearly all the bills that we have considered and has been a tireless advocate for the people of West Virginia in this matter. Mr. Speaker, I yield such time as he may consume to the gentleman from West Virginia (Mr. McKinley). Mr. McKINLEY. Mr. Speaker, I thank the chairman for those kind remarks. This is not just West Virginia, but it is all across this country. I think we are speaking for all and trying to give a voice all across the country. Mr. Speaker, I rise in support of H.R. 5176, the Preventing Overdoses While in the Emergency Room Act. The demand [[Page H5049]] for these substance abuse services in America's emergency rooms far exceeds their availability. Treatment is particularly scarce in rural counties, in spite of having an average overdose rate that is 45 percent higher than more urban areas. In March, the Centers for Disease Control reported that the emergency room visits for opioid overdoses had risen 30 percent since July of 2016, in less than 2 years, a 30 percent increase. That is why I am honored to be joined by Congressman Doyle in introducing this bipartisan act, also known as the POWER Act. This legislation will provide competitive grants to ensure that overdose patients receive the treatment they need while still in the emergency room, giving them a better shot at recovery. This bill, hopefully, is intended to reduce repeat overdoses and thereby save lives. I want to thank the cosponsor of this bill, Mr. Doyle, and particularly our chairman, Mr. Walden, for their work on this important issue. I urge my colleagues to support this legislation. Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. I rise in support of H.R. 5176, Preventing Overdoses While in Emergency Rooms Act. This legislation would provide grant funding for emergency departments to develop protocols for treating and discharging patients who have presented with an opioid overdose or are at increased risk for overdose. These protocols will help increase the uptake of evidence-based treatment services by promoting the initiation of medication-assisted treatment in emergency departments, as well as referral to community- based providers for treatment and recovery support services. This is particularly important since an individual's willingness to seek substance use disorder treatment often increases immediately following a nonfatal overdose. The protocols also will help reduce the risk of future fatal overdoses by such individuals by requiring the provision of naloxone at discharge. This helps ensure that these individuals at high risk of overdose have this lifesaving drug available if it is needed to reverse a potentially fatal overdose. So I urge my colleagues to support this legislation, and I yield back the balance of my time. Mr. WALDEN. Mr. Speaker, I just want to, again, thank our leaders on this effort, Mr. Doyle and certainly Mr. McKinley. I would encourage passage of the bill, and I yield back the balance of my time. The SPEAKER pro tempore (Mr. Francis Rooney of Florida). The question is on the motion offered by the gentleman from Oregon (Mr. Walden) that the House suspend the rules and pass the bill, H.R. 5176, as amended. The question was taken; and (two-thirds being in the affirmative) the rules were suspended and the bill, as amended, was passed. A motion to reconsider was laid on the table. ____________________