[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 524 Enrolled Bill (ENR)]
S.524
One Hundred Fourteenth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Monday,
the fourth day of January, two thousand and sixteen
An Act
To authorize the Attorney General and Secretary of Health and Human
Services to award grants to address the prescription opioid abuse and
heroin use crisis, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

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(a) Short Title.--This Act may be cited as the ``Comprehensive
Addiction and Recovery Act of 2016''.
(b) Table of Contents.--The table of contents for this Act is as
follows:

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TITLE I

-PREVENTION AND EDUCATION

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meet requirement for becoming civilian health care
professionals.

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1914adb151cdaefbc3c2677b7d9d01c8dd90b5136fad078b1a94e3f46a5369dc

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TITLE III

-TREATMENT AND RECOVERY

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TITLE IV

-ADDRESSING COLLATERAL CONSEQUENCES

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TITLE V

-ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND

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TITLE VI

-INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS

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TITLE VII

-MISCELLANEOUS

from the Medicaid additional rebate requirement for new
formulations of prescription drugs.

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technologies to identify and prevent waste, fraud, and abuse.

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challenges relating to designations under the Narcotics
Kingpin Designation Act.

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TITLE VIII

-KINGPIN DESIGNATION IMPROVEMENT

Subtitle A--Opioid Therapy and Pain Management

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TITLE IX

-DEPARTMENT OF VETERANS AFFAIRS

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Department of Veterans Affairs and the Department of Defense.

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treatment by Department of Veterans Affairs.

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controlled substance monitoring programs.

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opioid antagonists or education on use of opioid antagonists.
Subtitle B--Patient Advocacy

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patient bill of rights of Department of Veterans Affairs.

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of Veterans Affairs.
Subtitle C--Complementary and Integrative Health

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complementary and integrative health to veterans.

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health and related issues for veterans and family members of
veterans.
Subtitle D--Fitness of Health Care Providers

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Department of Veterans Affairs to State medical boards.

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reviews of health care providers leaving the Department or
transferring to other facilities.
Subtitle E--Other Matters

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(a) Definitions.--In this section:
(1) Secretary.--The term ``Secretary'' means the Secretary of
Health and Human Services.
(2) Task force.--The term ``task force'' means the Pain
Management Best Practices Inter-Agency Task Force convened under
subsection (b).
(b) Inter-Agency Task Force.--Not later than 2 years after the date
of enactment of this Act, the Secretary, in cooperation with the
Secretary of Veterans Affairs and the Secretary of Defense, shall
convene a Pain Management Best Practices Inter-Agency Task Force.
(c) Membership.--The task force shall be comprised of--
(1) representatives of--
(A) the Department of Health and Human Services and
relevant agencies within the Department of Health and Human
Services;
(B) the Department of Veterans Affairs;
(C) the Department of Defense; and
(D) the Office of National Drug Control Policy;
(2) currently licensed and practicing physicians, dentists, and
nonphysician prescribers;
(3) currently licensed and practicing pharmacists and
pharmacies;
(4) experts in the fields of pain research and addiction
research, including adolescent and young adult addiction research;
(5) representatives of--
(A) pain management professional organizations;
(B) the mental health treatment community;
(C) the addiction treatment community, including
individuals in recovery from substance use disorder;
(D) pain advocacy groups, including patients;
(E) veteran service organizations;
(F) groups with expertise on overdose reversal, including
first responders;
(G) State medical boards; and
(H) hospitals;
(6) experts on the health of, and prescription opioid use
disorders in, members of the Armed Forces and veterans; and
(7) experts in the field of minority health.
(d) Representation.--The Secretary shall ensure that the membership
of the task force includes individuals representing rural and
underserved areas.
(e) Duties.--The task force shall--
(1) identify, review, and, as appropriate, determine whether
there are gaps in or inconsistencies between best practices for
pain management (including chronic and acute pain) developed or
adopted by Federal agencies;
(2) not later than 1 year after the date on which the task
force is convened under subsection (b), propose updates to best
practices and recommendations on addressing gaps or inconsistencies
identified under paragraph (1), as appropriate, and submit to
relevant Federal agencies and the general public such proposed
updates and recommendations, taking into consideration--
(A) existing pain management research and other relevant
research;
(B) recommendations from relevant conferences and existing
relevant evidence-based guidelines;
(C) ongoing efforts at the State and local levels and by
medical professional organizations to develop improved pain
management strategies, including consideration of differences
within and between classes of opioids, the availability of
opioids with abuse deterrent technology, and pharmacological,
nonpharmacological, and medical device alternatives to opioids
to reduce opioid monotherapy in appropriate cases;
(D) the management of high-risk populations who receive
opioids in the course of medical care, other than for pain
management;
(E) the 2016 Guideline for Prescribing Opioids for Chronic
Pain issued by the Centers for Disease Control and Prevention;
and
(F) private sector, State, and local government efforts
related to pain management and prescribing pain medication;
(3) provide the public with at least 90 days to submit comments
on any proposed updates and recommendations under paragraph (2);
and
(4) develop a strategy for disseminating information about best
practices for pain management (including chronic and acute pain) to
stakeholders, if appropriate.
(f) Limitation.--The task force shall not have rulemaking
authority.
(g) Sunset.--The task force under this section shall sunset after 3
years.

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(a) In General.--The Secretary of Health and Human Services, in
coordination with the heads of other departments and agencies, shall,
as appropriate, through existing programs and activities, advance the
education and awareness of the public (including providers, patients,
and consumers) and other appropriate entities regarding the risk of
abuse of prescription opioids if such drugs are not taken as
prescribed.
(b) Topics.--The education and awareness campaigns under subsection
(a) shall address--
(1) the dangers of opioid abuse;
(2) the prevention of opioid abuse, including through safe
disposal of prescription medications and other safety precautions;
and
(3) the detection of early warning signs of addiction.
(c) Other Requirements.--The education and awareness campaigns
under subsection (a) shall, as appropriate--
(1) take into account any association between prescription
opioid abuse and heroin use;
(2) emphasize--
(A) the similarities between heroin and prescription
opioids; and
(B) the effects of heroin and prescription opioids on the
human body; and
(3) bring greater public awareness to the dangerous effects of
fentanyl when mixed with heroin or abused in a similar manner.

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LOCAL DRUG CRISES.
(a) Definitions.--In this section:
(1) Administrator.--The term ``Administrator'' means the
Administrator of the Substance Abuse and Mental Health Services
Administration.
(2) Director.--The term ``Director'' means the Director of the
Office of National Drug Control Policy.
(3) Drug-free communities act of 1997.--The term ``Drug-Free
Communities Act of 1997'' means chapter 2 of the National Narcotics
Leadership Act of 1988 (21 U.S.C. 1521 et seq.).
(4) Eligible entity.--The term ``eligible entity'' means an
organization that--
(A) on or before the date of submitting an application for
a grant under this section, receives or has received a grant
under the Drug-Free Communities Act of 1997; and
(B) has documented, using local data, rates of abuse of
opioids or methamphetamines at levels that are--
(i) significantly higher than the national average as
determined by the Secretary (including appropriate
consideration of the results of the Monitoring the Future
Survey published by the National Institute on Drug Abuse
and the National Survey on Drug Use and Health published by
the Substance Abuse and Mental Health Services
Administration); or
(ii) higher than the national average, as determined by
the Secretary (including appropriate consideration of the
results of the surveys described in clause (i)), over a
sustained period of time.
(5) Emerging drug abuse issue.--The term ``emerging drug abuse
issue'' means a substance use disorder within an area involving--
(A) a sudden increase in demand for particular drug abuse
treatment services relative to previous demand; and
(B) a lack of resources in the area to address the emerging
problem.
(6) Local drug crisis.--The term ``local drug crisis'' means,
with respect to the area served by an eligible entity--
(A) a sudden increase in the abuse of opioids or
methamphetamines, as documented by local data;
(B) the abuse of prescription medications, specifically
opioids or methamphetamines, that is significantly higher than
the national average, over a sustained period of time, as
documented by local data; or
(C) a sudden increase in opioid-related deaths, as
documented by local data.
(7) Opioid.--The term ``opioid'' means any drug having an
addiction-forming or addiction-sustaining liability similar to
morphine or being capable of conversion into a drug having such
addiction-forming or addiction-sustaining liability.
(b) Program Authorized.--The Director, in coordination with the
Administrator, may make grants to eligible entities to implement
comprehensive community-wide strategies that address local drug crises
and emerging drug abuse issues within the area served by the eligible
entity.
(c) Application.--
(1) In general.--An eligible entity seeking a grant under this
section shall submit an application to the Director at such time,
in such manner, and accompanied by such information as the Director
may require.
(2) Criteria.--As part of an application for a grant under this
section, the Director shall require an eligible entity to submit a
detailed, comprehensive, multisector plan for addressing the local
drug crisis or emerging drug abuse issue within the area served by
the eligible entity.
(d) Use of Funds.--An eligible entity shall use a grant received
under this section--
(1) for programs designed to implement comprehensive community-
wide prevention strategies to address the local drug crisis in the
area served by the eligible entity, in accordance with the plan
submitted under subsection (c)(2);
(2) to obtain specialized training and technical assistance
from the organization funded under section 4 of Public Law 107-82
(21 U.S.C. 1521 note); and
(3) for programs designed to implement comprehensive community-
wide strategies to address emerging drug abuse issues in the
community.
(e) Supplement Not Supplant.--An eligible entity shall use Federal
funds received under this section only to supplement the funds that
would, in the absence of those Federal funds, be made available from
other Federal and non-Federal sources for the activities described in
this section, and not to supplant those funds.
(f) Evaluation.--A grant under this section shall be subject to the
same evaluation requirements and procedures as the evaluation
requirements and procedures imposed on the recipient of a grant under
the Drug-Free Communities Act of 1997, and may also include an
evaluation of the effectiveness at reducing abuse of opioids or
methamphetamines.
(g) Limitation on Administrative Expenses.--Not more than 8 percent
of the amounts made available to carry out this section for a fiscal
year may be used to pay for administrative expenses.
(h) Delegation Authority.--The Director may enter into an
interagency agreement with the Administrator to delegate authority for
the execution of grants and for such other activities as may be
necessary to carry out this section.
(i) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $5,000,000
for each of fiscal years 2017 through 2021.

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RELATED TO YOUTH SPORTS INJURIES.
(a) Report.--The Secretary of Health and Human Services (referred
to in this section as the ``Secretary'') shall, not later than 24
months after the date of the enactment of this section, make publicly
available on the appropriate website of the Department of Health and
Human Services a report determining the extent to which informational
materials and resources described in subsection (c) are available to
teenagers and adolescents who play youth sports, families of such
teenagers and adolescents, nurses, youth sports groups, and relevant
health care provider groups.
(b) Development of Informational Materials and Resources.--The
Secretary may, for purposes of preventing substance use disorder in
teenagers and adolescents who are injured playing youth sports and are
subsequently prescribed an opioid, not later than 12 months after the
report is made publicly available under subsection (a), and taking into
consideration the findings of such report and in coordination with
relevant health care provider groups, facilitate the development of
informational materials and resources described in subsection (c) for
teenagers and adolescents who play youth sports, families of such
teenagers and adolescents, nurses, youth sports groups, and relevant
health care provider groups.
(c) Materials and Resources Described.--For purposes of this
section, the informational materials and resources described in this
subsection are informational materials and resources with respect to
youth sports injuries for which opioids are potentially prescribed,
including materials and resources focused on the risks associated with
opioid use and misuse, treatment options for such injuries that do not
involve the use of opioids, and how to seek treatment for addiction.
(d) No Additional Funds.--No additional funds are authorized to be
appropriated for the purpose of carrying out this section. This section
shall be carried out using amounts otherwise available for such
purpose.

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TRAINING TO MEET REQUIREMENT FOR BECOMING CIVILIAN HEALTH CARE
PROFESSIONALS.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 314 the following:
``SEC. 315. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL
TRAINING TO MEET REQUIREMENTS FOR BECOMING CIVILIAN HEALTH CARE
PROFESSIONALS.
``(a) Program.--
``(1) In general.--The Secretary may establish a program, in
consultation with the Secretary of Labor, consisting of awarding
demonstration grants to States to streamline State requirements and
procedures in order to assist veterans who held certain military
occupational specialties related to medical care or who have
completed certain medical training while serving in the Armed
Forces of the United States to meet certification, licensure, and
other requirements applicable to civilian health care professions
(such as emergency medical technician, paramedic, licensed
practical nurse, registered nurse, physical therapy assistant, or
physician assistant professions) in the State.
``(2) Consultation and collaboration.--In determining the
eligible military occupational specialties or training courses and
the assistance required as described in paragraph (1), the
Secretary shall consult with the Secretary of Defense, the
Secretary of Veterans Affairs, and the Assistant Secretary of Labor
for Veterans' Employment and Training, and shall collaborate with
the initiatives carried out under section 4114 of title 38, United
States Code, and sections 1142 through 1144 of title 10, United
States Code.
``(b) Use of Funds.--Amounts received as a demonstration grant
under this section shall be used to--
``(1) prepare and implement a plan to streamline State
requirements and procedures as described in subsection (a),
including by--
``(A) determining the extent to which the requirements for
the education, training, and skill level of civilian health
care professions (such as emergency medical technicians,
paramedics, licensed practical nurses, registered nurses,
physical therapy assistants, or physician assistants) in the
State are equivalent to requirements for the education,
training, and skill level of veterans who served in medical
related fields while a member of the Armed Forces of the United
States; and
``(B) identifying methods, such as waivers, for veterans
who served in medical related fields while a member of the
Armed Forces of the United States to forgo or meet any such
equivalent State requirements; and
``(2) if necessary to meet workforce shortages or address gaps
in education, training, or skill level to meet certification,
licensure or other requirements applicable to becoming a civilian
health care professional (such as an emergency medical technician,
paramedic, licensed practical nurse, registered nurse, physical
therapy assistant, or physician assistant professions) in the
State, develop or expand career pathways at institutions of higher
education to support veterans in meeting such requirements.
``(c) Report.--Upon the completion of the demonstration program
under this section, the Secretary shall submit to Congress a report on
the program.
``(d) Funding.--No additional funds are authorized to be
appropriated for the purpose of carrying out this section. This section
shall be carried out using amounts otherwise available for such
purpose.
``(e) Sunset.--The demonstration program under this section shall
not exceed 5 years.''.

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(a) In General.--
(1) New drug application.--
(A) In general.--Subject to subparagraph (B), prior to the
approval pursuant to an application submitted under section
505(b) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
355(b)) of a new drug that is an opioid, the Secretary of
Health and Human Services (referred to in this section as the
``Secretary'') shall refer the application to an advisory
committee of the Food and Drug Administration to seek
recommendations from such advisory committee.
(B) Public health exemption.--A referral to an advisory
committee under subparagraph (A) is not required with respect
to a new opioid drug or drugs if the Secretary--
(i) finds that such a referral is not in the interest
of protecting and promoting public health;
(ii) finds that such a referral is not necessary based
on a review of the relevant scientific information; and
(iii) submits a notice containing the rationale for
such findings to the Committee on Health, Education, Labor,
and Pensions of the Senate and the Committee on Energy and
Commerce of the House of Representatives.
(2) Pediatric opioid labeling.--The Secretary shall convene the
Pediatric Advisory Committee of the Food and Drug Administration to
seek recommendations from such Committee regarding a framework for
the inclusion of information in the labeling of drugs that are
opioids relating to the use of such drugs in pediatric populations
before the Secretary approves any labeling or change to labeling
for any drug that is an opioid intended for use in a pediatric
population.
(3) Sunset.--The requirements of paragraphs (1) and (2) shall
cease to be effective on October 1, 2022.
(b) Prescriber Education.--Not later than 1 year after the date of
the enactment of this Act, the Secretary, acting through the
Commissioner of Food and Drugs, as part of the Food and Drug
Administration's evaluation of the Extended-Release/Long-Acting Opioid
Analgesics Risk Evaluation and Mitigation Strategy, and in consultation
with relevant stakeholders, shall develop recommendations regarding
education programs for prescribers of opioids pursuant to section 505-1
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1),
including recommendations on--
(1) which prescribers should participate in such programs; and
(2) how often participation in such programs is necessary.
(c) Guidance on Evaluating the Abuse Deterrence of Generic Solid
Oral Opioid Drug Products.--Not later than 18 months after the end of
the period for public comment on the draft guidance entitled ``General
Principles for Evaluating the Abuse Deterrence of Generic Solid Oral
Opioid Drug Products'' issued by the Center for Drug Evaluation and
Research of the Food and Drug Administration in March 2016, the
Commissioner of Food and Drugs shall publish in the Federal Register a
final version of such guidance.

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(a) Grants for Reducing Overdose Deaths.--Part D of title V of the
Public Health Service Act (42 U.S.C. 290dd et seq.) is amended by
adding at the end the following:
``SEC. 544. GRANTS FOR REDUCING OVERDOSE DEATHS.
``(a) Establishment.--
``(1) In general.--The Secretary shall award grants to eligible
entities to expand access to drugs or devices approved or cleared
under the Federal Food, Drug, and Cosmetic Act for emergency
treatment of known or suspected opioid overdose.
``(2) Maximum grant amount.--A grant awarded under this section
may not be for more than $200,000 per grant year.
``(3) Eligible entity.--For purposes of this section, the term
`eligible entity' means a Federally qualified health center (as
defined in section 1861(aa) of the Social Security Act), an opioid
treatment program under part 8 of title 42, Code of Federal
Regulations, any practitioner dispensing narcotic drugs pursuant to
section 303(g) of the Controlled Substances Act, or any other
entity that the Secretary deems appropriate.
``(4) Prescribing.--For purposes of this section, the term
`prescribing' means, with respect to a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose, the
practice of prescribing such drug or device--
``(A) in conjunction with an opioid prescription for
patients at an elevated risk of overdose;
``(B) in conjunction with an opioid agonist approved under
section 505 of the Federal Food, Drug, and Cosmetic Act for the
treatment of opioid use disorder;
``(C) to the caregiver or a close relative of patients at
an elevated risk of overdose from opioids; or
``(D) in other circumstances in which a provider identifies
a patient is at an elevated risk for an intentional or
unintentional drug overdose from heroin or prescription opioid
therapies.
``(b) Application.--To be eligible to receive a grant under this
section, an eligible entity shall submit to the Secretary, in such form
and manner as specified by the Secretary, an application that
describes--
``(1) the extent to which the area to which the entity will
furnish services through use of the grant is experiencing
significant morbidity and mortality caused by opioid abuse;
``(2) the criteria that will be used to identify eligible
patients to participate in such program; and
``(3) a plan for sustaining the program after Federal support
for the program has ended.
``(c) Use of Funds.--An eligible entity receiving a grant under
this section may use amounts under the grant for any of the following
activities, but may use not more than 20 percent of the grant funds for
activities described in paragraphs (3) and (4):
``(1) To establish a program for prescribing a drug or device
approved or cleared under the Federal Food, Drug, and Cosmetic Act
for emergency treatment of known or suspected opioid overdose.
``(2) To train and provide resources for health care providers
and pharmacists on the prescribing of drugs or devices approved or
cleared under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose.
``(3) To purchase drugs or devices approved or cleared under
the Federal Food, Drug, and Cosmetic Act for emergency treatment of
known or suspected opioid overdose, for distribution under the
program described in paragraph (1).
``(4) To offset the co-payments and other cost sharing
associated with drugs or devices approved or cleared under the
Federal Food, Drug, and Cosmetic Act for emergency treatment of
known or suspected opioid overdose.
``(5) To establish protocols to connect patients who have
experienced a drug overdose with appropriate treatment, including
medication-assisted treatment and appropriate counseling and
behavioral therapies.
``(d) Evaluations by Recipients.--As a condition of receipt of a
grant under this section, an eligible entity shall, for each year for
which the grant is received, submit to the Secretary an evaluation of
activities funded by the grant which contains such information as the
Secretary may reasonably require.
``(e) Reports by the Secretary.--Not later than 5 years after the
date on which the first grant under this section is awarded, the
Secretary shall submit to the appropriate committees of the House of
Representatives and of the Senate a report aggregating the information
received from the grant recipients for such year under subsection (d)
and evaluating the outcomes achieved by the programs funded by grants
awarded under this section.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $5,000,000 for the period of
fiscal years 2017 through 2021.''.
(b) Improving Access to Overdose Treatment.--
(1) Information on best practices.--Not later than 180 days
after the date of enactment of this Act:
(A) The Secretary of Health and Human Services may provide
information to prescribers within Federally qualified health
centers (as defined in paragraph (4) of section 1861(aa) of the
Social Security Act (42 U.S.C. 1395x(aa))), and the health care
facilities of the Indian Health Service, on best practices for
prescribing or co-prescribing a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 301 et seq.) for emergency treatment of known or
suspected opioid overdose, including for patients receiving
chronic opioid therapy and patients being treated for opioid
use disorders.
(B) The Secretary of Defense may provide information to
prescribers within Department of Defense medical facilities on
best practices for prescribing or co-prescribing a drug or
device approved or cleared under the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 301 et seq.) for emergency treatment of
known or suspected opioid overdose, including for patients
receiving chronic opioid therapy and patients being treated for
opioid use disorders.
(C) The Secretary of Veterans Affairs may provide
information to prescribers within Department of Veterans
Affairs medical facilities on best practices for prescribing or
co-prescribing a drug or device approved or cleared under the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et seq.)
for emergency treatment of known or suspected opioid overdose,
including for patients receiving chronic opioid therapy and
patients being treated for opioid use disorders.
(2) Rule of construction.--Nothing in this subsection should be
construed to establish or contribute to a medical standard of care.

