,i #aac? ,,congress #b;d ,session ,h4 ,r4 #dafi ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,m>* #f1 #bjad ,ms4 ,edw>ds 7= h]self1 ,ms4 ,bass1 ,mr4 ,c>son ( ,indiana1 ,mr4 ,cumm+s1 ,mr4 ,ellison1 ,mr4 ,keat+1 ,ms4 ,lee ( ,cali=nia1 ,mr4 ,lyn*1 ,mr4 ,mi*aud1 ,mr4 ,rangel1 ,mr4 ,ryan ( ,ohio1 ,ms4 ,s*w>tz1 ,mr4 ,s]rano1 ,ms4 ,%ea-,port]1 ,mr4 ,ti]ney1 ,mr4 ,tonko1 ,ms4 ,wilson ( ,florida1 ,mr4 ,fo/]1 & ,mr4 ,b5 ,ray ,lujn ( ,new ,mexico7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,a ,,bill ,to prev5t dea?s occurr+ f drug ov]doses4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,/op ,ov]dose ,/at ,act or ! ,s4,o4,s4 ,act4 #b4 ,f9d+s ,! ,congress f9ds ! foll[+3 7#a7 ,accord+ to ! ,c5t]s = ,disease ,control & ,prev5tion 7,,cdc71 ea* day 9 ! ,unit$ ,/ates m ?an #ajj p die f a drug ov]dose4 ,among p #be to #fd ye>s old1 drug ov]dose caus$ m dea?s ?an motor vehicle accid5ts4 7#b7 ,! ,,cdc reports t m ?an #ch1jjj p 9 ! ,unit$ ,/ates di$ f a drug ov]dose 9 #bjaj alone4 ,sev5ty-eight p]c5t ( ^! dea?s 7 due to un9t5tional drug ov]doses1 & _m c\ld h be5 prev5t$4 7#c7 ,dea?s result+ f un9t5tional drug ov]doses increas$ m ?an #djj p]c5t betwe5 #aihj & #aiii1 & m ?an d\bl$ betwe5 #aiii & #bjaj4 7#d7 ,n9ety-"o p]c5t ( all un9t5tional poison+ dea?s are due to drugs4 ,s9ce #aiii1 9 ! ,unit$ ,/ates ! population ( ,non-,hispanic ,:ites & ! population ( ,am]ican ,indians & ,alaska ,natives h se5 ! highe/ rates ( un9t5tional drug poison+ dea?s4 7#e7 ,opioid m$ications su* z oxycodone & hydrocodone are involv$ 9 #ee p]c5t ( all un9t5tional drug poison+ dea?s4 7#f7 ,betwe5 #aiii & #bjaj1 opioid m$ication ov]dose fatalities increas$ by m ?an #djj p]c5t among wom5 & #bfe p]c5t among m54 7#g7 ,milit>y vet]ans are at elevat$ risk ( exp]i5c+ a drug ov]dose4 ,vietnam1 ,iraq1 & ,afghani/an vet]ans ) combat injuries1 po/traumatic /ress disord] 7,,ptsd71 & o!r co-occurr+ m5tal heal? diagnoses are at elevat$ risk ( fatal drug ov]dose f opioid m$ications4 7#h7 ,rural & suburban regions are disproportionately affect$ by opioid m$ication ov]doses4 ,urban c5t]s also cont9ue to /ruggle ) ov]dose1 :i* is ! lead+ cause ( dea? among homeless adults4 7#i7 ,9 ! ye> #bjji alone1 e/imat$ lo/ productivity & direct m$ical co/s f opioid m$ication poison+s exce$$ #bj1jjj1jjj1jjj4 7#aj7 ,bo? fatal & nonfatal ov]doses place a heavy burd5 on public heal? & public safety res\rces1 yet !re is no coord9at$ cross-,f$]al ag5cy response to prev5t ov]dose fatalities4 7#aa7 ,naloxone is a m$ication t rapidly rev]ses ov]dose f h]o9 & opioid m$ications4 7#ab7 ,9 #bjab1 ! ,food & ,drug ,adm9i/ration 7,,fda7 held a public work%op 9 collaboration ) ! ,national ,in/itute on ,drug ,abuse 7,,nida7 & ! ,,cdc1 & ) p>ticipation f ! ,sub/ance ,abuse & ,m5tal ,heal? ,s]vices ,adm9i/ration 7,,samhsa7 & ! ,(fice ( ,national ,drug ,control ,policy 7,,ondcp71 to discuss mak+ naloxone m widely available outside ( conv5tional m$ical sett+s to r$uce ! incid5ce ( opioid ov]dose fatalities4 7#ac7 ,lawmak]s 9 ,cali=nia1 ,colorado1 ,connecticut1 ,ill9ois1 ,k5tucky1 ,massa*usetts1 ,m>yl&1 ,new ,j]sey1 ,new ,mexico1 ,new ,york1 ,nor? ,c>ol9a1 ,oregon1 ,rhode ,isl&1 ,v]mont1 ,virg9ia1 ,wa%+ton1 & ! ,di/rict ( ,columbia h remov$ legal imp$im5ts to increas+ naloxone prescription & its use by by/&]s :o are 9 a position to respond to an ov]dose4 7#ad7 ,heal? practition]s are (t5 n fully aw>e ( ov]dose symptoms & prev5tion me?ods1 impact+ _! ability to adequately in=m pati5ts & c>egiv]s on h[ to recognize symptoms1 respond effectively by seek+ em]g5cy assi/ance1 & provide naloxone & o!r fir/ aid 9 ord] to save a life4 7#ae7 ,! ,am]ican ,m$ical ,association 7,,ama71 ! ,nation's l>ge/ physician organization1 supports fur!r implem5tation ( community-bas$ programs t (f] naloxone & o!r opioid ov]dose prev5tion s]vices4 7#af7 ,community-bas$ ov]dose prev5tion programs h successfully prev5t$ dea?s f opioid ov]doses by mak+ rescue tra9+s & naloxone available to fir/ respond]s1 p>5ts1 & o!r by/&]s :o may enc\nt] an ov]dose4 ,ov] #ej1jjj pot5tial by/&]s h be5 tra9$ by ov]dose prev5tion programs 9 ! ,unit$ ,/ates4 ,a ,,cdc report cr$its ov]dose prev5tion programs ) sav+ m ?an #aj1jjj lives s9ce #aiif4 7#ag7 ,at lea/ #ahh local ov]dose prev5tion programs are op]at+ 9 ! ,unit$ ,/ates1 includ+ 9 major cities su* z ,baltimore1 ,*icago1 ,los ,angeles1 ,new ,york ,city1 ,bo/on1 ,san ,francisco1 & ,philadelphia1 & /atewide 9 ,new ,mexico1 ,massa*usetts1 & ,new ,york4 ,betwe5 #bjjf & #bjji1 ov]dose prev5tion programs facilitat$ by ! ,massa*usetts ,dep>tm5t ( ,public ,heal? tra9$ ne>ly #c1jjj p :o report$ m ?an #cjj rescues4 ,s9ce #bjjd1 a program adm9i/]$ by ! ,baltimore ,city ,heal? ,dep>tm5t has tra9$ m ?an #c1jjj p :o report$ m ?an #bbj rescues4 ,project ,laz>us1 an ov]dose prev5tion program 9 ,wilkes ,c\nty1 ,nor? ,c>ol9a1 r$uc$ ov]dose dea?s #fi p]c5t betwe5 #bjji & #bjaa4 7#ah7 ,! ,,ondcp supports equipp+ fir/ respond]s to help rev]se ov]doses4 ,police (fic]s on patrol 9 ,qu9cy1 ,massa*usetts1 h conduct$ #agj ov]dose rescues ) naloxone s9ce #bjaj4 ,! police dep>tm5t has report$ a #ie-p]c5t success rate ) ov]dose rescue attempts by police (fic]s4 ,9 ,suffolk ,c\nty1 ,new ,york1 police (fic]s h sav$ m ?an #ej lives ) naloxone4 7#ai7 ,rese>* %[s t ! co/ p] ye> ( life ga9$ by mak+ naloxone available to rev]se ov]doses is )9 ! range ( :at ,am]icans usually pay = heal? treatm5ts4 7#bj7 ,ov]dose prev5tion programs are ne$$ 9 correctional facilities1 addiction treatm5t programs1 & o!r places :]e p are at high] risk ( ov]dos+ aft] a p]iod ( ab/95ce4 7#ba7 ,p affect$ by drug ov]dose ga!r