,i #aacth ,,congress #b;d ,session ,h4 ,r4 #dafi ,,in ,,the ,,house ,,of ,,representatives ,march #f1 #bjad ,ms4 ,edwards 7for herself1 ,ms4 ,bass1 ,mr4 ,carson of ,indiana1 ,mr4 ,cummings1 ,mr4 ,ellison1 ,mr4 ,keating1 ,ms4 ,lee of ,california1 ,mr4 ,lynch1 ,mr4 ,michaud1 ,mr4 ,rangel1 ,mr4 ,ryan of ,ohio1 ,ms4 ,schwartz1 ,mr4 ,serrano1 ,ms4 ,shea-,porter1 ,mr4 ,tierney1 ,mr4 ,tonko1 ,ms4 ,wilson of ,florida1 ,mr4 ,foster1 and ,mr4 ,ben ,ray ,lujn of ,new ,mexico7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to prevent deaths occurring from drug overdoses4 #a4 ,short title ,this ,act may be cited as the ,stop ,overdose ,stat ,act or the ,s4,o4,s4 ,act4 #b4 ,findings ,the ,congress finds the following3 7#a7 ,according to the ,centers for ,disease ,control and ,prevention 7,,cdc71 each day in the ,united ,states more than #ajj people die from a drug overdose4 ,among people #be to #fd years old1 drug overdose caused more deaths than motor vehicle accidents4 7#b7 ,the ,,cdc reports that more than #ch1jjj people in the ,united ,states died from a drug overdose in #bjaj alone4 ,seventy-eight percent of these deaths were due to unintentional drug overdoses1 and many could have been prevented4 7#c7 ,deaths resulting from unintentional drug overdoses increased more than #djj percent between #aihj and #aiii1 and more than doubled between #aiii and #bjaj4 7#d7 ,ninety-one percent of all unintentional poisoning deaths are due to drugs4 ,since #aiii1 in the ,united ,states the population of ,non-,hispanic ,whites and the population of ,american ,indians and ,alaska ,natives have seen the highest rates of unintentional drug poisoning deaths4 7#e7 ,opioid medications such as oxycodone and hydrocodone are involved in #ee percent of all unintentional drug poisoning deaths4 7#f7 ,between #aiii and #bjaj1 opioid medication overdose fatalities increased by more than #djj percent among women and #bfe percent among men4 7#g7 ,military veterans are at elevated risk of experiencing a drug overdose4 ,vietnam1 ,iraq1 and ,afghanistan veterans with combat injuries1 posttraumatic stress disorder 7,,ptsd71 and other co-occurring mental health diagnoses are at elevated risk of fatal drug overdose from opioid medications4 7#h7 ,rural and suburban regions are disproportionately affected by opioid medication overdoses4 ,urban centers also continue to struggle with overdose1 which is the leading cause of death among homeless adults4 7#i7 ,in the year #bjji alone1 estimated lost productivity and direct medical costs from opioid medication poisonings exceeded #bj1jjj1jjj1jjj4 7#aj7 ,both fatal and nonfatal overdoses place a heavy burden on public health and public safety resources1 yet there is no coordinated cross-,federal agency response to prevent overdose fatalities4 7#aa7 ,naloxone is a medication that rapidly reverses overdose from heroin and opioid medications4 7#ab7 ,in #bjab1 the ,food and ,drug ,administration 7,,fda7 held a public workshop in collaboration with the ,national ,institute on ,drug ,abuse 7,,nida7 and the ,,cdc1 and with participation from the ,substance ,abuse and ,mental ,health ,services ,administration 7,,samhsa7 and the ,office of ,national ,drug ,control ,policy 7,,ondcp71 to discuss making naloxone more widely available outside of conventional medical settings to reduce the incidence of opioid overdose fatalities4 7#ac7 ,lawmakers in ,california1 ,colorado1 ,connecticut1 ,illinois1 ,kentucky1 ,massachusetts1 ,maryland1 ,new ,jersey1 ,new ,mexico1 ,new ,york1 ,north ,carolina1 ,oregon1 ,rhode ,island1 ,vermont1 ,virginia1 ,washington1 and the ,district of ,columbia have removed legal impediments to increasing naloxone prescription and its use by bystanders who are in a position to respond to an overdose4 7#ad7 ,health practitioners are often not fully aware of overdose symptoms and prevention methods1 impacting their ability to adequately inform patients and caregivers on how to recognize symptoms1 respond effectively by seeking emergency assistance1 and provide naloxone and other first aid in order to save a life4 7#ae7 ,the ,american ,medical ,association 7,,ama71 the ,nation's largest physician organization1 supports further implementation of community-based programs that offer naloxone and other opioid overdose prevention services4 7#af7 ,community-based overdose prevention programs have successfully prevented deaths from opioid overdoses by making rescue trainings and naloxone available to first responders1 parents1 and other bystanders who may encounter an overdose4 ,over #ej1jjj potential bystanders have been trained by overdose prevention programs in the ,united ,states4 ,a ,,cdc report credits