2ca89afcfd4cb7e92740ed8f11cd9e8b9fe9657185b2876ce7c76c8938a82ce0

(a) In General.--The Director of the National Institutes of Health
(referred to in this section as the ``NIH'') may intensify and
coordinate fundamental, translational, and clinical research of the NIH
with respect to--
(1) the understanding of pain;
(2) the discovery and development of therapies for chronic
pain; and
(3) the development of alternatives to opioids for effective
pain treatments.
(b) Priority and Direction.--The prioritization and direction of
the Federally funded portfolio of pain research studies shall consider
recommendations made by the Interagency Pain Research Coordinating
Committee in concert with the Pain Management Best Practices Inter-
Agency Task Force, and in accordance with the National Pain Strategy,
the Federal Pain Research Strategy, and the NIH-Wide Strategic Plan for
Fiscal Years 2016-2020, the latter of which calls for the relative
burdens of individual diseases and medical disorders to be regarded as
crucial considerations in balancing the priorities of the Federal
research portfolio.

98c7c3fd266f9924b64d7379242f397a3245e52efd4e7a5e86df4cc32333e795

REAUTHORIZATION.
(a) Amendment to Purpose.--Paragraph (1) of section 2 of the
National All Schedules Prescription Electronic Reporting Act of 2005
(Public Law 109-60) is amended to read as follows:
``(1) foster the establishment of State-administered controlled
substance monitoring systems in order to ensure that health care
providers have access to the accurate, timely prescription history
information that they may use as a tool for the early
identification of patients at risk for addiction in order to
initiate appropriate medical interventions and avert the tragic
personal, family, and community consequences of untreated
addiction; and''.
(b) 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)(1)--
(A) in the matter preceding subparagraph (A), by inserting
``, in consultation with the Administrator of the Substance
Abuse and Mental Health Services Administration and Director of
the Centers for Disease Control and Prevention,'' after ``the
Secretary'';
(B) in subparagraph (A), by striking ``or'';
(C) in subparagraph (B), by striking the period at the end
and inserting ``; or''; and
(D) by adding at the end the following:
``(C) to maintain an existing State-controlled substance
monitoring program.'';
(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, to the extent practicable, 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 so redesignated), by striking
``; and'' and inserting the following: ``and at least one
health information technology system such as electronic
health records, health information exchanges, or e-
prescribing systems;'';
(vi) in clause (v) (as so redesignated)--
(I) by striking ``public health'' and inserting
``public health or safety''; and
(II) by striking the period and inserting ``;
and''; and
(vii) by adding at the end the following:
``(vi) information, where applicable, on how the
controlled substance monitoring program jointly works with
the applicant's respective State substance abuse agency to
ensure information collected and maintained by the
controlled substance monitoring program is used to inform
the provision of clinically appropriate substance use
disorder services to individuals in need.'';
(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 inserting before the period at the end ``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 the 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).''; and
(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 safety''; and
(B) by adding at the end the following:
``(5) The State shall report on interoperability with the
controlled substance monitoring program of Federal agencies, where
appropriate, interoperability with health information technology
systems such as electronic health records, health information
exchanges, and e-prescribing, where appropriate, and whether or not
the State provides automatic, up-to-date, 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 Substances Act'';
and
(ii) in subparagraph (D)--
(I) by inserting ``a State substance abuse
agency,'' after ``State health department,''; and
(II) by striking ``such department, program, or
administration'' each place it appears and inserting
``such department, program, agency, or administration''
in each such place; 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 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 (k)(2).
``(4) Research by other entities.--A department, program,
agency, or administration receiving nonidentifiable information
under paragraph (1)(D) may make such information available to other
entities for research purposes.'';
(7) by striking subsection (k);
(8) by redesignating subsections (h) through (j) as subsections
(i) through (k), respectively;
(9) in subsections (c)(1)(A)(iv) and (d)(4), by striking
``subsection (h)'' each place it appears and inserting ``subsection
(i)'';
(10) 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, to the extent practicable;
and
``(2) educate prescribers and dispensers on the benefits of the
system.'';
(11) in subsection (k)(2)(A), as so redesignated--
(A) in clause (ii), by striking ``or affected'' and
inserting ``, established or strengthened initiatives to ensure
linkages to substance use disorder services, or affected''; and
(B) in clause (iii), by striking ``including an
assessment'' and inserting ``and between controlled substance
monitoring programs and health information technology systems,
including an assessment'';
(12) in subsection (l)(1), by striking ``establishment,
implementation, or improvement'' and inserting ``establishment,
improvement, or maintenance'';
(13) in subsection (m)(8), by striking ``and the District of
Columbia'' and inserting ``, the District of Columbia, and any
commonwealth or territory of the United States''; and
(14) by amending subsection (n) to read as follows:
``(n) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated, $10,000,000 for each of fiscal
years 2017 through 2021.''.

e52d11193afc38251fe7da0fa708061054457480f470d251d05c39ffb2ad3a38

GRANT PROGRAMS.
(a) In General.--Part D of title V of the Public Health Service Act
(42 U.S.C. 290dd et seq.), as amended by section 107, is further
amended by adding at the end the following:
``SEC. 545. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND
EDUCATION GRANT PROGRAMS.
``(a) Grants to States.--The Secretary shall make grants to States
to--
``(1) implement strategies for pharmacists to dispense a drug
or device approved or cleared under the Federal Food, Drug, and
Cosmetic Act for emergency treatment of known or suspected opioid
overdose, as appropriate, pursuant to a standing order;
``(2) encourage pharmacies to dispense opioid overdose reversal
medication pursuant to a standing order;
``(3) develop or provide training materials that persons
authorized to prescribe or dispense a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose may use
to educate the public concerning--
``(A) when and how to safely administer such drug or
device; and
``(B) steps to be taken after administering such drug or
device; and
``(4) educate the public concerning the availability of drugs
or devices approved or cleared under the Federal Food, Drug, and
Cosmetic Act for emergency treatment of known or suspected opioid
overdose 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 to be issued
for drugs or devices approved or cleared under the Federal Food, Drug,
and Cosmetic Act for emergency treatment of known or suspected opioid
overdose.
``(c) Preference in Making Grants.--In making grants under this
section, the Secretary may give preference to States that have a
significantly higher rate of opioid overdoses than the national
average, and that--
``(1) have not implemented standing orders regarding drugs or
devices approved or cleared under the Federal Food, Drug, and
Cosmetic Act for emergency treatment of known or suspected opioid
overdose;
``(2) authorize standing orders to be issued that permit
community-based organizations, substance abuse programs, or other
nonprofit entities to acquire, dispense, or administer drugs or
devices approved or cleared under the Federal Food, Drug, and
Cosmetic Act for emergency treatment of known or suspected opioid
overdose; or
``(3) authorize standing orders to be issued that permit
police, fire, or emergency medical services agencies to acquire and
administer drugs or devices approved or cleared under the Federal
Food, Drug, and Cosmetic Act for emergency treatment of known or
suspected opioid overdose.
``(d) Grant Terms.--
``(1) Number.--A State may not receive more than one grant
under this section at a time.
``(2) Period.--A grant under this section shall be for a period
of 3 years.
``(3) Limitation.--A State may use not more than 20 percent of
a grant under this section for educating the public pursuant to
subsection (a)(4).
``(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
reasonably require, including detailed proposed expenditures of grant
funds.
``(f) Reporting.--A State that receives a grant under this section
shall, at least annually for the duration of the grant, submit a report
to the Secretary evaluating the progress of the activities supported
through the grant. Such reports shall include information on the number
of pharmacies in the State that dispense a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act for emergency
treatment of known or suspected opioid overdose under a standing order,
and other information as the Secretary determines appropriate to
evaluate the use of grant funds.
``(g) Definitions.--In this section 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 are
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.''.
(b) 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''.

17712c813026b7116d9bb6c9e7349a21e3ac0472e10a9a2afa30d4aaec2c7b32

(a) Comprehensive Opioid Abuse Grant Program.--
(1) In general.--Title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3711 et seq.) is amended by adding
at the end the following:
``PART LL--COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM
``SEC. 3021. DESCRIPTION.
``(a) Grants Authorized.--From amounts made available to carry out
this part, the Attorney General may make grants to States, units of
local government, and Indian tribes, for use by the State, unit of
local government, or Indian tribe to provide services primarily
relating to opioid abuse, including for any one or more of the
following:
``(1) Developing, implementing, or expanding a treatment
alternative to incarceration program, which may include--
``(A) prebooking or postbooking components, which may
include the activities described in part DD or HH of this
title;
``(B) training for criminal justice agency personnel on
substance use disorders and co-occurring mental illness and
substance use disorders;
``(C) a mental health court, including the activities
described in part V of this title;
``(D) a drug court, including the activities described in
part EE of this title;
``(E) a veterans treatment court program, including the
activities described in subsection (i) of section 2991 of this
title;
``(F) a focus on parents whose incarceration could result
in their children entering the child welfare system; and
``(G) a community-based substance use diversion program
sponsored by a law enforcement agency.
``(2) In the case of a State, facilitating or enhancing
planning and collaboration between State criminal justice agencies
and State substance abuse agencies in order to more efficiently and
effectively carry out activities or services described in any
paragraph of this subsection that address problems related to
opioid abuse.
``(3) Providing training and resources for first responders on
carrying and administering an opioid overdose reversal drug or
device approved or cleared by the Food and Drug Administration, and
purchasing such a drug or device for first responders who have
received such training to so carry and administer.
``(4) Locating or investigating illicit activities related to
the unlawful distribution of opioids.
``(5) Developing, implementing, or expanding a medication-
assisted treatment program used or operated by a criminal justice
agency, which may include training criminal justice agency
personnel on medication-assisted treatment, and carrying out the
activities described in part S of this title.
``(6) In the case of a State, developing, implementing, or
expanding a prescription drug monitoring program to collect and
analyze data related to the prescribing of schedules II, III, and
IV controlled substances through a centralized database
administered by an authorized State agency, which includes tracking
the dispensation of such substances, and providing for
interoperability and data sharing with each other such program in
each other State, and with any interstate entity that shares
information between such programs.
``(7) Developing, implementing, or expanding a program to
prevent and address opioid abuse by juveniles.
``(8) Developing, implementing, or expanding a program (which
may include demonstration projects) to utilize technology that
provides a secure container for prescription drugs that would
prevent or deter individuals, particularly adolescents, from
gaining access to opioid medications that are lawfully prescribed
for other individuals.
``(9) Developing, implementing, or expanding a prescription
drug take-back program.
``(10) Developing, implementing, or expanding an integrated and
comprehensive opioid abuse response program.
``(b) Contracts and Subawards.--A State, unit of local government,
or Indian tribe may, in using a grant under this part for purposes
authorized by subsection (a), use all or a portion of that grant to
contract with, or make one or more subawards to, one or more--
``(1) local or regional organizations that are private and
nonprofit, including faith-based organizations;
``(2) units of local government; or
``(3) tribal organizations.
``(c) Program Assessment Component; Waiver.--
``(1) Program assessment component.--Each program funded under
this part shall contain a program assessment component, developed
pursuant to guidelines established by the Attorney General, in
coordination with the National Institute of Justice.
``(2) Waiver.--The Attorney General may waive the requirement
of paragraph (1) with respect to a program if, in the opinion of
the Attorney General, the program is not of sufficient size to
justify a full program assessment.
``(d) Administrative Costs.--Not more than 10 percent of a grant
made under this part may be used for costs incurred to administer such
grant.
``(e) Period.--The period of a grant made under this part may not
be longer than 4 years, except that renewals and extensions beyond that
period may be granted at the discretion of the Attorney General.
``SEC. 3022. APPLICATIONS.
``To request a grant under this part, the chief executive officer
of a State, unit of local government, or Indian tribe shall submit an
application to the Attorney General at such time and in such form as
the Attorney General may require. Such application shall include the
following:
``(1) A certification that Federal funds made available under
this part will not be used to supplant State, local, or tribal
funds, but will be used to increase the amounts of such funds that
would, in the absence of Federal funds, be made available for the
activities described in section 3021(a).
``(2) An assurance that, for each fiscal year covered by an
application, the applicant shall maintain and report such data,
records, and information (programmatic and financial) as the
Attorney General may reasonably require.
``(3) A certification, made in a form acceptable to the
Attorney General and executed by the chief executive officer of the
applicant (or by another officer of the applicant, if qualified
under regulations promulgated by the Attorney General), that--
``(A) the activities or services to be funded by the grant
meet all the requirements of this part;
``(B) all the information contained in the application is
correct;
``(C) there has been appropriate coordination with affected
agencies; and
``(D) the applicant will comply with all provisions of this
part and all other applicable Federal laws.
``(4) An assurance that the applicant will work with the Drug
Enforcement Administration to develop an integrated and
comprehensive strategy to address opioid abuse.
``SEC. 3023. REVIEW OF APPLICATIONS.
``The Attorney General shall not finally disapprove any application
(or any amendment to that application) submitted under this part
without first affording the applicant reasonable notice of any
deficiencies in the application and an opportunity for correction of
any such deficiencies and reconsideration.
``SEC. 3024. EQUITABLE DISTRIBUTION OF FUNDS.
``In awarding grants under this part, the Attorney General shall
distribute funds in a manner that--
``(1) equitably addresses the needs of underserved populations,
including rural and tribal communities; and
``(2) focuses on communities that have been disproportionately
impacted by opioid abuse as evidenced in part by--
``(A) high rates of primary treatment admissions for heroin
and other opioids;
``(B) high rates of drug poisoning deaths from heroin and
other opioids; and
``(C) a lack of accessibility to treatment providers and
facilities and to emergency medical services.
``SEC. 3025. DEFINITIONS.
``In this part:
``(1) The term `first responder' includes a firefighter, law
enforcement officer, paramedic, emergency medical technician, or
other individual (including an employee of a legally organized and
recognized volunteer organization, whether compensated or not),
who, in the course of his or her professional duties, responds to
fire, medical, hazardous material, or other similar emergencies.
``(2) The term `medication-assisted treatment' means the use of
medications approved by the Food and Drug Administration for the
treatment of opioid abuse.
``(3) The term `opioid' means any drug, including heroin,
having an addiction-forming or addiction-sustaining liability
similar to morphine or being capable of conversion into a drug
having such addiction-forming or addiction-sustaining liability.
``(4) The term `schedule II, III, or IV controlled substance'
means a controlled substance that is listed on schedule II,
schedule III, or schedule IV of section 202(c) of the Controlled
Substances Act (21 U.S.C. 812(c)).
``(5) The terms `drug' and `device' have the meanings given
those terms in section 201 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 321).
``(6) The term `criminal justice agency' means a State, local,
or tribal--
``(A) court;
``(B) prison;
``(C) jail;
``(D) law enforcement agency; or
``(E) other agency that performs the administration of
criminal justice, including prosecution, pretrial services, and
community supervision.
``(7) The term `tribal organization' has the meaning given that
term in section 4 of the Indian Self-Determination and Education
Assistance Act (25 U.S.C. 450b).
``(8) The term `State substance abuse agency' has the meaning
given that term in section 508(r)(6) of the Public Health Service
Act (42 U.S.C. 290bb-1).''.
(2) Authorization of appropriations.--Section 1001(a) of title
I of the Omnibus Crime Control and Safe Streets Act of 1968 (42
U.S.C. 3793(a)) is amended by inserting after paragraph (26) the
following:
``(27) There are authorized to be appropriated to carry out
part LL $103,000,000 for each of fiscal years 2017 through 2021.''.
(b) Emergency Federal Law Enforcement Assistance.--Section 609Y(a)
of the Justice Assistance Act of 1984 (42 U.S.C. 10513(a)) is amended
by striking ``September 30, 1984'' and inserting ``September 30,
2021''.
(c) Inclusion of Services for Pregnant Women Under Family-Based
Substance Abuse Grants.--Part DD of title I of the Omnibus Crime
Control and Safe Streets Act (42 U.S.C. 3797s et seq.) is amended--
(1) in section 2921(2), by inserting before the period at the
end ``or pregnant women''; and
(2) in section 2927--
(A) in paragraph (1)(A), by inserting ``pregnant or''
before ``a parent''; and
(B) in paragraph (3), by inserting ``or pregnant women''
after ``incarcerated parents''.
(d) GAO Study and Report on Federal Agency Programs and Research
Relative to Substance Use and Substance Use Disorders Among Adolescents
and Young Adults.--
(1) Study.--The Comptroller General of the United States shall
conduct a study on how Federal agencies, through grant programs,
are addressing prevention of, treatment for, and recovery from,
substance use by, and substance use disorders among, adolescents
and young adults. Such study shall include an analysis of each of
the following:
(A) The research that has been, and is being, conducted or
supported pursuant to grant programs operated by Federal
agencies on prevention of, treatment for, and recovery from
substance use by and substance use disorders among adolescents
and young adults, including an assessment of--
(i) such research relative to any unique circumstances
(including social and biological circumstances) of
adolescents and young adults that may make adolescent-
specific and young adult-specific treatment protocols
necessary, including any effects that substance use and
substance use disorders may have on brain development and
the implications for treatment and recovery; and
(ii) areas of such research in which greater investment
or focus is necessary relative to other areas of such
research.
(B) Federal agency nonresearch programs and activities that
address prevention of, treatment for, and recovery from
substance use by and substance use disorders among adolescents
and young adults, including an assessment of the effectiveness
of such programs and activities in preventing substance use by
and substance use disorders among adolescents and young adults,
treating such adolescents and young adults in a way that
accounts for any unique circumstances faced by adolescents and
young adults, and supports long-term recovery among adolescents
and young adults.
(C) Gaps that have been identified by officials of Federal
agencies or experts in the efforts supported by grant programs
operated by Federal agencies relating to prevention of,
treatment for, and recovery from substance use by and substance
use disorders among adolescents and young adults, including
gaps in research, data collection, and measures to evaluate the
effectiveness of such efforts, and the reasons for such gaps.
(2) Report.--Not later than 2 years after the date of enactment
of this Act, the Comptroller General shall submit to the
appropriate committees of the Congress a report containing the
results of the study conducted under paragraph (1), including--
(A) a summary of the findings of the study; and
(B) recommendations based on the results of the study,
including recommendations for such areas of research and
legislative and administrative action as the Comptroller
General determines appropriate.