ea* ye> 9 communities nationwide on ,augu/ #ca/ = ,ov]dose ,aw>5ess ,day to m\rn & pay tribute to lov$ ones & raise aw>5ess ab\t ov]dose risk & prev5tion4 #c4 ,ov]dose prev5tion grant program 7a7 ,program au?oriz$ ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,,cdc1 %all aw>d grants or coop]ative agreem5ts to eligible entities to enable ! eligible entities to r$uce dea?s occurr+ f ov]doses ( drugs4 7b7 ,application 7#a7 ,9 g5]al ,an eligible entity desir+ a grant or coop]ative agreem5t "u ?is section %all submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7#b7 ,cont5ts ,an application "u p>agraph 7#a7 %all include-- 7,a7 a description ( ! activities to be fund$ ?r\gh ! grant or coop]ative agreem5t2 & 7,b7 a demon/ration t ! eligible entity has ! capacity to c>ry out su* activities4 7c7 ,priority ,9 aw>d+ grants & coop]ative agreem5ts "u subsection 7a71 ! ,secret>y %all give priority to eligible entities t-- 7#a7 are a public heal? ag5cy or community-bas$ organization2 & 7#b7 h exp]tise 9 prev5t+ dea?s occurr+ f ov]doses ( drugs 9 populations at high risk ( su* dea?s4 7d7 ,eligible activities 7#a7 ,requir$ activity ,z a condition on receipt ( a grant or coop]ative agreem5t "u ?is section1 an eligible entity %all agree to use ! grant or coop]ative agreem5t to pur*ase & di/ribute ! drug naloxone4 7#b7 ,additional activities ,9 addition to ! activity describ$ 9 p>agraph 7#a71 an eligible entity %all use a grant or coop]ative agreem5t "u ?is section to c>ry out "o or m ( ! foll[+ activities3 7,a7 ,educat+ prescrib]s & ph>maci/s ab\t ov]dose prev5tion & naloxone prescription4 7,b7 ,tra9+ fir/ respond]s1 o!r individuals 9 a position to respond to an ov]dose1 & law en=cem5t & corrections (ficials on ! effective response to individuals :o h ov]dos$ on drugs4 ,tra9+ pursuant to ?is subp>agraph may include any activity t is educational1 in/ructional1 or consultative 9 nature1 & may include volunte] tra9+s1 aw>5ess build+ ex]cises1 outrea* to individuals :o are at-risk ( a drug ov]dose1 & di/ribution ( educational mat]ials4 7,c7 ,implem5t+ & enhanc+ programs to provide ov]dose prev5tion1 recognition1 treatm5t1 & response to individuals 9 ne$ ( su* s]vices4 7,d7 ,exp&+ activities describ$ 9 p>agraph 7#a74 7,e7 ,exp&+ activities describ$ 9 subp>agraph 7,a7 or 7,b74 7e7 ,coord9at+ c5t] 7#a7 ,e/abli%m5t ,! ,secret>y %all e/abli% & provide = ! op]ation ( a coord9at+ c5t] responsible =-- 7,a7 collect+1 compil+1 & dissem9at+ data on ! programs & activities "u ?is section2 7,b7 evaluat+ su* data &1 bas$ on su* evaluation1 develop+ be/ practices = prev5t+ dea?s occurr+ f drug ov]doses2 & 7,c7 mak+ su* be/ practices specific to ! type ( community involv$4 7#b7 ,reports to c5t] ,z a condition on receipt ( a grant or coop]ative agreem5t "u ?is section1 an eligible