overdose prevention programs with saving more than #aj1jjj lives since #aiif4 7#ag7 ,at least #ahh local overdose prevention programs are operating in the ,united ,states1 including in major cities such as ,baltimore1 ,chicago1 ,los ,angeles1 ,new ,york ,city1 ,boston1 ,san ,francisco1 and ,philadelphia1 and statewide in ,new ,mexico1 ,massachusetts1 and ,new ,york4 ,between #bjjf and #bjji1 overdose prevention programs facilitated by the ,massachusetts ,department of ,public ,health trained nearly #c1jjj people who reported more than #cjj rescues4 ,since #bjjd1 a program administered by the ,baltimore ,city ,health ,department has trained more than #c1jjj people who reported more than #bbj rescues4 ,project ,lazarus1 an overdose prevention program in ,wilkes ,county1 ,north ,carolina1 reduced overdose deaths #fi percent between #bjji and #bjaa4 7#ah7 ,the ,,ondcp supports equipping first responders to help reverse overdoses4 ,police officers on patrol in ,quincy1 ,massachusetts1 have conducted #agj overdose rescues with naloxone since #bjaj4 ,the police department has reported a #ie-percent success rate with overdose rescue attempts by police officers4 ,in ,suffolk ,county1 ,new ,york1 police officers have saved more than #ej lives with naloxone4 7#ai7 ,research shows that the cost per year of life gained by making naloxone available to reverse overdoses is within the range of what ,americans usually pay for health treatments4 7#bj7 ,overdose prevention programs are needed in correctional facilities1 addiction treatment programs1 and other places where people are at higher risk of overdosing after a period of abstinence4 7#ba7 ,people affected by drug overdose gather each year in communities nationwide on ,august #cast for ,overdose ,awareness ,day to mourn and pay tribute to loved ones and raise awareness about overdose risk and prevention4 #c4 ,overdose prevention grant program 7a7 ,program authorized ,the ,secretary1 acting through the ,director of the ,,cdc1 shall award grants or cooperative agreements to eligible entities to enable the eligible entities to reduce deaths occurring from overdoses of drugs4 7b7 ,application 7#a7 ,in general ,an eligible entity desiring a grant or cooperative agreement under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,an application under paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the grant or cooperative agreement2 and 7,b7 a demonstration that the eligible entity has the capacity to carry out such activities4 7c7 ,priority ,in awarding grants and cooperative agreements under subsection 7a71 the ,secretary shall give priority to eligible entities that-- 7#a7 are a public health agency or community-based organization2 and 7#b7 have expertise in preventing deaths occurring from overdoses of drugs in populations at high risk of such deaths4 7d7 ,eligible activities 7#a7 ,required activity ,as a condition on receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to use the grant or cooperative agreement to purchase and distribute the drug naloxone4 7#b7 ,additional activities ,in addition to the activity described in paragraph 7#a71 an eligible entity shall use a grant or cooperative agreement under this section to carry out one or more of the following activities3 7,a7 ,educating prescribers and pharmacists about overdose prevention and naloxone prescription4 7,b7 ,training first responders1 other individuals in a position to respond to an overdose1 and law enforcement and corrections officials on the effective response to individuals who have overdosed on drugs4 ,training pursuant to this subparagraph may include any activity that is educational1 instructional1 or consultative in nature1 and may include volunteer trainings1 awareness building exercises1 outreach to individuals who are at-risk of a drug overdose1 and distribution of educational materials4 7,c7 ,implementing and enhancing programs to provide overdose prevention1 recognition1 treatment1 and response to individuals in need of such services4 7,d7 ,expanding activities described in paragraph 7#a74 7,e7 ,expanding activities described in subparagraph 7,a7 or 7,b74 7e7 ,coordinating center 7#a7 ,establishment ,the ,secretary shall establish and provide for the operation of a coordinating center responsible for-- 7,a7 collecting1 compiling1 and disseminating data on the programs and activities under this section2 7,b7 evaluating such data and1 based on such evaluation1 developing best practices for preventing deaths occurring from drug overdoses2 and 7,c7 making such best practices specific to the type of community involved4 7#b7 ,reports to center ,as a condition on receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree to prepare and submit1 not later than #ij days after the end of the grant or cooperative agreement period1 a report to such coordinating center and the ,secretary describing the results of the activities supported through the grant or cooperative agreement4 7f7 ,matching funds 7#a7 ,in general ,as a condition on receipt of a grant or cooperative agreement under this section1 an eligible entity shall agree that1 with respect to the costs to be incurred by the eligible entity in carrying out the activities for which the grant or cooperative agreement is awarded1 the eligible entity will make available non-,federal contributions in an amount equal to not less than #ej percent of the ,federal funds provided through the grant or cooperative agreement4 7#b7 ,satisfying matching requirement ,the non-,federal contributions required under paragraph 7#a7 may be-- 7,a7 in cash or in-kind1 including services1 fairly evaluated2 and 7,b7 from-- 7i7 any private source2 or 7ii7 a ,state1 tribal1 or local agency4 7#c7 ,waiver ,the ,secretary may waive or reduce the non-,federal contribution required by paragraph 7#a7 if the eligible entity involved demonstrates that the eligible entity cannot meet the contribution requirement due to financial hardship4 7g7 ,duration ,the period of a grant or cooperative agreement under this section shall be #d years4 7h7 ,authorization of appropriations ,there are authorized to be appropriated #aj1jjj1jjj to carry out this section for each of the fiscal years #bjad through #bjah4 #d4 ,surveillance capacity building 7a7 ,program authorized ,the ,secretary1 acting through the ,director of the ,,cdc1 shall award grants or cooperative agreements to ,state1 local1 or tribal governments1 or the ,national ,poison ,data ,system working in conjunction with ,state1 local1 or tribal governments1 to improve fatal and nonfatal drug overdose surveillance and reporting capabilities1 including the following3 7#a7 ,providing training to improve identification of drug overdose as the cause of death by coroners and medical examiners4 7#b7 ,establishing1 in cooperation with the ,national ,poison ,data ,system1 coroners1 and medical examiners1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 drug overdose deaths in the ,united ,states4 7#c7 ,establishing1 in cooperation with the ,national ,poison ,data ,system1 a comprehensive national program for surveillance of1 and reporting to an electronic database on1 fatal and nonfatal drug overdose occurrences1 including epidemiological and toxicologic analysis and trends4 7b7 ,application 7#a7 ,in general ,a ,state1 local1 or tribal government or the ,national ,poison ,data ,system desiring a grant or cooperative agreement under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,the application described in paragraph 7#a7 shall include-- 7,a7 a description of the activities to be funded through the grant or cooperative agreement2 and 7,b7 a demonstration that the ,state1 local1 or tribal government or the ,national ,poison ,data ,system has the capacity to carry out such activities4 7c7 ,report ,as a condition on receipt of a grant or cooperative agreement under this section1 a ,state1 local1 or tribal government or the ,national ,poison ,data ,system shall agree to prepare and submit1 not later than #ij days after the end of the grant or cooperative agreement period1 a report to the ,secretary describing the results of the activities supported through the grant or cooperative agreement4 7d7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #e1jjj1jjj for each of the fiscal years #bjad through #bjah4 #e4 ,reducing overdose deaths ,part ,j of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;b et seq47 is amended by inserting after section #cic;,d 7#db ,u4,s4,c4 #bhj;b-#a;f7 the following3 #cic;,f4 ,reducing overdose deaths 7a7 ,prevention of drug overdose ,not later than #ahj days after the date of the enactment of this section1 the ,secretary1 in consultation with a task force comprised of stakeholders1 shall develop a plan to reduce the number of deaths occurring from overdoses of drugs and shall submit the plan to ,congress4 ,the plan shall include-- 7#a7 a plan for implementation of a public health campaign to educate prescribers and the public about overdose prevention and naloxone prescription2 7#b7 recommendations for improving and expanding overdose prevention programming2 and 7#c7 recommendations for such legislative or administrative action as the ,secretary considers appropriate4 7b7 ,task force representation 7#a7 ,required members ,the task force referred to in subsection 7a7 shall include at least one representative