8c6c506bf8b60d4688747dd411aaa183d530a4f764d4faea848cfc9fb7b5824a

TITLE II

-LAW ENFORCEMENT AND TREATMENT

Part D of title V of the Public Health Service Act (42 U.S.C. 290dd
et seq.), as amended by section 110, is further amended by adding at
the end the following:
``SEC. 546. FIRST RESPONDER TRAINING.
``(a) Program Authorized.--The Secretary shall make grants to
States, local governmental entities, and Indian tribes and tribal
organizations (as defined in section 4 of the Indian Self-Determination
and Education Assistance Act) to allow first responders and members of
other key community sectors to administer a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act for emergency
treatment of known or suspected opioid overdose.
``(b) Application.--
``(1) In general.--An entity seeking a grant under this section
shall submit an application to the Secretary--
``(A) that meets the criteria under paragraph (2); and
``(B) at such time, in such manner, and accompanied by such
information as the Secretary may require.
``(2) Criteria.--An entity, in submitting an application under
paragraph (1), shall--
``(A) describe the evidence-based methodology and outcome
measurements 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;
``(B) describe how the program could be broadly replicated
if demonstrated to be effective;
``(C) identify the governmental and community agencies with
which the entity will coordinate to implement the program; and
``(D) describe how the entity will ensure that law
enforcement agencies will coordinate with their corresponding
State substance abuse and mental health agencies to identify
protocols and resources that are available to overdose victims
and families, including information on treatment and recovery
resources.
``(c) Use of Funds.--An entity shall use a grant received under
this section to--
``(1) make a drug or device approved or cleared under the
Federal Food, Drug, and Cosmetic Act for emergency treatment of
known or suspected opioid overdose available to be carried and
administered by first responders and members of other key community
sectors;
``(2) train and provide resources for first responders and
members of other key community sectors on carrying and
administering a drug or device approved or cleared under the
Federal Food, Drug, and Cosmetic Act for emergency treatment of
known or suspected opioid overdose; and
``(3) establish processes, protocols, and mechanisms for
referral to appropriate treatment, which may include an outreach
coordinator or team to connect individuals receiving opioid
overdose reversal drugs to followup services.
``(d) Technical Assistance Grants.--The Secretary shall make a
grant for the purpose of providing technical assistance and training on
the use of a drug or device approved or cleared under the Federal Food,
Drug, and Cosmetic Act for emergency treatment of known or suspected
opioid overdose, and mechanisms for referral to appropriate treatment
for an entity receiving a grant under this section.
``(e) Geographic Distribution.--In making grants under this
section, the Secretary shall ensure that not less than 20 percent of
grant funds are awarded to eligible entities that are not located in
metropolitan statistical areas (as defined by the Office of Management
and Budget). The Secretary shall take into account the unique needs of
rural communities, including communities with an incidence of
individuals with opioid use disorder that is above the national average
and communities with a shortage of prevention and treatment services.
``(f) Evaluation.--The Secretary shall conduct an evaluation of
grants made under this section to determine--
``(1) the number of first responders and members of other key
community sectors equipped with a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose;
``(2) the number of opioid and heroin overdoses reversed by
first responders and members of other key community sectors
receiving training and supplies of a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose, through
a grant received under this section;
``(3) the number of responses to requests for services by the
entity or subgrantee, to 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.
``(g) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $12,000,000 for each of fiscal
years 2017 through 2021.''.

9073e118263053ba85b7805ddaa4b89c97b0a7347fe40f6193c26462b190bab6

(a) Definition of Covered Entity.--In this section, the term
``covered entity'' means--
(1) a State, local, or tribal law enforcement agency;
(2) a manufacturer, distributor, or reverse distributor of
prescription medications;
(3) a retail pharmacy;
(4) a registered narcotic treatment program;
(5) a hospital or clinic with an onsite pharmacy;
(6) an eligible long-term care facility; or
(7) any other entity authorized by the Drug Enforcement
Administration to dispose of prescription medications.
(b) Program Authorized.--The Attorney General, in coordination with
the Administrator of the Drug Enforcement Administration, the Secretary
of Health and Human Services, and the Director of the Office of
National Drug Control Policy, shall coordinate with covered entities in
expanding or making available disposal sites for unwanted prescription
medications.

70bfbcffa394026e9c0870369afd9e1ed7aadcbb022ade7d5fe572a4b3745f40

AND INTERVENTIONS DEMONSTRATION.
Subpart 1 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb et seq.) is amended by adding at the end the following:
``SEC. 514B. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN TREATMENT
AND INTERVENTIONS DEMONSTRATION.
``(a) Grants To Expand Access.--
``(1) Authority to award grants.--The Secretary shall award
grants, contracts, or cooperative agreements to State substance
abuse agencies, units of local government, nonprofit organizations,
and Indian tribes and tribal organizations (as defined in section 4
of the Indian Self-Determination and Education Assistance Act) that
have a high rate, or have had a rapid increase, in the use of
heroin or other opioids, in order to permit such entities to expand
activities, including an expansion in the availability of evidence-
based medication-assisted treatment and other clinically
appropriate services, with respect to the treatment of addiction in
the specific geographical areas of such entities where there is a
high rate or rapid increase in the use of heroin or other opioids,
such as in rural areas.
``(2) Nature of activities.--Funds awarded under paragraph (1)
shall be used for activities that are based on reliable scientific
evidence of efficacy in the treatment of problems related to heroin
or other opioids.
``(b) Application.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a), an entity shall submit an
application to the Secretary at such time, in such manner, and
accompanied by such information as the Secretary may reasonably
require.
``(c) Evaluation.--An entity that receives a grant, contract, or
cooperative agreement under subsection (a) shall submit, in the
application for such grant, contract, or agreement a plan for the
evaluation of any project undertaken with funds provided under this
section. Such entity shall provide the Secretary with periodic
evaluations of the progress of such project and an evaluation at the
completion of such project as the Secretary determines to be
appropriate.
``(d) Geographic Distribution.--In awarding grants, contracts, and
cooperative agreements under this section, the Secretary shall ensure
that not less than 15 percent of funds are awarded to eligible entities
that are not located in metropolitan statistical areas (as defined by
the Office of Management and Budget). The Secretary shall take into
account the unique needs of rural communities, including communities
with an incidence of individuals with opioid use disorder that is above
the national average and communities with a shortage of prevention and
treatment services.
``(e) Additional Activities.--In administering grants, contracts,
and cooperative agreements under subsection (a), the Secretary shall--
``(1) evaluate the activities supported under such subsection;
``(2) disseminate information, as appropriate, derived from
evaluations as the Secretary considers appropriate;
``(3) provide States, Indian tribes and tribal organizations,
and providers with technical assistance in connection with the
provision of treatment of problems related to heroin and other
opioids; and
``(4) fund only those applications that specifically support
recovery services as a critical component of the program involved.
``(f) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $25,000,000 for each of fiscal
years 2017 through 2021.''.

49760e8a3d4631c80a839296a6e1bc5c5344957c176163b19630f3c2e86c74c3

Part D of title V of the Public Health Service Act (42 U.S.C. 290dd
et seq.), as amended by section 202, is further amended by adding at
the end the following:
``SEC. 547. BUILDING COMMUNITIES OF RECOVERY.
``(a) Definition.--In this section, the term `recovery community
organization' means an independent nonprofit organization that--
``(1) mobilizes resources within and outside of the recovery
community to increase the prevalence and quality of long-term
recovery from substance use disorders; and
``(2) is wholly or principally governed by people in recovery
for substance use disorders who reflect the community served.
``(b) Grants Authorized.--The Secretary shall award grants to
recovery community organizations to enable such organizations to
develop, expand, and enhance recovery services.
``(c) Federal Share.--The Federal share of the costs of a program
funded by a grant under this section may not exceed 50 percent.
``(d) Use of Funds.--Grants awarded under subsection (b)--
``(1) shall be used to develop, expand, and enhance community
and statewide recovery support services; and
``(2) may be used to--
``(A) build connections between recovery networks, between
recovery community organizations, and with other recovery
support services, including--
``(i) behavioral health providers;
``(ii) primary care providers and physicians;
``(iii) the criminal justice system;
``(iv) employers;
``(v) housing services;
``(vi) child welfare agencies; and
``(vii) other recovery support services that facilitate
recovery from substance use disorders;
``(B) reduce the stigma associated with substance use
disorders; and
``(C) conduct outreach on issues relating to substance use
disorders and recovery, including--
``(i) identifying the signs of addiction;
``(ii) the resources available to individuals
struggling with addiction and to families with a family
member struggling with, or being treated for, addiction,
including programs that mentor and provide support services
to children;
``(iii) the resources available to help support
individuals in recovery; and
``(iv) related medical outcomes of substance use
disorders, the potential of acquiring an infectious disease
from intravenous drug use, and neonatal abstinence syndrome
among infants exposed to opioids during pregnancy.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $1,000,000 for each of fiscal
years 2017 through 2021.''.

91242931873ba4b4dbb42684925f2802cd41f85882f594049de420c578458872

ADDICTION.
(a) In General.--
(1) In general.--Section 303(g)(2) of the Controlled Substances
Act (21 U.S.C. 823(g)(2)) is amended--
(A) in subparagraph (B), by striking clauses (i), (ii), and
(iii) and inserting the following:
``(i) The practitioner is a qualifying practitioner (as defined
in subparagraph (G)).
``(ii) With respect to patients to whom the practitioner will
provide such drugs or combinations of drugs, the practitioner has
the capacity to provide directly, by referral, or in such other
manner as determined by the Secretary--
``(I) all drugs approved by the Food and Drug
Administration for the treatment of opioid use disorder,
including for maintenance, detoxification, overdose reversal,
and relapse prevention; and
``(II) appropriate counseling and other appropriate
ancillary services.
``(iii)(I) The total number of such patients of the
practitioner at any one time will not exceed the applicable number.
Except as provided in subclause (II), the applicable number is 30.
``(II) The applicable number is 100 if, not sooner than 1 year
after the date on which the practitioner submitted the initial
notification, the practitioner submits a second notification to the
Secretary of the need and intent of the practitioner to treat up to
100 patients.
``(III) The Secretary may by regulation change such applicable
number.
``(IV) The Secretary may exclude from the applicable number
patients to whom such drugs or combinations of drugs are directly
administered by the qualifying practitioner in the office
setting.'';
(B) in subparagraph (D)--
(i) in clause (ii), by striking ``Upon receiving a
notification under subparagraph (B)'' and inserting ``Upon
receiving a determination from the Secretary under clause
(iii) finding that a practitioner meets all requirements
for a waiver under subparagraph (B)''; and
(ii) in clause (iii)--
(I) by inserting ``and shall forward such
determination to the Attorney General'' before the
period at the end of the first sentence; and
(II) by striking ``physician'' and inserting
``practitioner'';
(C) in subparagraph (G)--
(i) by amending clause (ii)(I) to read as follows:
``(I) The physician holds a board certification in
addiction psychiatry or addiction medicine from the
American Board of Medical Specialties.'';
(ii) by amending clause (ii)(II) to read as follows:
``(II) The physician holds an addiction
certification or board certification from the American
Society of Addiction Medicine or the American Board of
Addiction Medicine.'';
(iii) in clause (ii)(III), by striking
``subspecialty'';
(iv) by amending clause (ii)(IV) to read as follows:
``(IV) The physician has, with respect to the treatment and
management of opiate-dependent patients, completed not less
than 8 hours of training (through classroom situations,
seminars at professional society meetings, electronic
communications, or otherwise) that is provided by the American
Society of Addiction Medicine, the American Academy of
Addiction Psychiatry, the American Medical Association, the
American Osteopathic Association, the American Psychiatric
Association, or any other organization that the Secretary
determines is appropriate for purposes of this subclause. Such
training shall include--
``(aa) opioid maintenance and detoxification;
``(bb) appropriate clinical use of all drugs approved
by the Food and Drug Administration for the treatment of
opioid use disorder;
``(cc) initial and periodic patient assessments
(including substance use monitoring);
``(dd) individualized treatment planning, overdose
reversal, and relapse prevention;
``(ee) counseling and recovery support services;
``(ff) staffing roles and considerations;
``(gg) diversion control; and
``(hh) other best practices, as identified by the
Secretary.''; and
(v) by adding at the end the following:
``(iii) The term `qualifying practitioner' means--
``(I) a qualifying physician, as defined in clause (ii); or
``(II) during the period beginning on the date of enactment
of the Comprehensive Addiction and Recovery Act of 2016 and
ending on October 1, 2021, a qualifying other practitioner, as
defined in clause (iv).
``(iv) The term `qualifying other practitioner' means a nurse
practitioner or physician assistant who satisfies each of the
following:
``(I) The nurse practitioner or physician assistant is
licensed under State law to prescribe schedule III, IV, or V
medications for the treatment of pain.
``(II) The nurse practitioner or physician assistant has--
``(aa) completed not fewer than 24 hours of initial
training addressing each of the topics listed in clause
(ii)(IV) (through classroom situations, seminars at
professional society meetings, electronic communications,
or otherwise) provided by the American Society of Addiction
Medicine, the American Academy of Addiction Psychiatry, the
American Medical Association, the American Osteopathic
Association, the American Nurses Credentialing Center, the
American Psychiatric Association, the American Association
of Nurse Practitioners, the American Academy of Physician
Assistants, or any other organization that the Secretary
determines is appropriate for purposes of this subclause;
or
``(bb) has such other training or experience as the
Secretary determines will demonstrate the ability of the
nurse practitioner or physician assistant to treat and
manage opiate-dependent patients.
``(III) The nurse practitioner or physician assistant is
supervised by, or works in collaboration with, a qualifying
physician, if the nurse practitioner or physician assistant is
required by State law to prescribe medications for the
treatment of opioid use disorder in collaboration with or under
the supervision of a physician.
The Secretary may, by regulation, revise the requirements for being
a qualifying other practitioner under this clause.''; and
(D) in subparagraph (H)--
(i) in clause (i), by inserting after subclause (II)
the following:
``(III) Such other elements of the requirements under this
paragraph as the Secretary determines necessary for purposes of
implementing such requirements.''; and
(ii) by amending clause (ii) to read as follows:
``(ii) Not later than 18 months after the date of enactment of the
Opioid Use Disorder Treatment Expansion and Modernization Act, the
Secretary shall update the treatment improvement protocol containing
best practice guidelines for the treatment of opioid-dependent patients
in office-based settings. The Secretary shall update such protocol in
consultation with experts in opioid use disorder research and
treatment.''.
(2) Opioid defined.--Section 102(18) of the Controlled
Substances Act (21 U.S.C. 802(18)) is amended by inserting ``or
`opioid''' after ``The term `opiate'''.
(3) Reports to congress.--
(A) In general.--Not later than 3 years after the date of
enactment of this Act and not later than 3 years thereafter,
the Secretary of Health and Human Services, in consultation
with the Drug Enforcement Administration and experts in opioid
use disorder research and treatment, shall--
(i) perform a thorough review of the provision of
opioid use disorder treatment services in the United
States, including services provided in opioid treatment
programs and other specialty and nonspecialty settings; and
(ii) submit a report to the Congress on the findings
and conclusions of such review.
(B) Contents.--Each report under subparagraph (A) shall
include an assessment of--
(i) compliance with the requirements of section
303(g)(2) of the Controlled Substances Act (21 U.S.C.
823(g)(2)), as amended by this section;
(ii) the measures taken by the Secretary of Health and
Human Services to ensure such compliance;
(iii) whether there is further need to increase or
decrease the number of patients a practitioner, pursuant to
a waiver under section 303(g)(2) of the Controlled
Substances Act (21 U.S.C. 823(g)(2)), is permitted to
treat;
(iv) the extent to which, and proportions with which,
the full range of Food and Drug Administration-approved
treatments for opioid use disorder are used in routine
health care settings and specialty substance use disorder
treatment settings;
(v) access to, and use of, counseling and recovery
support services, including the percentage of patients
receiving such services;
(vi) changes in State or local policies and legislation
relating to opioid use disorder treatment;
(vii) the use of prescription drug monitoring programs
by practitioners who are permitted to dispense narcotic
drugs to individuals pursuant to a waiver described in
clause (iii);
(viii) the findings resulting from inspections by the
Drug Enforcement Administration of practitioners described
in clause (vii); and
(ix) the effectiveness of cross-agency collaboration
between Department of Health and Human Services and the
Drug Enforcement Administration for expanding effective
opioid use disorder treatment.
(b) State Flexibility.--Section 303(g)(2) of the Controlled
Substances Act (21 U.S.C. 823(g)(2)) is amended by striking
subparagraphs (I) and (J), and inserting the following:
``(I) Notwithstanding section 708, nothing in this paragraph shall
be construed to preempt any State law that--
``(i) permits a qualifying practitioner to dispense narcotic
drugs in schedule III, IV, or V, or combinations of such drugs, for
maintenance or detoxification treatment in accordance with this
paragraph to a total number of patients that is more than 30 or
less than the total number applicable to the qualifying
practitioner under subparagraph (B)(iii)(II) if a State enacts a
law modifying such total number and the Attorney General is
notified by the State of such modification; or
``(ii) requires a qualifying practitioner to comply with
additional requirements relating to the dispensing of narcotic
drugs in schedule III, IV, or V, or combinations of such drugs,
including requirements relating to the practice setting in which
the qualifying practitioner practices and education, training, and
reporting requirements.''.
(c) Update Regulations.--Not later than 18 months after the date of
enactment of this Act, the Attorney General and the Secretary of Health
and Human Services, as appropriate, shall update regulations regarding
practitioners described in subsection (a)(3)(B)(vii) (as amended by
this section) to include nurse practitioners and physician assistants
to ensure the quality of patient care and prevent diversion.

