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114th Congress    }                                     {       Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                     {      114-560

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



 
         EXAMINING OPIOID TREATMENT INFRASTRUCTURE ACT OF 2016

                                _______
                                

  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. 4982]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 4982) to direct the Comptroller General of the 
United States to evaluate and report on the in-patient and 
outpatient treatment capacity, availability, and needs of the 
United States, having considered the same, report favorably 
thereon with an amendment and recommend that the bill as 
amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     2
Hearings.........................................................     2
Committee Consideration..........................................     2
Committee Votes..................................................     3
Committee Oversight Findings.....................................     3
Statement of General Performance Goals and Objectives............     3
New Budget Authority, Entitlement Authority, and Tax Expenditures     3
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     3
Committee Cost Estimate..........................................     3
Congressional Budget Office Estimate.............................     3
Federal Mandates Statement.......................................     4
Duplication of Federal Programs..................................     4
Disclosure of Directed Rule Makings..............................     4
Advisory Committee Statement.....................................     4
Applicability to Legislative Branch..............................     5
Section-by-Section Analysis of the Legislation...................     5
Changes in Existing Law Made by the Bill, as Reported............     5

    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 the ``Examining Opioid Treatment 
Infrastructure Act of 2016''.

SEC. 2. STUDY ON TREATMENT INFRASTRUCTURE.

  Not later than 24 months after the date of enactment of this Act, the 
Comptroller General of the United States shall initiate an evaluation, 
and submit to Congress a report, of the inpatient and outpatient 
treatment capacity, availability, and needs of the United States, which 
shall include, to the extent data are available--
          (1) the capacity of acute residential or inpatient 
        detoxification programs;
          (2) the capacity of inpatient clinical stabilization 
        programs, transitional residential support services, and 
        residential rehabilitation programs;
          (3) the capacity of demographic specific residential or 
        inpatient treatment programs, such as those designed for 
        pregnant women or adolescents;
          (4) geographical differences of the availability of 
        residential and outpatient treatment and recovery options for 
        substance use disorders across the continuum of care;
          (5) the availability of residential and outpatient treatment 
        programs that offer treatment options based on reliable 
        scientific evidence of efficacy for the treatment of substance 
        use disorders, including the use of Food and Drug 
        Administration-approved medicines and evidence-based 
        nonpharmacological therapies;
          (6) the number of patients in residential and specialty 
        outpatient treatment services for substance use disorders;
          (7) an assessment of the need for residential and outpatient 
        treatment for substance use disorders across the continuum of 
        care;
          (8) the availability of residential and outpatient treatment 
        programs to American Indians and Alaska Natives through an 
        Indian health program (as defined by section 4 of the Indian 
        Health Care Improvement Act (25 U.S.C. 1603)); and
          (9) the barriers (including technological barriers) at the 
        Federal, State, and local levels to real-time reporting of de-
        identified information on drug overdoses and ways to overcome 
        such barriers.

                          PURPOSE AND SUMMARY

    H.R. 4982, the ``Examining Opioid Treatment Infrastructure 
Act of 2016'' was introduced by Rep. Foster (D-IL) on April 18, 
2016. The bill directs the Government Accountability Office 
(GAO) to evaluate and report on the in-patient and outpatient 
treatment capacity, availability, and needs of the United 
States.

                  BACKGROUND AND NEED FOR LEGISLATION

    Opiate-related overdoses have become a significant cause of 
injury related to death nationwide. This bill directs GAO to 
issue a report that will provide important information related 
to treatment capacity, availability, and needs throughout the 
United States.

                                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 a discussion draft entitled the 
``Examining Opioid Treatment Infrastructure Act of 2016'' to 
the full Committee, without amendment, by a voice vote. The 
discussion draft was identical to H.R. 4982. On April 26, 27, 
and 28, 2016, the full Committee on Energy and Commerce met in 
open markup session and ordered H.R. 4982 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. 4982 reported.

                      COMMITTEE OVERSIGHT FINDINGS

    Pursuant to clause 3(c)(1) of Rule XIII of the Rules of the 
House of Representatives, the Committee did not hold a hearing 
on this legislation.

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    The goal of the legislation is to examine in-patient and 
outpatient opioid treatment capacities.

   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. 
4982 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. 4982 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. 4982, the 
Examining Opioid Treatment Infrastructure Act of 2016.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Zoe Williams.
            Sincerely,
                                                        Keith Hall.
    Enclosure.

H.R. 4982--Examining Opioid Treatment Infrastructure Act of 2016

    H.R. 4982 would direct the Government Accountability Office 
(GAO) to conduct an evaluation of the infrastructure for 
treating opioid and other substance abuse in the United States. 
The bill would require GAO to submit a report to the Congress 
on the evaluation no later than 24 months after the date of 
enactment.
    The evaluation would assess the capacity of detoxification 
and stabilization programs, transitional residential support 
services, residential rehabilitation programs, and demographic-
specific treatment programs. The evaluation also would measure 
any geographical differences in the treatment infrastructure 
and the need for residential and outpatient treatment for 
substance use disorders. GAO's report would include an 
assessment of the availability of certain treatment programs 
and detail any barriers to real-time reporting of information 
on drug overdoses.
    CBO estimates that implementing H.R. 4982 would cost less 
than $500,000 over the 2017-2021 period; any such spending 
would be subject to the availability of appropriated funds. 
Pay-as-you-go procedures do not apply to this legislation 
because it would not affect direct spending or revenues.
    CBO estimates that enacting H.R. 4982 would not increase 
direct spending or on-budget deficits in any of the four 
consecutive 10-year periods beginning in 2027.
    H.R. 4982 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act and 
would impose no costs on state, local, or tribal governments.
    The CBO staff contact for this estimate is Zoe Williams. 
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. 4982 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. 4982 
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 the 
``Examining Opioid Treatment Infrastructure Act of 2016''

Section 2. Study on treatment infrastructure

    Within 24 months of enactment of the legislation, the 
Comptroller General of the United States shall initiate an 
evaluation and submit to Congress a report on opioid abuse 
disorder treatment services including:
     (1) the capacity of acute residential or inpatient 
detoxification programs;
     (2) the capacity of inpatient clinical stabilization 
programs, transitional residential support services, and 
residential rehabilitation programs;
     (3) the capacity of demographic specific residential or 
inpatient treatment programs, such as those designed for 
pregnant women or adolescents;
     (4) geographical differences of the availability of 
residential and outpatient treatment and recovery options for 
substance use disorders across the continuum of care;
     (5) the availability of residential and outpatient 
treatment programs that offer treatment options based on 
reliable scientific evidence of efficacy for the treatment of 
substance use disorders, including the use of Food and Drug 
Administration-approved medicines and evidence-based 
nonpharmacological therapies;
     (6) the number of patients in residential and specialty 
outpatient treatment services for substance use disorders;
     (7) an assessment of the need for residential and 
outpatient treatment for substance use disorders across the 
continuum of care;
     (8) an examination of the barriers of real time reporting 
of de-identified information on drug overdoses; and
    (9) an examination of the availability of residential and 
outpatient treatment programs within the Indian Health Service 
program.

         CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

    This legislation does not amend any existing Federal 
statute.

                                  [all]