entity %all agree to prep>e & submit1 n lat] ?an #ij days aft] ! end ( ! grant or coop]ative agreem5t p]iod1 a report to su* coord9at+ c5t] & ! ,secret>y describ+ ! results ( ! activities support$ ?r\gh ! grant or coop]ative agreem5t4 7f7 ,mat*+ funds 7#a7 ,9 g5]al ,z a condition on receipt ( a grant or coop]ative agreem5t "u ?is section1 an eligible entity %all agree t1 ) respect to ! co/s to be incurr$ by ! eligible entity 9 c>ry+ out ! activities = :i* ! grant or coop]ative agreem5t is aw>d$1 ! eligible entity w make available non-,f$]al contributions 9 an am\nt equal to n less ?an #ej p]c5t ( ! ,f$]al funds provid$ ?r\gh ! grant or coop]ative agreem5t4 7#b7 ,satisfy+ mat*+ requirem5t ,! non-,f$]al contributions requir$ "u p>agraph 7#a7 may be-- 7,a7 9 ca% or 9-k9d1 includ+ s]vices1 fairly evaluat$2 & 7,b7 f-- 7i7 any private s\rce2 or 7ii7 a ,/ate1 tribal1 or local ag5cy4 7#c7 ,waiv] ,! ,secret>y may waive or r$uce ! non-,f$]al contribution requir$ by p>agraph 7#a7 if ! eligible entity involv$ demon/rates t ! eligible entity _c meet ! contribution requirem5t due to f9ancial h>d%ip4 7g7 ,duration ,! p]iod ( a grant or coop]ative agreem5t "u ?is section %all be #d ye>s4 7h7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ #aj1jjj1jjj to c>ry out ?is section = ea* ( ! fiscal ye>s #bjad ?r\gh #bjah4 #d4 ,surveillance capacity build+ 7a7 ,program au?oriz$ ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,,cdc1 %all aw>d grants or coop]ative agreem5ts to ,/ate1 local1 or tribal gov]nm5ts1 or ! ,national ,poison ,data ,sy/em work+ 9 conjunction ) ,/ate1 local1 or tribal gov]nm5ts1 to improve fatal & nonfatal drug ov]dose surveillance & report+ capabilities1 includ+ ! foll[+3 7#a7 ,provid+ tra9+ to improve id5tification ( drug ov]dose z ! cause ( dea? by coron]s & m$ical exam9]s4 7#b7 ,e/abli%+1 9 coop]ation ) ! ,national ,poison ,data ,sy/em1 coron]s1 & m$ical exam9]s1 a compreh5sive national program = surveillance (1 & report+ to an electronic database on1 drug ov]dose dea?s 9 ! ,unit$ ,/ates4 7#c7 ,e/abli%+1 9 coop]ation ) ! ,national ,poison ,data ,sy/em1 a compreh5sive national program = surveillance (1 & report+ to an electronic database on1 fatal & nonfatal drug ov]dose occurr5ces1 includ+ epidemiological & toxicologic analysis & tr5ds4 7b7 ,application 7#a7 ,9 g5]al ,a ,/ate1 local1 or tribal gov]nm5t or ! ,national ,poison ,data ,sy/em desir+ a grant or coop]ative agreem5t "u ?is section %all submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7#b7 ,cont5ts ,! application describ$ 9 p>agraph 7#a7 %all include-- 7,a7 a description ( ! activities to be fund$ ?r\gh ! grant or coop]ative agreem5t2 & 7,b7 a demon/ration t ! ,/ate1 local1 or tribal gov]nm5t or ! ,national ,poison ,data ,sy/em has ! capacity to c>ry out su* activities4 7c7 ,report ,z a condition on receipt ( a grant or coop]ative agreem5t "u ?is section1 a ,/ate1 local1 or tribal gov]nm5t or ! ,national ,poison ,data ,sy/em %all agree to prep>e & submit1 n lat] ?an #ij days aft] ! end ( ! grant or coop]ative agreem5t p]iod1 a report to ! ,secret>y describ+ ! results ( ! activities support$ ?r\gh ! grant or coop]ative agreem5t4 7d7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section #e1jjj1jjj = ea* ( ! fiscal ye>s #bjad ?r\gh #bjah4 #e4 ,r$uc+ ov]dose dea?s ,"p ,j ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bhj;b et seq47 is am5d$ by ins]t+ aft] section #cic;,d 7#db ,u4,s4,c4 #bhj;b-#a;f7 ! foll[+3 #cic;,f4 ,r$uc+ ov]dose dea?s 7a7 ,prev5tion ( drug ov]dose ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is section1 ! ,secret>y1 9 consultation ) a task =ce compris$ ( /akehold]s1 %all develop a plan to r$uce ! numb] ( dea?s occurr+ f ov]doses ( drugs & %all submit ! plan to ,congress4 ,! plan %all include-- 7#a7 a plan = implem5tation ( a public heal? campaign to educate prescrib]s & ! public ab\t ov]dose prev5tion & naloxone prescription2 7#b7 recomm5dations = improv+ & exp&+ ov]dose prev5tion programm+2 & 7#c7 recomm5dations = su* legislative or adm9i/rative action z ! ,secret>y consid]s appropriate4 7b7 ,task =ce repres5tation 7#a7 ,requir$ memb]s ,! task =ce ref]r$ to 9 subsection 7a7 %all include at lea/ "o repres5tative ( ea* ( ! foll[+3 7,a7 ,individuals directly impact$ by drug ov]dose4 7,b7 ,direct s]vice provid]s :o engage individuals at risk ( a drug ov]dose4 7,c7 ,drug ov]dose prev5tion advocates4 7,d7 ,! ,,nida4 7,e7 ,! ,c5t] = ,sub/ance ,abuse ,treatm5t4 7,f7 ,! ,,cdc4 7,g7 ,! ,heal? ,res\rces & ,s]vices ,adm9i/ration4 7,h7 ,! ,food & ,drug ,adm9i/ration4 7,i7 ,! ,(fice ( ,national ,drug ,control ,policy4 7,j7 ,! ,am]ican ,m$ical ,association4 7,k7 ,! ,am]ican ,association ( ,poison ,control ,c5t]s4 7,l7 ,! ,bureau ( ,prisons4 7,m7 ,! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7,n7 ,! ,dep>tm5t ( ,ju/ice4 7#b7 ,additional memb]s ,9 addition to ! repres5tatives requir$ by p>agraph 7#a71 ! task =ce ref]r$ to 9 subsection 7a7 may include o!r repres5tatives ( individuals or entities ) exp]tise relat+ to drug ov]doses4 4 #f4 ,ov]dose prev5tion rese>* 7a7 ,ov]dose rese>* ,! ,director ( ! ,,nida %all prioritize & conduct or support rese>* on drug ov]dose & ov]dose prev5tion4 ,! prim>y aims ( ?is rese>* %all include-- 7#a7 exam9ation ( circum/ances t contribute to drug ov]dose & id5tification ( drugs associat$ ) fatal ov]dose2 7#b7 evaluation ( exi/+ ov]dose prev5tion me?ods2 7#c7 pilot programs or rese>* trials on new ov]dose prev5tion /rategies or programs t h n be5 /udi$ 9 ! ,unit$ ,/ates2 7#d7 sci5tific rese>* conc]n+ ! effectiv5ess ( ov]dose prev5tion programs1 includ+ h[ to effectively