f39f8e2f1c239b852ea37cd7c5f22270be23de63cb58b8b7e1b3ec81cb84f2f1

(a) Report Required.--Not later than 1 year after the date of
enactment of this Act, the Comptroller General of the United States
shall submit to the Committee on the Judiciary of the Senate and the
Committee on the Judiciary of the House of Representatives a report
that--
(1) describes the collateral consequences for individuals with
convictions for nonviolent drug-related offenses;
(2) describes the effect of the collateral consequences
described in paragraph (1) on individuals in resuming their
personal and professional activities, especially, to the extent
data are available, the effect on individuals who are participating
in or have completed a recovery program for a substance use
disorder;
(3) discusses policy bases and justifications for imposing
collateral consequences on individuals convicted of nonviolent
drug-related offenses identified under paragraph (1); and
(4) provides perspectives on the potential for mitigating the
effect of the collateral consequences described in paragraph (1) on
individuals who are participating in or have completed a recovery
program, while also taking into account the policy interests
described in paragraph (3).
(b) Definition.--In this section, the term ``collateral
consequence''--
(1) means a penalty, disability, or disadvantage imposed upon
an individual as a result of a criminal conviction for a drug-
related offense--
(A) automatically by operation of law; or
(B) by authorized action of an administrative agency or
court on a case-by-case basis; and
(2) does not include a direct consequence imposed as part of
the judgment of a court at sentencing, including a term of
imprisonment or community supervision, or a fine.
VETERANS

c323b57174181c5934dc7d34927992b8276614e5ff28e10bee7e5db52e97af4d

(a) General Amendments to the Residential Treatment Program for
Pregnant and Postpartum Women.--Section 508 of the Public Health
Service Act (42 U.S.C. 290bb-1) is amended--
(1) in subsection (a)--
(A) in the matter preceding paragraph (1)--
(i) by inserting ``(referred to in this section as the
`Director')'' after ``Substance Abuse Treatment'';
(ii) by striking ``grants, cooperative agreement,'' and
inserting ``grants, including the grants under subsection
(r), cooperative agreements''; and
(iii) by striking ``for substance abuse'' and inserting
``for substance use disorders''; and
(B) in paragraph (1), by inserting ``or receive outpatient
treatment services from'' after ``reside in'';
(2) in subsection (b)(2), by inserting ``and her children''
before the period at the end;
(3) in subsection (c)--
(A) in paragraph (1), by striking ``to the woman of the
services'' and inserting ``of services for the woman and her
children''; and
(B) in paragraph (2)--
(i) in subparagraph (A), by striking ``substance
abuse'' and inserting ``substance use disorders''; and
(ii) in subparagraph (B), by striking ``such abuse''
and inserting ``such a disorder'';
(4) in subsection (d)--
(A) in paragraph (3)(A), by striking ``maternal substance
abuse'' and inserting ``a maternal substance use disorder'';
(B) by amending paragraph (4) to read as follows:
``(4) Providing therapeutic, comprehensive child care for
children during the periods in which the woman is engaged in
therapy or in other necessary health and rehabilitative
activities.'';
(C) in paragraphs (9), (10), and (11), by striking
``women'' each place such term appears and inserting ``woman'';
(D) in paragraph (9), by striking ``units'' and inserting
``unit''; and
(E) in paragraph (11)--
(i) in subparagraph (A), by striking ``their children''
and inserting ``any child of such woman'';
(ii) in subparagraph (B), by striking ``; and'' and
inserting a semicolon;
(iii) in subparagraph (C), by striking the period and
inserting ``; and''; and
(iv) by adding at the end the following:
``(D) family reunification with children in kinship or
foster care arrangements, where safe and appropriate.'';
(5) in subsection (e)--
(A) in paragraph (1)--
(i) in the matter preceding subparagraph (A), by
striking ``substance abuse'' and inserting ``substance use
disorders''; and
(ii) in subparagraph (B), by striking ``substance
abuse'' and inserting ``substance use disorders''; and
(B) in paragraph (2)--
(i) by striking ``(A) Subject'' and inserting the
following:
``(A) In general.--Subject'';
(ii) in subparagraph (B)--
(I) by striking ``(B)(i) In the case'' and
inserting the following:
``(B) Waiver of participation agreements.--
``(i) In general.--In the case''; and
(II) by striking ``(ii) A determination'' and
inserting the following:
``(ii) Donations.--A determination''; and
(iii) by striking ``(C) With respect'' and inserting
the following:
``(C) Nonapplication of certain requirements.--With
respect'';
(6) in subsection (g)--
(A) by striking ``who are engaging in substance abuse'' and
inserting ``who have a substance use disorder''; and
(B) by striking ``such abuse'' and inserting ``such
disorder'';
(7) in subsection (j)--
(A) in the matter preceding paragraph (1), by striking ``to
on'' and inserting ``to or on''; and
(B) in paragraph (3), by striking ``Office for'' and
inserting ``Office of'';
(8) by amending subsection (m) to read as follows:
``(m) Allocation of Awards.--In making awards under subsection (a),
the Director shall give priority to an applicant that agrees to use the
award for a program serving an area that is a rural area, an area
designated under section 332 by the Secretary as a health professional
shortage area, or an area determined by the Director to have a shortage
of family-based substance use disorder treatment options.''; and
(9) in subsection (q)--
(A) in paragraph (3), by striking ``funding agreement under
subsection (a)'' and inserting ``funding agreement''; and
(B) in paragraph (4), by striking ``substance abuse'' and
inserting ``a substance use disorder''.
(b) Reauthorization of Program.--Section 508 of the Public Health
Service Act (42 U.S.C. 290bb-1), as amended by subsection (a), is
further amended--
(1) in subsection (p), in the first sentence, by inserting
``(other than subsection (r))'' after ``section''; and
(2) in subsection (r), by striking ``such sums'' and all that
follows through ``2003'' and inserting ``$16,900,000 for each of
fiscal years 2017 through 2021''.
(c) Pilot Program Grants for State Substance Abuse Agencies.--
(1) In general.--Section 508 of the Public Health Service Act
(42 U.S.C. 290bb-1), as amended by subsections (a) and (b), is
further amended--
(A) by redesignating subsection (r), as amended by
subsection (b), as subsection (s); and
(B) by inserting after subsection (q) the following new
subsection:
``(r) Pilot Program for State Substance Abuse Agencies.--
``(1) In general.--From amounts made available under subsection
(s), the Director of the Center for Substance Abuse Treatment shall
carry out a pilot program under which competitive grants are made
by the Director to State substance abuse agencies--
``(A) to enhance flexibility in the use of funds designed
to support family-based services for pregnant and postpartum
women with a primary diagnosis of a substance use disorder,
including opioid use disorders;
``(B) to help State substance abuse agencies address
identified gaps in services furnished to such women along the
continuum of care, including services provided to women in
nonresidential-based settings; and
``(C) to promote a coordinated, effective, and efficient
State system managed by State substance abuse agencies by
encouraging new approaches and models of service delivery.
``(2) Requirements.--In carrying out the pilot program under
this subsection, the Director shall--
``(A) require State substance abuse agencies to submit to
the Director applications, in such form and manner and
containing such information as specified by the Director, to be
eligible to receive a grant under the program;
``(B) identify, based on such submitted applications, State
substance abuse agencies that are eligible for such grants;
``(C) require services proposed to be furnished through
such a grant to support family-based treatment and other
services for pregnant and postpartum women with a primary
diagnosis of a substance use disorder, including opioid use
disorders;
``(D) not require that services furnished through such a
grant be provided solely to women that reside in facilities;
``(E) not require that grant recipients under the program
make available through use of the grant all the services
described in subsection (d); and
``(F) consider not applying the requirements described in
paragraphs (1) and (2) of subsection (f) to an applicant,
depending on the circumstances of the applicant.
``(3) Required services.--
``(A) In general.--The Director shall specify a minimum set
of services required to be made available to eligible women
through a grant awarded under the pilot program under this
subsection. Such minimum set of services--
``(i) shall include the services requirements described
in subsection (c) and be based on the recommendations
submitted under subparagraph (B); and
``(ii) may be selected from among the services
described in subsection (d) and include other services as
appropriate.
``(B) Stakeholder input.--The Director shall convene and
solicit recommendations from stakeholders, including State
substance abuse agencies, health care providers, persons in
recovery from substance abuse, and other appropriate
individuals, for the minimum set of services described in
subparagraph (A).
``(4) Duration.--The pilot program under this subsection shall
not exceed 5 years.
``(5) Evaluation and report to congress.--
``(A) In general.--The Director of the Center for
Behavioral Health Statistics and Quality shall evaluate the
pilot program at the conclusion of the first grant cycle funded
by the pilot program.
``(B) Report.--The Director of the Center for Behavioral
Health Statistics and Quality, in coordination with the
Director of the Center for Substance Abuse Treatment shall
submit to the relevant committees of jurisdiction of the House
of Representatives and the Senate a report on the evaluation
under subparagraph (A). The report shall include, at a
minimum--
``(i) outcomes information from the pilot program,
including any resulting reductions in the use of alcohol
and other drugs;
``(ii) engagement in treatment services;
``(iii) retention in the appropriate level and duration
of services;
``(iv) increased access to the use of medications
approved by the Food and Drug Administration for the
treatment of substance use disorders in combination with
counseling; and
``(v) other appropriate measures.
``(C) Recommendation.--The report under subparagraph (B)
shall include a recommendation by the Director of the Center
for Substance Abuse Treatment as to whether the pilot program
under this subsection should be extended.
``(6) State substance abuse agencies defined.--For purposes of
this subsection, the term `State substance abuse agency' means,
with respect to a State, the agency in such State that manages the
Substance Abuse Prevention and Treatment Block Grant under part B
of title XIX.''.
(2) Funding.--Subsection (s) of section 508 of the Public
Health Service Act (42 U.S.C. 290bb-1), as amended by subsection
(a) and redesignated by paragraph (1), is further amended by adding
at the end the following new sentences: ``Of the amounts made
available for a year pursuant to the previous sentence to carry out
this section, not more than 25 percent of such amounts shall be
made available for such year to carry out subsection (r), other
than paragraph (5) of such subsection. Notwithstanding the
preceding sentence, no funds shall be made available to carry out
subsection (r) for a fiscal year unless the amount made available
to carry out this section for such fiscal year is more than the
amount made available to carry out this section for fiscal year
2016.''.

5da2bea4e12fd8acf6c05ed25aefeb05502bd2feb8df2e81b546f9785e146469

Section 2991 of the Omnibus Crime Control and Safe Streets Act of
1968 (42 U.S.C. 3797aa) is amended--
(1) by redesignating subsection (i) as subsection (j); and
(2) by inserting after subsection (h) the following:
``(i) Assisting Veterans.--
``(1) Definitions.--In this subsection:
``(A) Peer-to-peer services or programs.--The term `peer-
to-peer services or programs' means services or programs that
connect qualified veterans with other veterans for the purpose
of providing support and mentorship to assist qualified
veterans in obtaining treatment, recovery, stabilization, or
rehabilitation.
``(B) Qualified veteran.--The term `qualified veteran'
means a preliminarily qualified offender who--
``(i) served on active duty in any branch of the Armed
Forces, including the National Guard or Reserves; and
``(ii) was discharged or released from such service
under conditions other than dishonorable, unless the reason
for the dishonorable discharge was attributable to a
substance abuse disorder.
``(C) Veterans treatment court program.--The term `veterans
treatment court program' means a court program involving
collaboration among criminal justice, veterans, and mental
health and substance abuse agencies that provides qualified
veterans with--
``(i) intensive judicial supervision and case
management, which may include random and frequent drug
testing where appropriate;
``(ii) a full continuum of treatment services,
including mental health services, substance abuse services,
medical services, and services to address trauma;
``(iii) alternatives to incarceration; or
``(iv) other appropriate services, including housing,
transportation, mentoring, employment, job training,
education, or assistance in applying for and obtaining
available benefits.
``(2) Veterans assistance program.--
``(A) In general.--The Attorney General, in consultation
with the Secretary of Veterans Affairs, may award grants under
this subsection to applicants to establish or expand--
``(i) veterans treatment court programs;
``(ii) peer-to-peer services or programs for qualified
veterans;
``(iii) practices that identify and provide treatment,
rehabilitation, legal, transitional, and other appropriate
services to qualified veterans who have been incarcerated;
or
``(iv) training programs to teach criminal justice, law
enforcement, corrections, mental health, and substance
abuse personnel how to identify and appropriately respond
to incidents involving qualified veterans.
``(B) Priority.--In awarding grants under this subsection,
the Attorney General shall give priority to applications that--
``(i) demonstrate collaboration between and joint
investments by criminal justice, mental health, substance
abuse, and veterans service agencies;
``(ii) promote effective strategies to identify and
reduce the risk of harm to qualified veterans and public
safety; and
``(iii) propose interventions with empirical support to
improve outcomes for qualified veterans.''.

b7ce3a38331487a36d9e87d8337cc3e607d2f5b543be034599de3d75a565e1e7

(a) Best Practices for Development of Plans of Safe Care.--Section
103(b) of the Child Abuse Prevention and Treatment Act (42 U.S.C.
5104(b)) is amended--
(1) by redesignating paragraphs (5) through (8) as paragraphs
(6) through (9), respectively; and
(2) by inserting after paragraph (4) the following:
``(5) maintain and disseminate information about the
requirements of section 106(b)(2)(B)(iii) and best practices
relating to the development of plans of safe care as described in
such section for infants born and identified as being affected by
substance abuse or withdrawal symptoms, or a Fetal Alcohol Spectrum
Disorder;''.
(b) State Plans.--Section 106(b)(2)(B) of the Child Abuse
Prevention and Treatment Act (42 U.S.C. 5106a(b)(2)(B)) is amended--
(1) in clause (ii), by striking ``illegal substance abuse'' and
inserting ``substance abuse''; and
(2) in clause (iii)--
(A) by striking ``illegal substance abuse'' and inserting
``substance abuse''; and
(B) by inserting before the semicolon at the end the
following: ``to ensure the safety and well-being of such infant
following release from the care of health care providers,
including through--
``(I) addressing the health and substance use disorder
treatment needs of the infant and affected family or
caregiver; and
``(II) the development and implementation by the State
of monitoring systems regarding the implementation of such
plans to determine whether and in what manner local
entities are providing, in accordance with State
requirements, referrals to and delivery of appropriate
services for the infant and affected family or caregiver''.
(c) Data Reports.--
(1) In general.--Section 106(d) of the Child Abuse Prevention
and Treatment Act (42 U.S.C. 5106a(d)) is amended by adding at the
end of the following:
``(17) The number of infants--
``(A) identified under subsection (b)(2)(B)(ii);
``(B) for whom a plan of safe care was developed under
subsection (b)(2)(B)(iii); and
``(C) for whom a referral was made for appropriate
services, including services for the affected family or
caregiver, under subsection (b)(2)(B)(iii).''.
(2) Redesignation.--Effective on May 29, 2017, section 106(d)
of the Child Abuse Prevention and Treatment Act (42 U.S.C.
5106a(d)) is amended by redesignating paragraph (17) (as added by
paragraph (1)) as paragraph (18).
(d) Monitoring and Oversight.--
(1) Amendment.--Title I of the Child Abuse Prevention and
Treatment Act (42 U.S.C. 5101 et seq.) is amended by adding at the
end the following:
``SEC. 114. MONITORING AND OVERSIGHT.
``The Secretary shall conduct monitoring to ensure that each State
that receives a grant under section 106 is in compliance with the
requirements of section 106(b), which--
``(1) shall--
``(A) be in addition to the review of the State plan upon
its submission under section 106(b)(1)(A); and
``(B) include monitoring of State policies and procedures
required under clauses (ii) and (iii) of section 106(b)(2)(B);
and
``(2) may include--
``(A) a comparison of activities carried out by the State
to comply with the requirements of section 106(b) with the
State plan most recently approved under section 432 of the
Social Security Act;
``(B) a review of information available on the website of
the State relating to its compliance with the requirements of
section 106(b);
``(C) site visits, as may be necessary to carry out such
monitoring; and
``(D) a review of information available in the State's
Annual Progress and Services Report most recently submitted
under section 1357.16 of title 45, Code of Federal Regulations
(or successor regulations).''.
(2) Table of contents.--The table of contents in section 1(b)
of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5101
note) is amended by inserting after the item relating to section
113, the following:
``Sec. 114. Monitoring and oversight.''.
(e) Rule of Construction.--Nothing in this section, or the
amendments made by this section, shall be construed to authorize the
Secretary of Health and Human Services or any other officer of the
Federal Government to add new requirements to section 106(b) of the
Child Abuse Prevention and Treatment Act (42 U.S.C. 5106a(b)), as
amended by this section.

6750daa6338aebaa1b0011eb138da9be557cad158f6f0937a32513ef11633fa7

(a) In General.--Not later than 1 year after the date of the
enactment of this Act, the Comptroller General of the United States
shall submit to the Committee on Energy and Commerce of the House of
Representatives and the Committee on Finance and the Committee on
Health, Education, Labor, and Pensions of the Senate a report on
neonatal abstinence syndrome (in this section referred to as ``NAS'')
in the United States.
(b) Information To Be Included in Report.--Such report shall
include information on the following:
(1) The prevalence of NAS in the United States, including the
proportion of children born in the United States with NAS who are
eligible for medical assistance under State Medicaid programs under
title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) at
birth, and the costs associated with coverage under such programs
for treatment of infants with NAS.
(2) The services for which coverage is available under State
Medicaid programs for treatment of infants with NAS.
(3) The settings (including inpatient, outpatient, hospital-
based, and other settings) for the treatment of infants with NAS
and the reimbursement methodologies and costs associated with such
treatment in such settings.
(4) The prevalence of utilization of various care settings
under State Medicaid programs for treatment of infants with NAS and
any Federal barriers to treating such infants under such programs,
particularly in non-hospital-based settings.
(5) What is known about best practices for treating infants
with NAS.
(c) Recommendations.--Such report also shall include such
recommendations as the Comptroller General determines appropriate for
improvements that will ensure access to treatment for infants with NAS
under State Medicaid programs.
PRESCRIPTION OPIOID ABUSE