of each of the following3 7,a7 ,individuals directly impacted by drug overdose4 7,b7 ,direct service providers who engage individuals at risk of a drug overdose4 7,c7 ,drug overdose prevention advocates4 7,d7 ,the ,,nida4 7,e7 ,the ,center for ,substance ,abuse ,treatment4 7,f7 ,the ,,cdc4 7,g7 ,the ,health ,resources and ,services ,administration4 7,h7 ,the ,food and ,drug ,administration4 7,i7 ,the ,office of ,national ,drug ,control ,policy4 7,j7 ,the ,american ,medical ,association4 7,k7 ,the ,american ,association of ,poison ,control ,centers4 7,l7 ,the ,bureau of ,prisons4 7,m7 ,the ,centers for ,medicare ,medicaid ,services4 7,n7 ,the ,department of ,justice4 7#b7 ,additional members ,in addition to the representatives required by paragraph 7#a71 the task force referred to in subsection 7a7 may include other representatives of individuals or entities with expertise relating to drug overdoses4 4 #f4 ,overdose prevention research 7a7 ,overdose research ,the ,director of the ,,nida shall prioritize and conduct or support research on drug overdose and overdose prevention4 ,the primary aims of this research shall include-- 7#a7 examination of circumstances that contribute to drug overdose and identification of drugs associated with fatal overdose2 7#b7 evaluation of existing overdose prevention methods2 7#c7 pilot programs or research trials on new overdose prevention strategies or programs that have not been studied in the ,united ,states2 7#d7 scientific research concerning the effectiveness of overdose prevention programs1 including how to effectively implement and sustain such programs2 and 7#e7 comparative effectiveness research on overdose prevention programs4 7b7 ,formulations of naloxone ,the ,director of the ,,nida shall support research on the development of formulations of naloxone and dosage delivery devices specifically intended to be used by lay persons or first responders for the prehospital treatment of unintentional drug overdose4 7c7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #e1jjj1jjj for each of the fiscal years #bjad through #bjah4 #g4 ,offset of costs and personnel ,notwithstanding any other provision of law1 the ,secretary shall-- 7#a7 eliminate such initiatives1 positions1 and programs as the ,secretary deems necessary to ensure any and all costs incurred to carry out the provisions of this ,act1 and the amendments made by this ,act1 are entirely offset2 7#b7 ensure no net increase in personnel are added to carry out the provisions of this ,act1 with any new full- or part-time employees or equivalents offset by eliminating an equivalent number of existing staff2 7#c7 not later than #fj days after the date of the enactment of this ,act1 report to the ,congress on the actions taken to ensure compliance with paragraphs 7#a7 and 7#b71 including the specific initiatives1 positions1 and programs that have been eliminated to ensure that the costs of carrying out this ,act will be offset2 and 7#d7 not implement any other provision of this ,act 7other than paragraphs 7#a71 7#b71 and 7#c77 or any amendment made by this ,act until the ,secretary has certified that the actions specified in paragraphs 7#a71 7#b71 and 7#c7 have been completed4 #h4 ,definitions ,in this ,act3 7#a7 ,,cdc ,the term ,,cdc means the ,centers for ,disease ,control and ,prevention4 7#b7 ,drug ,the term drug-- 7,a7 means a drug 7as that term is defined in section #bja of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba772 and 7,b7 includes any controlled substance 7as that term is defined in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb774 7#c7 ,eligible entity ,the term eligible entity means an entity that is a ,state1 local1 or tribal government1 a correctional institution1 a law enforcement agency1 a community agency1 a professional organization in the field of poison control and surveillance1 or a private nonprofit organization4 7#d7 ,national poison data system ,the term ,national ,poison ,data ,system means the system operated by the ,american ,association of ,poison ,control ,centers1 in partnership with the ,,cdc1 for real-time local1 ,state1 and national electronic reporting1 and the corresponding database network4 7#e7 ,,nida ,the term ,,nida means the ,national ,institute on ,drug ,abuse4 7#f7 ,,ondcp ,the term ,,ondcp means the ,office of ,national ,drug ,control ,policy4 7#g7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#h7 ,state ,the term ,state means any of the several ,states1 the ,district of ,columbia1 ,puerto ,rico1 the ,northern ,mariana ,islands1 the ,united ,states ,virgin ,islands1 ,guam1 ,american ,samoa1 and any other territory or possession of the ,united ,states4