implem5t & su/a9 su* programs2 & 7#e7 comp>ative effectiv5ess rese>* on ov]dose prev5tion programs4 7b7 ,=mulations ( naloxone ,! ,director ( ! ,,nida %all support rese>* on ! developm5t ( =mulations ( naloxone & dosage deliv]y devices specifically int5d$ to be us$ by lay p]sons or fir/ respond]s = ! prehospital treatm5t ( un9t5tional drug ov]dose4 7c7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section #e1jjj1jjj = ea* ( ! fiscal ye>s #bjad ?r\gh #bjah4 #g4 ,(fset ( co/s & p]sonnel ,not)/&+ any o!r provision ( law1 ! ,secret>y %all-- 7#a7 elim9ate su* initiatives1 positions1 & programs z ! ,secret>y deems necess>y to ensure any & all co/s incurr$ to c>ry out ! provisions ( ?is ,act1 & ! am5dm5ts made by ?is ,act1 are entirely (fset2 7#b7 ensure no net increase 9 p]sonnel are add$ to c>ry out ! provisions ( ?is ,act1 ) any new full- or "p-"t employees or equival5ts (fset by elim9at+ an equival5t numb] ( exi/+ /aff2 7#c7 n lat] ?an #fj days aft] ! date ( ! enactm5t ( ?is ,act1 report to ! ,congress on ! actions tak5 to ensure compliance ) p>agraphs 7#a7 & 7#b71 includ+ ! specific initiatives1 positions1 & programs t h be5 elim9at$ to ensure t ! co/s ( c>ry+ out ?is ,act w be (fset2 & 7#d7 n implem5t any o!r provision ( ?is ,act 7o!r ?an p>agraphs 7#a71 7#b71 & 7#c77 or any am5dm5t made by ?is ,act until ! ,secret>y has c]tifi$ t ! actions specifi$ 9 p>agraphs 7#a71 7#b71 & 7#c7 h be5 complet$4 #h4 ,def9itions ,9 ?is ,act3 7#a7 ,,cdc ,! t]m ,,cdc means ! ,c5t]s = ,disease ,control & ,prev5tion4 7#b7 ,drug ,! t]m drug-- 7,a7 means a drug 7z t t]m is def9$ 9 section #bja ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act 7#ba ,u4,s4,c4 #cba772 & 7,b7 includes any controll$ sub/ance 7z t t]m is def9$ 9 section #ajb ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hjb774 7#c7 ,eligible entity ,! t]m eligible entity means an entity t is a ,/ate1 local1 or tribal gov]nm5t1 a correctional in/itution1 a law en=cem5t ag5cy1 a community ag5cy1 a pr(essional organization 9 ! field ( poison control & surveillance1 or a private nonpr(it organization4 7#d7 ,national poison data sy/em ,! t]m ,national ,poison ,data ,sy/em means ! sy/em op]at$ by ! ,am]ican ,association ( ,poison ,control ,c5t]s1 9 p>tn]%ip ) ! ,,cdc1 = real-"t local1 ,/ate1 & national electronic report+1 & ! correspond+ database network4 7#e7 ,,nida ,! t]m ,,nida means ! ,national ,in/itute on ,drug ,abuse4 7#f7 ,,ondcp ,! t]m ,,ondcp means ! ,(fice ( ,national ,drug ,control ,policy4 7#g7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7#h7 ,/ate ,! t]m ,/ate means any ( ! sev]al ,/ates1 ! ,di/rict ( ,columbia1 ,pu]to ,rico1 ! ,nor!rn ,m>iana ,isl&s1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,guam1 ,am]ican ,samoa1 & any o!r t]ritory or possession ( ! ,unit$ ,/ates4