1c8bf17860d77b6d316ea6c3c181a42cceefcedc6e722643e053150188eb6659

RESPONSE.
Part D of title V of the Public Health Service Act (42 U.S.C. 290dd
et seq.), as amended by section 302, is further amended by adding at
the end the following:
``SEC. 548. STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE OPIOID
ABUSE RESPONSE.
``(a) Definitions.--In this section:
``(1) Dispenser.--The term `dispenser' has the meaning given
the term in section 102 of the Controlled Substances Act (21 U.S.C.
802).
``(2) Prescriber.--The term `prescriber' means a dispenser who
prescribes a controlled substance, or the agent of such a
dispenser.
``(3) Prescriber of a schedule ii, iii, or iv controlled
substance.--The term `prescriber of a schedule II, III, or IV
controlled substance' does not include a prescriber of a schedule
II, III, or IV controlled substance that dispenses the substance--
``(A) for use on the premises on which the substance is
dispensed;
``(B) in a hospital emergency room, when the substance is
in short supply;
``(C) for a certified opioid treatment program; or
``(D) in other situations as the Secretary may reasonably
determine.
``(4) Schedule ii, iii, or iv controlled substance.--The term
`schedule II, III, or IV controlled substance' means a controlled
substance that is listed on schedule II, schedule III, or schedule
IV of section 202(c) of the Controlled Substances Act.
``(b) Grants for Comprehensive Opioid Abuse Response.--
``(1) In general.--The Secretary shall award grants to States,
and combinations of States, to implement an integrated opioid abuse
response initiative.
``(2) Purposes.--A State receiving a grant under this section
shall establish a comprehensive response plan to opioid abuse,
which may include--
``(A) education efforts around opioid use, treatment, and
addiction recovery, including education of residents, medical
students, and physicians and other prescribers of schedule II,
III, or IV controlled substances on relevant prescribing
guidelines, the prescription drug monitoring program of the
State described in subparagraph (B), and overdose prevention
methods;
``(B) establishing, maintaining, or improving a
comprehensive prescription drug monitoring program to track
dispensing of schedule II, III, or IV controlled substances,
which may--
``(i) provide for data sharing with other States; and
``(ii) allow all individuals authorized by the State to
write prescriptions for schedule II, III, or IV controlled
substances to access the prescription drug monitoring
program of the State;
``(C) developing, implementing, or expanding prescription
drug and opioid addiction treatment programs by--
``(i) expanding the availability of treatment for
prescription drug and opioid addiction, including
medication-assisted treatment and behavioral health
therapy, as appropriate;
``(ii) developing, implementing, or expanding screening
for individuals in treatment for prescription drug and
opioid addiction for hepatitis C and HIV, and treating or
referring those individuals if clinically appropriate; or
``(iii) developing, implementing, or expanding recovery
support services and programs at high schools or
institutions of higher education;
``(D) developing, implementing, and expanding efforts to
prevent overdose death from opioid abuse or addiction to
prescription medications and opioids; and
``(E) advancing the education and awareness of the public,
providers, patients, consumers, and other appropriate entities
regarding the dangers of opioid abuse, safe disposal of
prescription medications, and detection of early warning signs
of opioid use disorders.
``(3) Application.--A State seeking a grant under this section
shall submit to the Secretary an application in such form, and
containing such information, as the Secretary may reasonably
require.
``(4) Use of funds.--A State that receives a grant under this
section shall use the grant for the cost, including the cost for
technical assistance, training, and administration expenses, of
carrying out an integrated opioid abuse response initiative as
outlined by the State's comprehensive response plan to opioid abuse
established under paragraph (2).
``(5) Priority considerations.--In awarding grants under this
section, the Secretary shall, as appropriate, give priority to a
State that--
``(A)(i) provides civil liability protection for first
responders, health professionals, and family members who have
received appropriate training in administering a drug or device
approved or cleared under the Federal Food, Drug, and Cosmetic
Act for emergency treatment of known or suspected opioid
overdose; and
``(ii) submits to the Secretary 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, health care
professionals, family members, and other individuals who--
``(aa) have received appropriate training in
administering a drug or device approved or cleared
under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid
overdose; and
``(bb) may administer a drug or device approved or
cleared under the Federal Food, Drug, and Cosmetic Act
for emergency treatment of known or suspected opioid
overdose; and
``(II) concluded that the law described in subclause
(I) provides adequate civil liability protection applicable
to such persons;
``(B) has a process for enrollment in services and benefits
necessary by criminal justice agencies to initiate or continue
treatment in the community, under which an individual who is
incarcerated may, while incarcerated, enroll in services and
benefits that are necessary for the individual to continue
treatment upon release from incarceration;
``(C) ensures the capability of data sharing with other
States, where applicable, such as by making data available to a
prescription monitoring hub;
``(D) ensures that data recorded in the prescription drug
monitoring program database of the State are regularly updated,
to the extent possible;
``(E) ensures that the prescription drug monitoring program
of the State notifies prescribers and dispensers of schedule
II, III, or IV controlled substances when overuse or misuse of
such controlled substances by patients is suspected; and
``(F) has in effect one or more statutes or implements
policies that maximize use of prescription drug monitoring
programs by individuals authorized by the State to prescribe
schedule II, III, or IV controlled substances.
``(6) Evaluation.--In conducting an evaluation of the program
under this section pursuant to section 701 of the Comprehensive
Addiction and Recovery Act of 2016, with respect to a State, the
Secretary shall report on State legislation or policies related to
maximizing the use of prescription drug monitoring programs and the
incidence of opioid use disorders and overdose deaths in such
State.
``(7) States with local prescription drug monitoring
programs.--
``(A) In general.--In the case of a State that does not
have a prescription drug monitoring program, a county or other
unit of local government within the State that has a
prescription drug monitoring program shall be treated as a
State for purposes of this section, including for purposes of
eligibility for grants under paragraph (1).
``(B) Plan for interoperability.--In submitting an
application to the Secretary under paragraph (3), a county or
other unit of local government shall submit a plan outlining
the methods such county or unit of local government shall use
to ensure the capability of data sharing with other counties
and units of local government within the state and with other
States, as applicable.
``(c) Authorization of Funding.--For the purpose of carrying out
this section, there are authorized to be appropriated $5,000,000 for
each of fiscal years 2017 through 2021.''.

8b1742b8bcb2f8af0086e9887e57f1bb168d547101734912796742315d1a8dc2

(a) Department of Justice Grant Accountability.--Part LL of title I
of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C.
3711 et seq.), as added by section 201, is amended by adding at the end
the following:
``SEC. 3026. GRANT ACCOUNTABILITY.
``(a) Definition of Applicable Committees.--In this section, the
term `applicable committees' means--
``(1) the Committee on the Judiciary of the Senate; and
``(2) the Committee on the Judiciary of the House of
Representatives.
``(b) Accountability.--All grants awarded by the Attorney General
under this part shall be subject to the following accountability
provisions:
``(1) Audit requirement.--
``(A) Definition.--In this paragraph, the term `unresolved
audit finding' means a finding in the final audit report of the
Inspector General of the Department of Justice that the audited
grantee has utilized grant funds for an unauthorized
expenditure or otherwise unallowable cost that is not closed or
resolved within 12 months after the date on which the final
audit report is issued.
``(B) Audit.--Beginning in the first fiscal year beginning
after the date of enactment of this section, and in each fiscal
year thereafter, the Inspector General of the Department of
Justice shall conduct audits of recipients of grants awarded by
the Attorney General under this part to prevent waste, fraud,
and abuse of funds by grantees. The Inspector General shall
determine the appropriate number of grantees to be audited each
year.
``(C) Mandatory exclusion.--A recipient of grant funds
under this part that is found to have an unresolved audit
finding shall not be eligible to receive grant funds under this
part during the first 2 fiscal years beginning after the end of
the 12-month period described in subparagraph (A).
``(D) Priority.--In awarding grants under this part, the
Attorney General shall give priority to eligible applicants
that did not have an unresolved audit finding during the 3
fiscal years before submitting an application for a grant under
this part.
``(E) Reimbursement.--If an entity is awarded grant funds
under this part during the 2-fiscal-year period during which
the entity is barred from receiving grants under subparagraph
(C), the Attorney General shall--
``(i) deposit an amount equal to the amount of the
grant funds that were improperly awarded to the grantee
into the General Fund of the Treasury; and
``(ii) seek to recoup the costs of the repayment to the
fund from the grant recipient that was erroneously awarded
grant funds.
``(2) Nonprofit organization requirements.--
``(A) Definition.--For purposes of this paragraph and the
grant programs under this part, the term `nonprofit
organization' means an organization that is described in
section 501(c)(3) of the Internal Revenue Code of 1986 and is
exempt from taxation under section 501(a) of such Code.
``(B) Prohibition.--A nonprofit organization that holds
money in offshore accounts for the purpose of avoiding paying
the tax described in section 511(a) of the Internal Revenue
Code of 1986 may not--
``(i) be party to a contract entered into under section
3021(b); or
``(ii) receive a subaward under section 3021(b).
``(C) Disclosure.--Each nonprofit organization that
receives a subaward or is party to a contract entered into
under section 3021(b) and uses the procedures prescribed in
regulations to create a rebuttable presumption of
reasonableness for the compensation of its officers, directors,
trustees, and key employees, shall disclose, in the application
for such contract or subaward, the process for determining such
compensation, including the independent persons involved in
reviewing and approving such compensation, the comparability
data used, and contemporaneous substantiation of the
deliberation and decision. Upon request, the Attorney General
shall make the information disclosed under this subparagraph
available for public inspection.
``(3) Conference expenditures.--
``(A) Limitation.--No amounts made available to the
Attorney General under this part may be used by the Attorney
General, or by any State, unit of local government, or entity
awarded a grant, subaward, or contract under this part, to host
or support any expenditure for conferences that uses more than
$20,000 in funds made available by the Attorney General, unless
the head of the relevant agency, bureau, or program office
provides prior written authorization that the funds may be
expended to host or support the conference.
``(B) Written authorization.--Written authorization under
subparagraph (A) shall include a written estimate of all costs
associated with the conference, including the cost of all food,
beverages, audio-visual equipment, honoraria for speakers, and
entertainment.
``(C) Report.--The Deputy Attorney General shall submit to
the applicable committees an annual report on all conference
expenditures approved by the Attorney General under this
paragraph.
``(4) Annual certification.--Beginning in the first fiscal year
beginning after the date of enactment of this section, the Attorney
General shall submit to the applicable committees an annual
certification--
``(A) indicating whether--
``(i) all audits issued by the Inspector General of the
Department of Justice under paragraph (1) have been
completed and reviewed by the appropriate Assistant
Attorney General or Director;
``(ii) all mandatory exclusions required under
paragraph (1)(C) have been issued; and
``(iii) all reimbursements required under paragraph
(1)(E) have been made; and
``(B) that includes a list of any grant recipients excluded
under paragraph (1) from the previous year.
``(c) Preventing Duplicative Grants.--
``(1) In general.--Before the Attorney General awards a grant
to an applicant under this part, the Attorney General shall compare
potential grant awards with other grants awarded under this part by
the Attorney General to determine if duplicate grant awards are
awarded for the same purpose.
``(2) Report.--If the Attorney General awards duplicate grants
under this part to the same applicant for the same purpose, the
Attorney General shall submit to the applicable committees a report
that includes--
``(A) a list of all duplicate grants awarded under this
part, including the total dollar amount of any duplicate grants
awarded; and
``(B) the reason the Attorney General awarded the duplicate
grants.''.
(b) Evaluation of Performance of Department of Justice Programs.--
(1) Evaluation of justice department comprehensive opioid abuse
grant program.--Not later than 5 years after the date of enactment
of this Act, the Attorney General shall complete an evaluation of
the effectiveness of the Comprehensive Opioid Abuse Grant Program
under part LL of title I of the Omnibus Crime Control and Safe
Streets Act of 1968, as added by section 201, administered by the
Department of Justice based upon the information reported under
paragraph (4).
(2) Interim evaluation.--Not later than 3 years after the date
of enactment of this Act, the Attorney General shall complete an
interim evaluation assessing the nature and extent of the incidence
of opioid abuse and illegal opioid distribution in the United
States.
(3) Metrics and outcomes for evaluation.--Not later than 180
days after the date of enactment of this Act, the Attorney General
shall identify outcomes that are to be achieved by activities
funded by the Comprehensive Opioid Abuse Grant Program and the
metrics by which the achievement of such outcomes shall be
determined.
(4) Metrics data collection.--The Attorney General shall
require grantees under the Comprehensive Opioid Abuse Grant Program
(and those receiving subawards under section 3021(b) of part LL of
title I of the Omnibus Crime Control and Safe Streets Act of 1968,
as added by section 201) to collect and annually report to the
Department of Justice data based upon the metrics identified under
paragraph (3).
(5) Publication of data and findings.--
(A) Publication of outcomes and metrics.--The Attorney
General shall, not later than 30 days after completion of the
requirement under paragraph (3), publish the outcomes and
metrics identified under that paragraph.
(B) Publication of evaluation.--In the case of the interim
evaluation under paragraph (2), and the final evaluation under
paragraph (1), the entity conducting the evaluation shall, not
later than 90 days after such an evaluation is completed,
publish the results of such evaluation and issue a report on
such evaluation to the Committee on the Judiciary of the House
of Representatives and the Committee on the Judiciary of the
Senate. Such report shall also be published along with the data
used to make such evaluation.
(6) Independent evaluation.--For purposes of paragraphs (1),
(2), and (3), the Attorney General shall--
(A) enter into an arrangement with the National Academy of
Sciences; or
(B) enter into a contract or cooperative agreement with an
entity that is not an agency of the Federal Government, and is
qualified to conduct and evaluate research pertaining to opioid
use and abuse, and draw conclusions about overall opioid use
and abuse on the basis of that research.
(c) Department of Health and Human Services Grant Accountability.--
(1) Definitions.--In this subsection:
(A) Applicable committees.--The term ``applicable
committees'' means--
(i) the Committee on Health, Education, Labor and
Pensions of the Senate; and
(ii) the Committee on Energy and Commerce of the House
of Representatives.
(B) Covered grant.--The term ``covered grant'' means a
grant awarded by the Secretary under a program established
under this Act (or an amendment made by this Act, other than
sections 703 through 707), including any grant administered by
the Administrator of the Substance Abuse and Mental Health
Services Administration under section 103.
(C) Grantee.--The term ``grantee'' means the recipient of a
covered grant.
(D) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(2) Accountability measures.--Each covered grant shall be
subject to the following accountability requirements:
(A) Effectiveness report.--The Secretary shall require
grantees to report on the effectiveness of the activities
carried out with amounts made available to carry out the
program under which the covered grant is awarded, including the
number of persons served by such grant, if applicable, the
number of persons seeking services who could not be served by
such grant, and such other information as the Secretary may
prescribe.
(B) Report on prevention of fraud, waste, and abuse.--
(i) In general.--Not later than 1 year after the date
of the enactment of this Act, the Secretary, in
coordination with the Inspector General of the Department
of Health and Human Services, shall submit to the
applicable committees a report on the policies and
procedures the Department has in place to prevent waste,
fraud, and abuse in the administration of covered grants.
(ii) Contents.--The policies and procedures referred to
in clause (i) shall include policies and procedures that
are designed to--
(I) prevent grantees from utilizing funds awarded
through a covered grant for unauthorized expenditures
or otherwise unallowable costs; and
(II) ensure grantees will not receive unwarranted
duplicate grants for the same purpose.
(C) Conference expenditures.--
(i) In general.--No amounts made available to the
Secretary under this Act (or in a provision of law amended
by this Act, other than sections 703 through 707) may be
used by the Secretary, or by any individual or entity
awarded discretionary funds through a cooperative agreement
under a program established under this Act (or in a
provision of law amended by this Act), to host or support
any expenditure for conferences that uses more than $20,000
in funds made available by the Secretary, unless the head
of the relevant operating division or program office
provides prior written authorization that the funds may be
expended to host or support the conference. Such written
authorization shall include a written estimate of all costs
associated with the conference, including the cost of all
food, beverages, audio-visual equipment, honoraria for
speakers, and entertainment.
(ii) Report.--The Secretary (or the Secretary's
designee) shall submit to the applicable committees an
annual report on all conference expenditures approved by
the Secretary under this subparagraph.
(d) Evaluation of Performance of Department of Health and Human
Services Programs.--
(1) Evaluations.--
(A) In general.--Not later than 5 years after the date of
enactment of this Act, except as otherwise provided in this
section, the Secretary of Health and Human Services (in this
subsection referred to as the ``Secretary'') shall complete an
evaluation of any program administered by the Secretary
included in this Act (or an amendment made by this Act,
excluding sections 703 through 707), including any grant
administered by the Administrator of the Substance Abuse and
Mental Health Services Administration under section 103, that
provides grants for the primary purpose of providing assistance
in addressing problems pertaining to opioid abuse based upon
the outcomes and metrics identified under paragraph (2).
(B) Publication.--With respect to each evaluation completed
under subparagraph (A), the Secretary shall, not later than 90
days after the date on which such evaluation is completed,
publish the results of such evaluation and issue a report on
such evaluation to the appropriate committees. Such report
shall also be published along with the data used to make such
evaluation.
(2) Metrics and outcomes.--
(A) In general.--Not later than 180 days after the date of
enactment of this Act, the Secretary shall identify--
(i) outcomes that are to be achieved by activities
funded by the programs described in paragraph (1)(A); and
(ii) the metrics by which the achievement of such
outcomes shall be determined.
(B) Publication.--The Secretary shall, not later than 30
days after completion of the requirement under subparagraph
(A), publish the outcomes and metrics identified under such
subparagraph.
(3) Metrics data collection.--The Secretary shall require
grantees under the programs described in paragraph (1)(A) to
collect, and annually report to the Secretary, data based upon the
metrics identified under paragraph (2)(A).
(4) Independent evaluation.--For purposes of paragraph (1), the
Secretary shall--
(A) enter into an arrangement with the National Academy of
Sciences; or
(B) enter into a contract or cooperative agreement with an
entity that--
(i) is not an agency of the Federal Government; and
(ii) is qualified to conduct and evaluate research
pertaining to opioid use and abuse and draw conclusions
about overall opioid use and abuse on the basis of that
research.
(5) Exception.--If a program described in paragraph (1)(A) is
subject to an evaluation similar to the evaluation required under
such paragraph pursuant to another provision of Federal law, the
Secretary may opt not to conduct an evaluation under such paragraph
with respect to such program.
(e) Additional Report.--In the case of a report submitted under
subsection (c) to the applicable committees, if such report pertains to
a grant under section 103, that report shall also be submitted, in the
same manner and at the same time, to the Committee on Oversight and
Government Reform of the House of Representatives and to the Committee
on the Judiciary of the Senate.
(f) No Additional Funds Authorized.--No additional funds are
authorized to be appropriated to carry out this section.

5766b5548af55154680f5db4ca29bc01528b2799bf90debcee71c8f54c488705

(a) In General.--Section 309 of the Controlled Substances Act (21
U.S.C. 829) is amended by adding at the end the following:
``(f) Partial Fills of Schedule II Controlled Substances.--
``(1) Partial fills.--A prescription for a controlled substance
in schedule II may be partially filled if--
``(A) it is not prohibited by State law;
``(B) the prescription is written and filled in accordance
with this title, regulations prescribed by the Attorney
General, and State law;
``(C) the partial fill is requested by the patient or the
practitioner that wrote the prescription; and
``(D) the total quantity dispensed in all partial fillings
does not exceed the total quantity prescribed.
``(2) Remaining portions.--
``(A) In general.--Except as provided in subparagraph (B),
remaining portions of a partially filled prescription for a
controlled substance in schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 30 days after the
date on which the prescription is written.
``(B) Emergency situations.--In emergency situations, as
described in subsection (a), the remaining portions of a
partially filled prescription for a controlled substance in
schedule II--
``(i) may be filled; and
``(ii) shall be filled not later than 72 hours after
the prescription is issued.
``(3) Currently lawful partial fills.--Notwithstanding
paragraph (1) or (2), in any circumstance in which, as of the day
before the date of enactment of this subsection, a prescription for
a controlled substance in schedule II may be lawfully partially
filled, the Attorney General may allow such a prescription to be
partially filled.''.
(b) Rule of Construction.--Nothing in this section shall be
construed to affect the authority of the Attorney General to allow a
prescription for a controlled substance in schedule III, IV, or V of
section 202(c) of the Controlled Substances Act (21 U.S.C. 812(c)) to
be partially filled.

79cf3d5285a1e01428986651752e790ac5c47ce609d7deb2202f4e1d5de47666

(a) Finding.--The Congress finds that the executive branch,
including the Office of National Drug Control Policy, has a policy
focus on preventing and addressing prescription drug misuse and heroin
use, and has worked with States and municipalities to enact Good
Samaritan laws that would protect caregivers, law enforcement
personnel, and first responders who administer opioid overdose reversal
drugs or devices.
(b) GAO Study on Good Samaritan Laws Pertaining to Treatment of
Opioid Overdoses.--The Comptroller General of the United States shall
submit to the Committee on the Judiciary of the House of
Representatives, the Committee on Oversight and Government Reform of
the House of Representatives, the Committee on the Judiciary of the
Senate, and the Committee on Homeland Security and Governmental Affairs
of the Senate a report on--
(1) the extent to which the Director of National Drug Control
Policy has reviewed Good Samaritan laws, and any findings from such
a review, including findings related to the potential effects of
such laws, if available;
(2) efforts by the Director to encourage the enactment of Good
Samaritan laws; and
(3) a compilation of Good Samaritan laws in effect in the
States, the territories, and the District of Columbia.
(c) Definitions.--In this section--
(1) the term ``Good Samaritan law'' means a law of a State or
unit of local government that exempts from criminal or civil
liability any individual who administers an opioid overdose
reversal drug or device, or who contacts emergency services
providers in response to an overdose; and
(2) the term ``opioid'' means any drug, including heroin,
having an addiction-forming or addiction-sustaining liability
similar to morphine or being capable of conversion into a drug
having such addiction-forming or addiction-sustaining liability.

787e55ad5229567c2f72e3a15a65b700be017de128a406724dcece158d6d34aa

f33c294aebd1dde2554208d6c4a116b38ee87328c658d73c7819ad2530904ba1

DRUGS FROM THE MEDICAID ADDITIONAL REBATE REQUIREMENT FOR NEW
FORMULATIONS OF PRESCRIPTION DRUGS.
(a) In General.--The last sentence of section 1927(c)(2)(C) of the
Social Security Act (42 U.S.C. 1396r-8(c)(2)(C)) is amended by
inserting before the period at the end the following: ``, but does not
include an abuse-deterrent formulation of the drug (as determined by
the Secretary), regardless of whether such abuse-deterrent formulation
is an extended release formulation''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to drugs that are paid for by a State in calendar quarters
beginning on or after the date of the enactment of this Act.

90901413583c78180eae0be51952ce8d1813ac1a2591b224d4c2dd8618609035

ANALYTICS TECHNOLOGIES TO IDENTIFY AND PREVENT WASTE, FRAUD, AND
ABUSE.
(a) In General.--Title XI of the Social Security Act is amended by
inserting after section 1128J (42 U.S.C. 1320a-7k) the following new
section:
``SEC. 1128K. DISCLOSURE OF PREDICTIVE MODELING AND OTHER ANALYTICS
TECHNOLOGIES TO IDENTIFY AND PREVENT WASTE, FRAUD, AND ABUSE.
``(a) Reference to Predictive Modeling Technologies Requirements.--
For provisions relating to the use of predictive modeling and other
analytics technologies to identify and prevent waste, fraud, and abuse
with respect to the Medicare program under title XVIII, the Medicaid
program under title XIX, and the Children's Health Insurance Program
under title XXI, see section 4241 of the Small Business Jobs Act of
2010 (42 U.S.C. 1320a-7m).
``(b) Limiting Disclosure of Predictive Modeling Technologies.--In
implementing such provisions under such section 4241 with respect to
covered algorithms (as defined in subsection (c)), the following shall
apply:
``(1) Nonapplication of foia.--The covered algorithms used or
developed for purposes of such section 4241 (including by the
Secretary or a State (or an entity operating under a contract with
a State)) shall be exempt from disclosure under section 552(b)(3)
of title 5, United States Code.
``(2) Limitation with respect to use and disclosure of
information by state agencies.--
``(A) In general.--A State agency may not use or disclose
covered algorithms used or developed for purposes of such
section 4241 except for purposes of administering the State
plan (or a waiver of the plan) under the Medicaid program under
title XIX or the State child health plan (or a waiver of the
plan) under the Children's Health Insurance Program under title
XXI, including by enabling an entity operating under a contract
with a State to assist the State to identify or prevent waste,
fraud, and abuse with respect to such programs.
``(B) Information security.--A State agency shall have in
effect data security and control policies that the Secretary
finds adequate to ensure the security of covered algorithms
used or developed for purposes of such section 4241 and to
ensure that access to such information is restricted to
authorized persons for purposes of authorized uses and
disclosures described in subparagraph (A).
``(C) Procedural requirements.--State agencies to which
information is disclosed pursuant to such section 4241 shall
adhere to uniform procedures established by the Secretary.
``(c) Covered Algorithm Defined.--In this section, the term
`covered algorithm'--
``(1) means a predictive modeling or other analytics
technology, as used for purposes of section 4241(a) of the Small
Business Jobs Act of 2010 (42 U.S.C. 1320a-7m(a)) to identify and
prevent waste, fraud, and abuse with respect to the Medicare
program under title XVIII, the Medicaid program under title XIX,
and the Children's Health Insurance Program under title XXI; and
``(2) includes the mathematical expressions utilized in the
application of such technology and the means by which such
technology is developed.''.
(b) Conforming Amendments.--
(1) Medicaid state plan requirement.--Section 1902(a) of the
Social Security Act (42 U.S.C. 1396a(a)) is amended--
(A) in paragraph (80), by striking ``and'' at the end;
(B) in paragraph (81), by striking the period at the end
and inserting ``; and''; and
(C) by inserting after paragraph (81) the following new
paragraph:
``(82) provide that the State agency responsible for
administering the State plan under this title provides assurances
to the Secretary that the State agency is in compliance with
subparagraphs (A), (B), and (C) of section 1128K(b)(2).''.
(2) State child health plan requirement.--Section 2102(a)(7) of
the Social Security Act (42 U.S.C. 1397bb(a)(7)) is amended--
(A) in subparagraph (A), by striking ``, and'' at the end
and inserting a semicolon;
(B) in subparagraph (B), by striking the period at the end
and inserting ``; and''; and
(C) by adding at the end the following new subparagraph:
``(C) to ensure that the State agency involved is in
compliance with subparagraphs (A), (B), and (C) of section
1128K(b)(2).''.

db70ebcfe84b192d035bcc12aa34d93ff280b8bd9db847aa98523bbd35338d2f

Section 1941(b)(1) of the Social Security Act (42 U.S.C. 1396w-
1(b)(1)) is amended to read as follows:
``(1) In general.--There shall be available to the Fund, for
expenditures from the Fund for fiscal year 2021 and thereafter,
$5,000,000.''.

10bee57e8388c901a3a502709caa2bb78fe8491c03f6d838fbb82a66dd8187f7

ABUSE EPIDEMICS.
It is the sense of the Congress that decades of experience and
research have demonstrated that a fiscally responsible approach to
addressing the opioid abuse epidemic and other substance abuse
epidemics requires treating such epidemics as a public health emergency
emphasizing prevention, treatment, and recovery.

5c6612cd4b4f3a7c320ace160b7e685a1be346f761de8e0559d219d61605905c

CHALLENGES RELATING TO DESIGNATIONS UNDER THE NARCOTICS KINGPIN
DESIGNATION ACT.
Section 804 of the Foreign Narcotics Kingpin Designation Act (21
U.S.C. 1903) is amended by adding at the end the following:
``(i) Protection of Classified Information in Federal Court
Challenges Relating to Designations.--In any judicial review of a
determination made under this section, if the determination was based
on classified information (as defined in section 1(a) of the Classified
Information Procedures Act) such information may be submitted to the
reviewing court ex parte and in camera. This subsection does not confer
or imply any right to judicial review.''.

0fb58727a8a3fa1175a49f1eced5ddc08bcadbb199f1e2552d8c240711d2d750

This title may be cited as the ``Jason Simcakoski Memorial and
Promise Act''.

b9537710c472f1e0a3f72562d13c47c35a60d35c29bf8e6f27e327a77f49e283

In this title:
(1) The term ``controlled substance'' has the meaning given
that term in section 102 of the Controlled Substances Act (21
U.S.C. 802).
(2) The term ``State'' means each of the several States,
territories, and possessions of the United States, the District of
Columbia, and the Commonwealth of Puerto Rico.
(3) The term ``complementary and integrative health'' has the
meaning given that term, or any successor term, by the National
Institutes of Health.
(4) The term ``opioid receptor antagonist'' means a drug or
device approved or cleared under the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 301 et seq.) for emergency treatment of
known or suspected opioid overdose.
Subtitle A--Opioid Therapy and Pain Management

a9bf104d61b9720fdd7d0903e9a87369c72bb2b3ce307ae82f6ed6b1d50dd93b

VETERANS AFFAIRS.
(a) Expansion of Opioid Safety Initiative.--
(1) Inclusion of all medical facilities.--Not later than 180
days after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall expand the Opioid Safety Initiative of the
Department of Veterans Affairs to include all medical facilities of
the Department.
(2) Guidance.--The Secretary shall establish guidance that each
health care provider of the Department of Veterans Affairs, before
initiating opioid therapy to treat a patient as part of the
comprehensive assessment conducted by the health care provider, use
the Opioid Therapy Risk Report tool of the Department of Veterans
Affairs (or any subsequent tool), which shall include information
from the prescription drug monitoring program of each participating
State as applicable, that includes the most recent information to
date relating to the patient that accessed such program to assess
the risk for adverse outcomes of opioid therapy for the patient,
including the concurrent use of controlled substances such as
benzodiazepines, as part of the comprehensive assessment conducted
by the health care provider.
(3) Enhanced standards.--The Secretary shall establish enhanced
standards with respect to the use of routine and random urine drug
tests for all patients before and during opioid therapy to help
prevent substance abuse, dependence, and diversion, including--
(A) that such tests occur not less frequently than once
each year or as otherwise determined according to treatment
protocols; and
(B) that health care providers appropriately order,
interpret and respond to the results from such tests to tailor
pain therapy, safeguards, and risk management strategies to
each patient.
(b) Pain Management Education and Training.--
(1) In general.--In carrying out the Opioid Safety Initiative
of the Department, the Secretary shall require all employees of the
Department responsible for prescribing opioids to receive education
and training described in paragraph (2).
(2) Education and training.--Education and training described
in this paragraph is education and training on pain management and
safe opioid prescribing practices for purposes of safely and
effectively managing patients with chronic pain, including
education and training on the following:
(A) The implementation of and full compliance with the VA/
DOD Clinical Practice Guideline for Management of Opioid
Therapy for Chronic Pain, including any update to such
guideline.
(B) The use of evidence-based pain management therapies and
complementary and integrative health services, including
cognitive-behavioral therapy, non-opioid alternatives, and non-
drug methods and procedures to managing pain and related health
conditions including, to the extent practicable, medical
devices approved or cleared by the Food and Drug Administration
for the treatment of patients with chronic pain and related
health conditions.
(C) Screening and identification of patients with substance
use disorder, including drug-seeking behavior, before
prescribing opioids, assessment of risk potential for patients
developing an addiction, and referral of patients to
appropriate addiction treatment professionals if addiction is
identified or strongly suspected.
(D) Communication with patients on the potential harm
associated with the use of opioids and other controlled
substances, including the need to safely store and dispose of
supplies relating to the use of opioids and other controlled
substances.
(E) Such other education and training as the Secretary
considers appropriate to ensure that veterans receive safe and
high-quality pain management care from the Department.
(3) Use of existing program.--In providing education and
training described in paragraph (2), the Secretary shall use the
Interdisciplinary Chronic Pain Management Training Team Program of
the Department (or successor program).
(c) Pain Management Teams.--
(1) In general.--In carrying out the Opioid Safety Initiative
of the Department, the director of each medical facility of the
Department shall identify and designate a pain management team of
health care professionals, which may include board certified pain
medicine specialists, responsible for coordinating and overseeing
pain management therapy at such facility for patients experiencing
acute and chronic pain that is non-cancer related.
(2) Establishment of protocols.--
(A) In general.--In consultation with the Directors of each
Veterans Integrated Service Network, the Secretary shall
establish standard protocols for the designation of pain
management teams at each medical facility within the
Department.
(B) Consultation on prescription of opioids.--Each protocol
established under subparagraph (A) shall ensure that any health
care provider without expertise in prescribing analgesics or
who has not completed the education and training under
subsection (b), including a mental health care provider, does
not prescribe opioids to a patient unless that health care
provider--
(i) consults with a health care provider with pain
management expertise or who is on the pain management team
of the medical facility; and
(ii) refers the patient to the pain management team for
any subsequent prescriptions and related therapy.
(3) Report.--
(A) In general.--Not later than one year after the date of
enactment of this Act, the director of each medical facility of
the Department shall submit to the Under Secretary for Health
and the director of the Veterans Integrated Service Network in
which the medical facility is located a report identifying the
health care professionals that have been designated as members
of the pain management team at the medical facility pursuant to
paragraph (1).
(B) Elements.--Each report submitted under subparagraph (A)
with respect to a medical facility of the Department shall
include--
(i) a certification as to whether all members of the
pain management team at the medical facility have completed
the education and training required under subsection (b);
(ii) a plan for the management and referral of patients
to such pain management team if health care providers
without expertise in prescribing analgesics prescribe
opioid medications to treat acute and chronic pain that is
non-cancer related; and
(iii) a certification as to whether the medical
facility--
(I) fully complies with the stepped-care model, or
successor models, of pain management and other pain
management policies of the Department; or
(II) does not fully comply with such stepped-care
model, or successor models, of pain management and
other pain management policies but is carrying out a
corrective plan of action to ensure such full
compliance.
(d) Tracking and Monitoring of Opioid Use.--
(1) Prescription drug monitoring programs of states.--In
carrying out the Opioid Safety Initiative and the Opioid Therapy
Risk Report tool of the Department, the Secretary shall--
(A) ensure access by health care providers of the
Department to information on controlled substances, including
opioids and benzodiazepines, prescribed to veterans who receive
care outside the Department through the prescription drug
monitoring program of each State with such a program, including
by seeking to enter into memoranda of understanding with States
to allow shared access of such information between States and
the Department;
(B) include such information in the Opioid Therapy Risk
Report tool; and
(C) require health care providers of the Department to
submit to the prescription drug monitoring program of each
State with such a program information on prescriptions of
controlled substances received by veterans in that State under
the laws administered by the Secretary.
(2) Report on tracking of data on opioid use.--Not later than
18 months after the date of the enactment of this Act, the
Secretary shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the feasibility and advisability of
improving the Opioid Therapy Risk Report tool of the Department to
allow for more advanced real-time tracking of and access to data
on--
(A) the key clinical indicators with respect to the
totality of opioid use by veterans;
(B) concurrent prescribing by health care providers of the
Department of opioids in different health care settings,
including data on concurrent prescribing of opioids to treat
mental health disorders other than opioid use disorder; and
(C) mail-order prescriptions of opioids prescribed to
veterans under the laws administered by the Secretary.
(e) Availability of Opioid Receptor Antagonists.--
(1) Increased availability and use.--
(A) In general.--The Secretary shall maximize the
availability of opioid receptor antagonists, including
naloxone, to veterans.
(B) Availability, training, and distributing.--In carrying
out subparagraph (A), not later than 90 days after the date of
the enactment of this Act, the Secretary shall--
(i) equip each pharmacy of the Department with opioid
receptor antagonists to be dispensed to outpatients as
needed; and
(ii) expand the Overdose Education and Naloxone
Distribution program of the Department to ensure that all
veterans in receipt of health care under laws administered
by the Secretary who are at risk of opioid overdose may
access such opioid receptor antagonists and training on the
proper administration of such opioid receptor antagonists.
(C) Veterans who are at risk.--For purposes of subparagraph
(B), veterans who are at risk of opioid overdose include--
(i) veterans receiving long-term opioid therapy;
(ii) veterans receiving opioid therapy who have a
history of substance use disorder or prior instances of
overdose; and
(iii) veterans who are at risk as determined by a
health care provider who is treating the veteran.
(2) Report.--Not later than 120 days after the date of the
enactment of this Act, the Secretary shall submit to the Committee
on Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives a report on carrying out
paragraph (1), including an assessment of any remaining steps to be
carried out by the Secretary to carry out such paragraph.
(f) Inclusion of Certain Information and Capabilities in Opioid
Therapy Risk Report Tool of the Department.--
(1) Information.--The Secretary shall include in the Opioid
Therapy Risk Report tool of the Department--
(A) information on the most recent time the tool was
accessed by a health care provider of the Department with
respect to each veteran; and
(B) information on the results of the most recent urine
drug test for each veteran.
(2) Capabilities.--The Secretary shall include in the Opioid
Therapy Risk Report tool the ability of the health care providers
of the Department to determine whether a health care provider of
the Department prescribed opioids to a veteran without checking the
information in the tool with respect to the veteran.
(g) Notifications of Risk in Computerized Health Record.--The
Secretary shall modify the computerized patient record system of the
Department to ensure that any health care provider that accesses the
record of a veteran, regardless of the reason the veteran seeks care
from the health care provider, will be immediately notified whether the
veteran--
(1) is receiving opioid therapy and has a history of substance
use disorder or prior instances of overdose;
(2) has a history of opioid abuse; or
(3) is at risk of developing an opioid use disorder, as
determined by a health care provider who is treating the veteran.

37308840b95e107e41a4e3b74a4b149c07092bd40a9e1eca8c2fc34d56f4c70a

OF THE DEPARTMENT OF VETERANS AFFAIRS AND THE DEPARTMENT OF
DEFENSE.
(a) In General.--Not later than 90 days after the date of enactment
of this Act, the Secretary of Veterans Affairs and the Secretary of
Defense shall ensure that the Pain Management Working Group of the
Health Executive Committee of the Department of Veterans Affairs-
Department of Defense Joint Executive Committee (Pain Management
Working Group) established under section 320 of title 38, United States
Code, includes a focus on the following:
(1) The opioid prescribing practices of health care providers
of each Department.
(2) The ability of each Department to manage acute and chronic
pain among individuals receiving health care from the Department,
including training health care providers with respect to pain
management.
(3) The use by each Department of complementary and integrative
health in treating such individuals.
(4) The concurrent use and practice by health care providers of
each Department of opioids and prescription drugs to treat mental
health disorders, including benzodiazepines.
(5) The use of care transition plans by health care providers
of each Department to address case management issues for patients
receiving opioid therapy who transition between inpatient and
outpatient care.
(6) The coordination in coverage of and consistent access to
medications prescribed for patients transitioning from receiving
health care from the Department of Defense to receiving health care
from the Department of Veterans Affairs.
(7) The ability of each Department to properly screen,
identify, refer, and treat patients with substance use disorders
who are seeking treatment for acute and chronic pain management
conditions.
(b) Coordination and Consultation.--The Secretary of Veterans
Affairs and the Secretary of Defense shall ensure that the working
group described in subsection (a)--
(1) coordinates the activities of the working group with other
relevant working groups established under section 320 of title 38,
United States Code;
(2) consults with other relevant Federal agencies, including
the Centers for Disease Control and Prevention, with respect to the
activities of the working group; and
(3) consults with the Department of Veterans Affairs and the
Department of Defense with respect to the VA/DOD Clinical Practice
Guideline for Management of Opioid Therapy for Chronic Pain, or any
successor guideline, and reviews and provides comments before any
update to the guideline is released.
(c) Clinical Practice Guidelines.--
(1) In general.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs and the
Secretary of Defense shall issue an update to the VA/DOD Clinical
Practice Guideline for Management of Opioid Therapy for Chronic
Pain.
(2) Matters included.--In conducting the update under paragraph
(1), the Pain Management Working Group, in coordination with the
Clinical Practice Guideline VA/DoD Management of Opioid Therapy for
Chronic Pain Working Group, shall work to ensure that the Clinical
Practical Guideline includes the following:
(A) Enhanced guidance with respect to--
(i) the co-administration of an opioid and other drugs,
including benzodiazepines, that may result in life-limiting
drug interactions;
(ii) the treatment of patients with current acute
psychiatric instability or substance use disorder or
patients at risk of suicide; and
(iii) the use of opioid therapy to treat mental health
disorders other than opioid use disorder.
(B) Enhanced guidance with respect to the treatment of
patients with behaviors or comorbidities, such as post-
traumatic stress disorder or other psychiatric disorders, or a
history of substance abuse or addiction, that requires a
consultation or co-management of opioid therapy with one or
more specialists in pain management, mental health, or
addictions.
(C) Enhanced guidance with respect to health care
providers--
(i) conducting an effective assessment for patients
beginning or continuing opioid therapy, including
understanding and setting realistic goals with respect to
achieving and maintaining an expected level of pain relief,
improved function, or a clinically appropriate combination
of both; and
(ii) effectively assessing whether opioid therapy is
achieving or maintaining the established treatment goals of
the patient or whether the patient and health care provider
should discuss adjusting, augmenting, or discontinuing the
opioid therapy.
(D) Guidelines to inform the methodologies used by health
care providers of the Department of Veterans Affairs and the
Department of Defense to safely taper opioid therapy when
adjusting or discontinuing the use of opioid therapy,
including--
(i) prescription of the lowest effective dose based on
patient need;
(ii) use of opioids only for a limited time; and
(iii) augmentation of opioid therapy with other pain
management therapies and modalities.
(E) Guidelines with respect to appropriate case management
for patients receiving opioid therapy who transition between
inpatient and outpatient health care settings, which may
include the use of care transition plans.
(F) Guidelines with respect to appropriate case management
for patients receiving opioid therapy who transition from
receiving care during active duty to post-military health care
networks.
(G) Guidelines with respect to providing options, before
initiating opioid therapy, for pain management therapies
without the use of opioids and options to augment opioid
therapy with other clinical and complementary and integrative
health services to minimize opioid dependence.
(H) Guidelines with respect to the provision of evidence-
based non-opioid treatments within the Department of Veterans
Affairs and the Department of Defense, including medical
devices and other therapies approved or cleared by the Food and
Drug Administration for the treatment of chronic pain as an
alternative to or to augment opioid therapy.
(I) Guidelines developed by the Centers for Disease Control
and Prevention for safely prescribing opioids for the treatment
of chronic, non-cancer related pain in outpatient settings.
(3) Rule of construction.--Nothing in this subsection shall be
construed to prevent the Secretary of Veterans Affairs and the
Secretary of Defense from considering all relevant evidence, as
appropriate, in updating the VA/DOD Clinical Practice Guideline for
Management of Opioid Therapy for Chronic Pain, as required under
paragraph (1), or from ensuring that the final clinical practice
guideline updated under such paragraph remains applicable to the
patient populations of the Department of Veterans Affairs and the
Department of Defense.

8f547250de89b0ab698c3780f56591787e22ac28d732357cb4b6a4f7a4da346d

TREATMENT BY DEPARTMENT OF VETERANS AFFAIRS.
(a) Comptroller General Report.--
(1) In general.--Not later than two years after the date of the
enactment of this Act, the Comptroller General of the United States
shall submit to the Committee on Veterans' Affairs of the Senate
and the Committee on Veterans' Affairs of the House of
Representatives a report on the Opioid Safety Initiative of the
Department of Veterans Affairs and the opioid prescribing practices
of health care providers of the Department.
(2) Elements.--The report submitted under paragraph (1) shall
include the following:
(A) An assessment of the implementation and monitoring by
the Veterans Health Administration of the Opioid Safety
Initiative of the Department, including examining, as
appropriate, the following:
(i) How the Department monitors the key clinical
outcomes of such safety initiative (for example, the
percentage of unique veterans visiting each medical center
of the Department that are prescribed an opioid or an
opioid and benzodiazepine concurrently) and how the
Department uses that information--
(I) to improve prescribing practices; and
(II) to identify high prescribing or otherwise
inappropriate prescribing practices by health care
providers.
(ii) How the Department monitors the use of the Opioid
Therapy Risk Report tool of the Department (as developed
through such safety initiative) and compliance with such
tool by medical facilities and health care providers of the
Department, including any findings by the Department of
prescription rates or prescription practices by medical
facilities or health care providers that are inappropriate.
(iii) The implementation of academic detailing programs
within the Veterans Integrated Service Networks of the
Department and how such programs are being used to improve
opioid prescribing practices.
(iv) Recommendations on such improvements to the Opioid
Safety Initiative of the Department as the Comptroller
General considers appropriate.
(B) Information made available under the Opioid Therapy
Risk Report tool with respect to--
(i) deaths resulting from sentinel events involving
veterans prescribed opioids by a health care provider;
(ii) overall prescription rates and, if applicable,
indications used by health care providers for prescribing
chronic opioid therapy to treat non-cancer, non-palliative,
and non-hospice care patients;
(iii) the prescription rates and indications used by
health care providers for prescribing benzodiazepines and
opioids concomitantly;
(iv) the practice by health care providers of
prescribing opioids to treat patients without any pain,
including to treat patients with mental health disorders
other than opioid use disorder; and
(v) the effectiveness of opioid therapy for patients
receiving such therapy, including the effectiveness of
long-term opioid therapy.
(C) An evaluation of processes of the Department in place
to oversee opioid use among veterans, including procedures to
identify and remedy potential over-prescribing of opioids by
health care providers of the Department.
(D) An assessment of the implementation by the Secretary of
Veterans Affairs of the VA/DOD Clinical Practice Guideline for
Management of Opioid Therapy for Chronic Pain, including any
figures or approaches used by the Department to assess
compliance with such guidelines by medical centers of the
Department and identify any medical centers of the Department
operating action plans to improve compliance with such
guidelines.
(E) An assessment of the data that the Department has
developed to review the opioid prescribing practices of health
care providers of the Department, as required by this subtitle,
including a review of how the Department identifies the
practices of individual health care providers that warrant
further review based on prescribing levels, health conditions
for which the health care provider is prescribing opioids or
opioids and benzodiazepines concurrently, or other practices of
the health care provider.
(b) Semi-annual Progress Report on Implementation of Comptroller
General Recommendations.--Not later than 180 days after the date of the
submittal of the report required under subsection (a), and not less
frequently than annually thereafter until the Comptroller General of
the United States determines that all recommended actions are closed,
the Secretary of Veterans Affairs shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a progress report detailing the actions
by the Secretary to address any outstanding findings and
recommendations by the Comptroller General of the United States under
subsection (a) with respect to the Veterans Health Administration.
(c) Annual Report on Opioid Therapy and Prescription Rates.--Not
later than one year after the date of the enactment of this Act, and
not less frequently than annually for the following five years, the
Secretary shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on opioid therapy and prescription rates for
the one-year period preceding the date of the submission of the report.
Each such report shall include each of the following:
(1) The number of patients and the percentage of the patient
population of the Department who were prescribed benzodiazepines
and opioids concurrently by a health care provider of the
Department.
(2) The number of patients and the percentage of the patient
population of the Department without any pain who were prescribed
opioids by a health care provider of the Department, including
those who were prescribed benzodiazepines and opioids concurrently.
(3) The number of non-cancer, non-palliative, and non-hospice
care patients and the percentage of such patients who were treated
with opioids by a health care provider of the Department on an
inpatient-basis and who also received prescription opioids by mail
from the Department while being treated on an inpatient-basis.
(4) The number of non-cancer, non-palliative, and non-hospice
care patients and the percentage of such patients who were
prescribed opioids concurrently by a health care provider of the
Department and a health care provider that is not a health care
provider of the Department.
(5) With respect to each medical facility of the Department,
the collected and reviewed information on opioids prescribed by
health care providers at the facility to treat non-cancer, non-
palliative, and non-hospice care patients, including--
(A) the prescription rate at which each health care
provider at the facility prescribed benzodiazepines and opioids
concurrently to such patients and the aggregate of such
prescription rate for all health care providers at the
facility;
(B) the prescription rate at which each health care
provider at the facility prescribed benzodiazepines or opioids
to such patients to treat conditions for which benzodiazepines
or opioids are not approved treatment and the aggregate of such
prescription rate for all health care providers at the
facility;
(C) the prescription rate at which each health care
provider at the facility prescribed or dispensed mail-order
prescriptions of opioids to such patients while such patients
were being treated with opioids on an inpatient-basis and the
aggregate of such prescription rate for all health care
providers at the facility; and
(D) the prescription rate at which each health care
provider at the facility prescribed opioids to such patients
who were also concurrently prescribed opioids by a health care
provider that is not a health care provider of the Department
and the aggregate of such prescription rates for all health
care providers at the facility.
(6) With respect to each medical facility of the Department,
the number of times a pharmacist at the facility overrode a
critical drug interaction warning with respect to an interaction
between opioids and another medication before dispensing such
medication to a veteran.
(d) Investigation of Prescription Rates.--If the Secretary
determines that a prescription rate with respect to a health care
provider or medical facility of the Department conflicts with or is
otherwise inconsistent with the standards of appropriate and safe care,
the Secretary shall--
(1) immediately notify the Committee on Veterans' Affairs of
the Senate and the Committee on Veterans' Affairs of the House of
Representatives of such determination, including information
relating to such determination, prescription rate, and health care
provider or medical facility, as the case may be; and
(2) through the Office of the Medical Inspector of the Veterans
Health Administration, conduct a full investigation of the health
care provider or medical facility, as the case may be.
(e) Prescription Rate Defined.--In this section, the term
``prescription rate'' means, with respect to a health care provider or
medical facility of the Department, each of the following:
(1) The number of patients treated with opioids by the health
care provider or at the medical facility, as the case may be,
divided by the total number of pharmacy users of that health care
provider or medical facility.
(2) The average number of morphine equivalents per day
prescribed by the health care provider or at the medical facility,
as the case may be, to patients being treated with opioids.
(3) Of the patients being treated with opioids by the health
care provider or at the medical facility, as the case may be, the
average number of prescriptions of opioids per patient.

863970360a385cff9ef80c7e0b556b20849ce5081289d50a33073c55728c491b

STATE CONTROLLED SUBSTANCE MONITORING PROGRAMS.
Section 5701(l) of title 38, United States Code, is amended by
striking ``may'' and inserting ``shall''.

4d93793d00e05aa60338cb4609e99ffb57a91e67a54ffb334af453f3a1e2d11b

RECEIVING OPIOID ANTAGONISTS OR EDUCATION ON USE OF OPIOID
ANTAGONISTS.
(a) Copayment for Opioid Antagonists.--Section 1722A(a) of title
38, United States Code, is amended by adding at the end the following
new paragraph:
``(4) Paragraph (1) does not apply to opioid antagonists furnished
under this chapter to a veteran who is at high risk for overdose of a
specific medication or substance in order to reverse the effect of such
an overdose.''.
(b) Copayment for Education on Use of Opioid Antagonists.--Section
1710(g)(3) of such title is amended--
(1) by striking ``with respect to home health services'' and
inserting ``with respect to the following:''
``(A) Home health services''; and
(2) by adding at the end the following subparagraph:
``(B) Education on the use of opioid antagonists to reverse the
effects of overdoses of specific medications or substances.''.
Subtitle B--Patient Advocacy

3f947dc87e6263d016507de587fda708cf9ee280951434972aa6edf356f4d898

DEPARTMENT OF VETERANS AFFAIRS.
(a) Community Meetings.--
(1) Medical centers.--Not later than 90 days after the date of
the enactment of this Act, and not less frequently than once every
90 days thereafter, the Secretary shall ensure that each medical
facility of the Department of Veterans Affairs hosts a community
meeting open to the public on improving health care furnished by
the Secretary.
(2) Community-based outpatient clinics.--Not later than one
year after the date of the enactment of this Act, and not less
frequently than annually thereafter, the Secretary shall ensure
that each community-based outpatient clinic of the Department hosts
a community meeting open to the public on improving health care
furnished by the Secretary.
(b) Attendance by Director of Veterans Integrated Service Network
or Designee.--
(1) In general.--Each community meeting hosted by a medical
facility or community-based outpatient clinic under subsection (a)
shall be attended by the Director of the Veterans Integrated
Service Network in which the medical facility or community-based
outpatient clinic, as the case may be, is located. Subject to
paragraph (2), the Director may delegate such attendance only to an
employee who works in the Office of the Director.
(2) Attendance by director.--Each Director of a Veterans
Integrated Service Network shall personally attend not less than
one community meeting under subsection (a) hosted by each medical
facility located in the Veterans Integrated Service Network each
year.
(c) Notice.--The Secretary shall notify the Committee on Veterans'
Affairs of the Senate, the Committee on Veterans' Affairs of the House
of Representatives, and each Member of Congress (as defined in section
902) who represents the area in which the medical facility is located
of a community meeting under subsection (a) by not later than 10 days
before such community meeting occurs.

eac90237987c958164a69deee18f9e4fac7681e8536ed19d672e1adcc9baae48

PATIENT BILL OF RIGHTS OF DEPARTMENT OF VETERANS AFFAIRS.
Not later than 90 days after the date of the enactment of this Act,
the Secretary of Veterans Affairs shall, in as many prominent locations
as the Secretary determines appropriate to be seen by the largest
percentage of patients and family members of patients at each medical
facility of the Department of Veterans Affairs--
(1) display the purposes of the Patient Advocacy Program of the
Department and the contact information for the patient advocate at
such medical facility; and
(2) display the rights and responsibilities of--
(A) patients and family members of patients at such medical
facility; and
(B) with respect to community living centers and other
residential facilities of the Department, residents and family
members of residents at such medical facility.

85581e6a70c1fd828989c4dfe5b23f98fd8677f8785dd664a1b7193f957b6a0d

DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Not later than two years after the date of the
enactment of this Act, the Comptroller General of the United States
shall submit to the Committee on Veterans' Affairs of the Senate and
the Committee on Veterans' Affairs of the House of Representatives a
report on the Patient Advocacy Program of the Department of Veterans
Affairs (in this section referred to as the ``Program'').
(b) Elements.--The report required by subsection (a) shall include
the following:
(1) A description of the Program, including--
(A) the purpose of the Program;
(B) the activities carried out under the Program; and
(C) the sufficiency of the Program in achieving the purpose
of the Program.
(2) An assessment of the sufficiency of staffing of employees
of the Department responsible for carrying out the Program.
(3) An assessment of the sufficiency of the training of such
employees.
(4) An assessment of--
(A) the awareness of the Program among veterans and family
members of veterans; and
(B) the use of the Program by veterans and family members
of veterans.
(5) Such recommendations and proposals for improving or
modifying the Program as the Comptroller General considers
appropriate.
(6) Such other information with respect to the Program as the
Comptroller General considers appropriate.

a909fda9dfa9c6926cc031ad31a4531ea64e3fa64a6f3e526f4ffb3de86d7efc

DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Subchapter I of chapter 73 of title 38, United
States Code, is amended by adding at the end the following new section:
``Sec. 7309A. Office of Patient Advocacy
``(a) Establishment.--There is established in the Department within
the Office of the Under Secretary for Health an office to be known as
the `Office of Patient Advocacy' (in this section referred to as the
`Office').
``(b) Head.--(1) The Director of the Office of Patient Advocacy
shall be the head of the Office.
``(2) The Director of the Office of Patient Advocacy shall be
appointed by the Under Secretary for Health from among individuals
qualified to perform the duties of the position and shall report
directly to the Under Secretary for Health.
``(c) Function.--(1) The function of the Office is to carry out the
Patient Advocacy Program of the Department.
``(2) In carrying out the Patient Advocacy Program of the
Department, the Director shall ensure that patient advocates of the
Department--
``(A) advocate on behalf of veterans with respect to health
care received and sought by veterans under the laws administered by
the Secretary;
``(B) carry out the responsibilities specified in subsection
(d); and
``(C) receive training in patient advocacy.
``(d) Patient Advocacy Responsibilities.--The responsibilities of
each patient advocate at a medical facility of the Department are the
following:
``(1) To resolve complaints by veterans with respect to health
care furnished under the laws administered by the Secretary that
cannot be resolved at the point of service or at a higher level
easily accessible to the veteran.
``(2) To present at various meetings and to various committees
the issues experienced by veterans in receiving such health care at
such medical facility.
``(3) To express to veterans their rights and responsibilities
as patients in receiving such health care.
``(4) To manage the Patient Advocate Tracking System of the
Department at such medical facility.
``(5) To compile data at such medical facility of complaints
made by veterans with respect to the receipt of such health care at
such medical facility and the satisfaction of veterans with such
health care at such medical facility to determine whether there are
trends in such data.
``(6) To ensure that a process is in place for the distribution
of the data compiled under paragraph (5) to appropriate leaders,
committees, services, and staff of the Department.
``(7) To identify, not less frequently than quarterly,
opportunities for improvements in the furnishing of such health
care to veterans at such medical facility based on complaints by
veterans.
``(8) To ensure that any significant complaint by a veteran
with respect to such health care is brought to the attention of
appropriate staff of the Department to trigger an assessment of
whether there needs to be a further analysis of the problem at the
facility-wide level.
``(9) To support any patient advocacy programs carried out by
the Department.
``(10) To ensure that all appeals and final decisions with
respect to the receipt of such health care are entered into the
Patient Advocate Tracking System of the Department.
``(11) To understand all laws, directives, and other rules with
respect to the rights and responsibilities of veterans in receiving
such health care, including the appeals processes available to
veterans.
``(12) To ensure that veterans receiving mental health care, or
the surrogate decision-makers for such veterans, are aware of the
rights of veterans to seek representation from systems established
under section 103 of the Protection and Advocacy for Mentally Ill
Individuals Act of 1986 (42 U.S.C. 10803) to protect and advocate
the rights of individuals with mental illness and to investigate
incidents of abuse and neglect of such individuals.
``(13) To fulfill requirements established by the Secretary
with respect to the inspection of controlled substances.
``(14) To document potentially threatening behavior and report
such behavior to appropriate authorities.
``(e) Training.--In providing training to patient advocates under
subsection (c)(2)(C), the Director shall ensure that such training is
consistent throughout the Department.
``(f) Controlled Substance Defined.--In this section, the term
`controlled substance' has the meaning given that term in section 102
of the Controlled Substances Act (21 U.S.C. 802).''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 73 of such title is amended by inserting after the item
relating to section 7309 the following new item:
``7309A. Office of Patient Advocacy.''.
(c) Date Fully Operational.--The Secretary of Veterans Affairs
shall ensure that the Office of Patient Advocacy established under
section 7309A of title 38, United States Code, as added by subsection
(a), is fully operational not later than the date that is one year
after the date of the enactment of this Act.
Subtitle C--Complementary and Integrative Health

128323f51a529ead8336779a80689c39a583e22064d16d4bdc1488ea3fef0eb3

COMPLEMENTARY AND INTEGRATIVE HEALTH TO VETERANS.
(a) Establishment.--There is established a commission to be known
as the ``Creating Options for Veterans' Expedited Recovery'' or the
``COVER Commission'' (in this section referred to as the
``Commission''). The Commission shall examine the evidence-based
therapy treatment model used by the Secretary of Veterans Affairs for
treating mental health conditions of veterans and the potential
benefits of incorporating complementary and integrative health
treatments available in non-Department facilities (as defined in
section 1701 of title 38, United States Code).
(b) Duties.--The Commission shall perform the following duties:
(1) Examine the efficacy of the evidence-based therapy model
used by the Secretary for treating mental health illnesses of
veterans and identify areas to improve wellness-based outcomes.
(2) Conduct a patient-centered survey within each of the
Veterans Integrated Service Networks to examine--
(A) the experience of veterans with the Department of
Veterans Affairs when seeking medical assistance for mental
health issues through the health care system of the Department;
(B) the experience of veterans with non-Department
facilities and health professionals for treating mental health
issues;
(C) the preference of veterans regarding available
treatment for mental health issues and which methods the
veterans believe to be most effective;
(D) the experience, if any, of veterans with respect to the
complementary and integrative health treatment therapies
described in paragraph (3);
(E) the prevalence of prescribing prescription medication
among veterans seeking treatment through the health care system
of the Department as remedies for addressing mental health
issues; and
(F) the outreach efforts of the Secretary regarding the
availability of benefits and treatments for veterans for
addressing mental health issues, including by identifying ways
to reduce barriers to gaps in such benefits and treatments.
(3) Examine available research on complementary and integrative
health treatment therapies for mental health issues and identify
what benefits could be made with the inclusion of such treatments
for veterans, including with respect to--
(A) music therapy;
(B) equine therapy;
(C) training and caring for service dogs;
(D) yoga therapy;
(E) acupuncture therapy;
(F) meditation therapy;
(G) outdoor sports therapy;
(H) hyperbaric oxygen therapy;
(I) accelerated resolution therapy;
(J) art therapy;
(K) magnetic resonance therapy; and
(L) other therapies the Commission determines appropriate.
(4) Study the sufficiency of the resources of the Department to
ensure the delivery of quality health care for mental health issues
among veterans seeking treatment within the Department.
(5) Study the current treatments and resources available within
the Department and assess--
(A) the effectiveness of such treatments and resources in
decreasing the number of suicides per day by veterans;
(B) the number of veterans who have been diagnosed with
mental health issues;
(C) the percentage of veterans using the resources of the
Department who have been diagnosed with mental health issues;
(D) the percentage of veterans who have completed
counseling sessions offered by the Department; and
(E) the efforts of the Department to expand complementary
and integrative health treatments viable to the recovery of
veterans with mental health issues as determined by the
Secretary to improve the effectiveness of treatments offered by
the Department.
(c) Membership.--
(1) In general.--The Commission shall be composed of 10
members, appointed as follows:
(A) Two members appointed by the Speaker of the House of
Representatives, at least one of whom shall be a veteran.
(B) Two members appointed by the minority leader of the
House of Representatives, at least one of whom shall be a
veteran.
(C) Two members appointed by the majority leader of the
Senate, at least one of whom shall be a veteran.
(D) Two members appointed by the minority leader of the
Senate, at least one of whom shall be a veteran.
(E) Two members appointed by the President, at least one of
whom shall be a veteran.
(2) Qualifications.--Members of the Commission shall be
individuals who--
(A) are of recognized standing and distinction within the
medical community with a background in treating mental health;
(B) have experience working with the military and veteran
population; and
(C) do not have a financial interest in any of the
complementary and integrative health treatments reviewed by the
Commission.
(3) Chairman.--The President shall designate a member of the
Commission to be the Chairman.
(4) Period of appointment.--Members of the Commission shall be
appointed for the life of the Commission.
(5) Vacancy.--A vacancy in the Commission shall be filled in
the manner in which the original appointment was made.
(6) Appointment deadline.--The appointment of members of the
Commission in this section shall be made not later than 90 days
after the date of the enactment of this Act.
(d) Powers of Commission.--
(1) Meetings.--
(A) Initial meeting.--The Commission shall hold its first
meeting not later than 30 days after a majority of members are
appointed to the Commission.
(B) Meeting.--The Commission shall regularly meet at the
call of the Chairman. Such meetings may be carried out through
the use of telephonic or other appropriate telecommunication
technology if the Commission determines that such technology
will allow the members to communicate simultaneously.
(2) Hearings.--The Commission may hold such hearings, sit and
act at such times and places, take such testimony, and receive
evidence as the Commission considers advisable to carry out the
responsibilities of the Commission.
(3) Information from federal agencies.--The Commission may
secure directly from any department or agency of the Federal
Government such information as the Commission considers necessary
to carry out the duties of the Commission.
(4) Information from nongovernmental organizations.--In
carrying out its duties, the Commission may seek guidance through
consultation with foundations, veteran service organizations,
nonprofit groups, faith-based organizations, private and public
institutions of higher education, and other organizations as the
Commission determines appropriate.
(5) Commission records.--The Commission shall keep an accurate
and complete record of the actions and meetings of the Commission.
Such record shall be made available for public inspection and the
Comptroller General of the United States may audit and examine such
record.
(6) Personnel records.--The Commission shall keep an accurate
and complete record of the actions and meetings of the Commission.
Such record shall be made available for public inspection and the
Comptroller General of the United States may audit and examine such
records.
(7) Compensation of members; travel expenses.--Each member
shall serve without pay but shall receive travel expenses to
perform the duties of the Commission, including per diem in lieu of
substances, at rates authorized under subchapter I of chapter 57 of
title 5, United States Code.
(8) Staff.--The Chairman, in accordance with rules agreed upon
the Commission, may appoint and fix the compensation of a staff
director and such other personnel as may be necessary to enable the
Commission to carry out its functions, without regard to the
provisions of title 5, United States Code, governing appointments
in the competitive service, without regard to the provision of
chapter 51 and subchapter III of chapter 53 of such title relating
to classification and General Schedule pay rates, except that no
rate of pay fixed under this paragraph may exceed the equivalent of
that payable for a position at level IV of the Executive Schedule
under section 5315 of title 5, United States Code.
(9) Personnel as federal employees.--
(A) In general.--The executive director and any personnel
of the Commission are employees under section 2105 of title 5,
United States Code, for purpose of chapters 63, 81, 83, 84, 85,
87, 89, and 90 of such title.
(B) Members of the commission.--Subparagraph (A) shall not
be construed to apply to members of the Commission.
(10) Contracting.--The Commission may, to such extent and in
such amounts as are provided in appropriations Acts, enter into
contracts to enable the Commission to discharge the duties of the
Commission under this Act.
(11) Expert and consultant service.--The Commission may procure
the services of experts and consultants in accordance with section
3109 of title 5, United States Code, at rates not to exceed the
daily rate paid to a person occupying a position at level IV of the
Executive Schedule under section 5315 of title 5, United States
Code.
(12) Postal service.--The Commission may use the United States
mails in the same manner and under the same conditions as
departments and agencies of the United States.
(13) Physical facilities and equipment.--Upon the request of
the Commission, the Administrator of General Services shall provide
to the Commission, on a reimbursable basis, the administrative
support services necessary for the Commission to carry out its
responsibilities under this Act. These administrative services may
include human resource management, budget, leasing accounting, and
payroll services.
(e) Report.--
(1) Interim reports.--
(A) In general.--Not later than 60 days after the date on
which the Commission first meets, and each 30-day period
thereafter ending on the date on which the Commission submits
the final report under paragraph (2), the Commission shall
submit to the Committees on Veterans' Affairs of the House of
Representatives and the Senate and the President a report
detailing the level of cooperation the Secretary of Veterans
Affairs (and the heads of other departments or agencies of the
Federal Government) has provided to the Commission.
(B) Other reports.--In carrying out its duties, at times
that the Commission determines appropriate, the Commission
shall submit to the Committees on Veterans' Affairs of the
House of Representatives and the Senate and any other
appropriate entities an interim report with respect to the
findings identified by the Commission.
(2) Final report.--Not later than 18 months after the first
meeting of the Commission, the Commission shall submit to the
Committee on Veterans' Affairs of the House of Representatives and
the Senate, the President, and the Secretary of Veterans Affairs a
final report on the findings of the Commission. Such report shall
include the following:
(A) Recommendations to implement in a feasible, timely, and
cost-efficient manner the solutions and remedies identified
within the findings of the Commission pursuant to subsection
(b).
(B) An analysis of the evidence-based therapy model used by
the Secretary of Veterans Affairs for treating veterans with
mental health care issues, and an examination of the prevalence
and efficacy of prescription drugs as a means for treatment.
(C) The findings of the patient-centered survey conducted
within each of the Veterans Integrated Service Networks
pursuant to subsection (b)(2).
(D) An examination of complementary and integrative health
treatments described in subsection (b)(3) and the potential
benefits of incorporating such treatments in the therapy models
used by the Secretary for treating veterans with mental health
issues.
(3) Plan.--Not later than 90 days after the date on which the
Commission submits the final report under paragraph (2), the
Secretary of Veterans Affairs shall submit to the Committees on
Veterans' Affairs of the House of Representatives and the Senate a
report on the following:
(A) An action plan for implementing the recommendations
established by the Commission on such solutions and remedies
for improving wellness-based outcomes for veterans with mental
health care issues.
(B) A feasible timeframe on when the complementary and
integrative health treatments described in subsection (b)(3)
can be implemented Department-wide.
(C) With respect to each recommendation established by the
Commission, including any complementary and integrative health
treatment, that the Secretary determines is not appropriate or
feasible to implement, a justification for such determination
and an alternative solution to improve the efficacy of the
therapy models used by the Secretary for treating veterans with
mental health issues.
(f) Termination of Commission.--The Commission shall terminate 30
days after the Commission submits the final report under subsection
(e)(2).

b713038e4741c1bf65c16f35eef559e7fdec271aef10c2908c126382424b751a

COMPLEMENTARY AND INTEGRATIVE HEALTH TO VETERANS.
(a) Development of Plan To Expand Research, Education, and
Delivery.--Not later than 180 days after the date of the enactment of
this Act, the Secretary of Veterans Affairs shall develop a plan to
expand materially and substantially the scope of the effectiveness of
research and education on, and delivery and integration of,
complementary and integrative health services into the health care
services provided to veterans.
(b) Elements.--The plan required by subsection (a) shall provide
for the following:
(1) Research on the following:
(A) The effectiveness of various complementary and
integrative health services, including the effectiveness of
such services integrated with clinical services.
(B) Approaches to integrating complementary and integrative
health services into other health care services provided by the
Department of Veterans Affairs.
(2) Education and training for health care professionals of the
Department on the following:
(A) Complementary and integrative health services selected
by the Secretary for purposes of the plan.
(B) Appropriate uses of such services.
(C) Integration of such services into the delivery of
health care to veterans.
(3) Research, education, and clinical activities on
complementary and integrative health at centers of innovation at
medical centers of the Department.
(4) Identification or development of metrics and outcome
measures to evaluate the effectiveness of the provision and
integration of complementary and integrative health services into
the delivery of health care to veterans.
(5) Integration and delivery of complementary and integrative
health services with other health care services provided by the
Department.
(c) Consultation.--
(1) In general.--In carrying out subsection (a), the Secretary
shall consult with the following:
(A) The Director of the National Center for Complementary
and Integrative Health of the National Institutes of Health.
(B) The Commissioner of Food and Drugs.
(C) Institutions of higher education, private research
institutes, and individual researchers with extensive
experience in complementary and integrative health and the
integration of complementary and integrative health practices
into the delivery of health care.
(D) Nationally recognized providers of complementary and
integrative health.
(E) Such other officials, entities, and individuals with
expertise on complementary and integrative health as the
Secretary considers appropriate.
(2) Scope of consultation.--The Secretary shall undertake
consultation under paragraph (1) in carrying out subsection (a)
with respect to the following:
(A) To develop the plan.
(B) To identify specific complementary and integrative
health practices that, on the basis of research findings or
promising clinical interventions, are appropriate to include as
services to veterans.
(C) To identify barriers to the effective provision and
integration of complementary and integrative health services
into the delivery of health care to veterans, and to identify
mechanisms for overcoming such barriers.

463ae922a6aa35f2ef9713bb1e749bfb63ed68ab6e4706c4941799e5df96e1a9

INTEGRATIVE HEALTH AND RELATED ISSUES FOR VETERANS AND FAMILY
MEMBERS OF VETERANS.
(a) Pilot Program.--
(1) In general.--Not later than 180 days after the date on
which the Secretary of Veterans Affairs receives the final report
under section 931(e)(2), the Secretary shall commence a pilot
program to assess the feasibility and advisability of using
complementary and integrative health and wellness-based programs
(as defined by the Secretary) to complement the provision of pain
management and related health care services, including mental
health care services, to veterans.
(2) Matters addressed.--In carrying out the pilot program, the
Secretary shall assess the following:
(A) Means of improving coordination between Federal, State,
local, and community providers of health care in the provision
of pain management and related health care services to
veterans.
(B) Means of enhancing outreach, and coordination of
outreach, by and among providers of health care referred to in
subparagraph (A) on the pain management and related health care
services available to veterans.
(C) Means of using complementary and integrative health and
wellness-based programs of providers of health care referred to
in subparagraph (A) as complements to the provision by the
Department of Veterans Affairs of pain management and related
health care services to veterans.
(D) Whether complementary and integrative health and
wellness-based programs described in subparagraph (C)--
(i) are effective in enhancing the quality of life and
well-being of veterans;
(ii) are effective in increasing the adherence of
veterans to the primary pain management and related health
care services provided such veterans by the Department;
(iii) have an effect on the sense of well-being of
veterans who receive primary pain management and related
health care services from the Department; and
(iv) are effective in encouraging veterans receiving
health care from the Department to adopt a more healthy
lifestyle.
(b) Duration.--The Secretary shall carry out the pilot program
under subsection (a)(1) for a period of three years.
(c) Locations.--
(1) Facilities.--The Secretary shall carry out the pilot
program under subsection (a)(1) at facilities of the Department
providing pain management and related health care services,
including mental health care services, to veterans. In selecting
such facilities to carry out the pilot program, the Secretary shall
select not fewer than 15 geographically diverse medical centers of
the Department, of which not fewer than two shall be polytrauma
rehabilitation centers of the Department.
(2) Medical centers with prescription rates of opioids that
conflict with care standards.--In selecting the medical centers
under paragraph (1), the Secretary shall give priority to medical
centers of the Department at which there is a prescription rate of
opioids that conflicts with or is otherwise inconsistent with the
standards of appropriate and safe care.
(d) Provision of Services.--Under the pilot program under
subsection (a)(1), the Secretary shall provide covered services to
covered veterans by integrating complementary and integrative health
services with other services provided by the Department at the medical
centers selected under subsection (c).
(e) Covered Veterans.--For purposes of the pilot program under
subsection (a)(1), a covered veteran is any veteran who--
(1) has a mental health condition diagnosed by a clinician of
the Department;
(2) experiences chronic pain;
(3) has a chronic condition being treated by a clinician of the
Department; or
(4) is not described in paragraph (1), (2), or (3) and requests
to participate in the pilot program or is referred by a clinician
of the Department who is treating the veteran.
(f) Covered Services.--
(1) In general.--For purposes of the pilot program, covered
services are services consisting of complementary and integrative
health services as selected by the Secretary.
(2) Administration of services.--Covered services shall be
administered under the pilot program as follows:
(A) Covered services shall be administered by professionals
or other instructors with appropriate training and expertise in
complementary and integrative health services who are employees
of the Department or with whom the Department enters into an
agreement to provide such services.
(B) Covered services shall be included as part of the
Patient Aligned Care Teams initiative of the Office of Patient
Care Services, Primary Care Program Office, in coordination
with the Office of Patient Centered Care and Cultural
Transformation.
(C) Covered services shall be made available to--
(i) covered veterans who have received conventional
treatments from the Department for the conditions for which
the covered veteran seeks complementary and integrative
health services under the pilot program; and
(ii) covered veterans who have not received
conventional treatments from the Department for such
conditions.
(g) Reports.--
(1) In general.--Not later than 30 months after the date on
which the Secretary commences the pilot program under subsection
(a)(1), the Secretary shall submit to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report on the pilot program.
(2) Elements.--The report under paragraph (1) shall include the
following:
(A) The findings and conclusions of the Secretary with
respect to the pilot program under subsection (a)(1), including
with respect to--
(i) the use and efficacy of the complementary and
integrative health services established under the pilot
program;
(ii) the outreach conducted by the Secretary to inform
veterans and community organizations about the pilot
program; and
(iii) an assessment of the benefit of the pilot program
to covered veterans in mental health diagnoses, pain
management, and treatment of chronic illness.
(B) Identification of any unresolved barriers that impede
the ability of the Secretary to incorporate complementary and
integrative health services with other health care services
provided by the Department.
(C) Such recommendations for the continuation or expansion
of the pilot program as the Secretary considers appropriate.
Subtitle D--Fitness of Health Care Providers

28015fb1ae4646478536def22fd439ac6266ac6dd3810dfbf60b02058458e464

PROVIDERS BY DEPARTMENT OF VETERANS AFFAIRS.
As part of the hiring process for each health care provider
considered for a position at the Department of Veterans Affairs after
the date of the enactment of the Act, the Secretary of Veterans Affairs
shall require from the medical board of each State in which the health
care provider has or had a medical license--
(1) information on any violation of the requirements of the
medical license of the health care provider during the 20-year
period preceding the consideration of the health care provider by
the Department; and
(2) information on whether the health care provider has entered
into any settlement agreement for a disciplinary charge relating to
the practice of medicine by the health care provider.

0dee759591708b1c22e8670955e7e613e9e520f110f5e7949bae13903c9d7067

DEPARTMENT OF VETERANS AFFAIRS TO STATE MEDICAL BOARDS.
Notwithstanding section 552a of title 5, United States Code, with
respect to each health care provider of the Department of Veterans
Affairs who has violated a requirement of the medical license of the
health care provider, the Secretary of Veterans Affairs shall provide
to the medical board of each State in which the health care provider is
licensed detailed information with respect to such violation,
regardless of whether such board has formally requested such
information.

19f91052af3542ceec9fbd30a28f3d4e3945791f392ac104901ca6475e6e5fe6

WITH REVIEWS OF HEALTH CARE PROVIDERS LEAVING THE DEPARTMENT OR
TRANSFERRING TO OTHER FACILITIES.
Not later than 180 days after the date of the enactment of this
Act, the Secretary of Veterans Affairs shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a report on the compliance by the
Department of Veterans Affairs with the policy of the Department--
(1) to conduct a review of each health care provider of the
Department who transfers to another medical facility of the
Department, resigns, retires, or is terminated to determine whether
there are any concerns, complaints, or allegations of violations
relating to the medical practice of the health care provider; and
(2) to take appropriate action with respect to any such
concern, complaint, or allegation.
Subtitle E--Other Matters

3094ac531d2016c65814402f8c10ffd94a22450a9d936c7276904d3e63b4ff53

Section 705 of the Veterans Access, Choice, and Accountability Act
of 2014 (Public Law 113-146; 38 U.S.C. 703 note) is amended to read as
follows:
``SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO EMPLOYEES OF
DEPARTMENT OF VETERANS AFFAIRS.
``(a) Limitation.--The Secretary of Veterans Affairs shall ensure
that the aggregate amount of awards and bonuses paid by the Secretary
in a fiscal year under chapter 45 or 53 of title 5, United States Code,
or any other awards or bonuses authorized under such title or title 38,
United States Code, does not exceed the following amounts:
``(1) With respect to each of fiscal years 2017 through 2018,
$230,000,000.
``(2) With respect to each of fiscal years 2019 through 2021,
$225,000,000.
``(3) With respect to each of fiscal years 2022 through 2024,
$360,000,000.
``(b) Sense of Congress.--It is the sense of Congress that the
limitation under subsection (a) should not disproportionately impact
lower-wage employees and that the Department of Veterans Affairs is
encouraged to use bonuses to incentivize high-performing employees in
areas in which retention is challenging.''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

9d739b4557517a24fc4f5b5c9df36172a5a7e8d64610dba562769c12ce002f51

Comprehensive Addiction and Recovery Act of 2016 — S. 524

Other Sections