,,ii  #aad? ,,congress  #a/ ,session    
,s4 #bbef  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,novemb] #e1 #bjae ,mr4
 ,ka9e 7= himself & ,mrs4 ,capito7      
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to e/abli% programs = heal? 
c>e provid] tra9+ 9 ,f$]al heal? c>e &  
m$ical facilities1 to e/abli% ,f$]al    
co-prescrib+ guidel9es1 to e/abli% a    
grant program ) respect to naloxone1 & =
 o!r purposes4  #a4 ,%ort title  ,?is   
,act may be cit$ z ! ,co-,prescrib+     
,saves ,lives ,act ( #bjae4  #b4 ,f9d+s 
,congress f9ds z foll[s3 7#a7 ,toge!r1 !
 misuse ( h]o9 & opioids acc\nt =       
approximately #be1jjj dea?s 9 ! ,unit$  
,/ates p] ye>4  7#b7 ,drug ov]dose 0 !  
lead+ cause ( injury dea? 9 ! ,unit$    
,/ates 9 #bjac1 & among p #be to #fd    
ye>s old1 drug ov]dose caus$ m dea?s ?an
 motor vehicle fatalities 9 #bjac4  7#c7
 ,accord+ to ! ,c5t]s = ,disease        
,control & ,prev5tion1 9 ! ,unit$       

,/ates1 fatal opioid-relat$ drug ov]dose
 rates h m ?an quadrupl$ s9ce #aiij & h 
nev] be5 high]4 ,ea* day 9 ! ,unit$     
,/ates1 #df p die f an ov]dose (        
prescription pa9kill]s4 ,ne>ly          
#b1jjj1jjj ,am]icans ag$ #ab or old]    
ei!r abus$ or 7 dep5d5t on opioids 9    
#bjac4  7#d7 ,naloxone is a safe &      
effective antidote to all opioid-relat$ 
ov]doses1 includ+ h]o9 & f5tanyl1 & is a
 critical tool 9 prev5t+ fatal opioid   
ov]doses 9 bo? heal? c>e & at-home      
sett+s4  7#e7 ,! opioid ov]dose antidote
 naloxone has rev]s$ m ?an #bf1jjj      
ov]dose cases betwe5 #aiif & #bjad1     
accord+ to ! ,c5t]s = ,disease ,control 
& ,prev5tion4  #c4 ,heal? c>e provid]   
tra9+ 9 ,f$]al heal? c>e & m$ical       
facilities  7a7 ,guidel9es  7#a7 ,,hhs  
guidel9es ,! ,secret>y ( ,heal? & ,human
 ,s]vices %all e/abli% heal? c>e provid]
 tra9+ guidel9es = all ,f$]al heal? c>e 
facilities1 includ+ ,f$]ally qualifi$   
heal? c5t]s 7z def9$ 9 p>agraph 7#d7 (  
section #ahfa7;aa7 ( ! ,social ,security

 ,act 7#db ,u4,s4,c4 #aciex7aa777 &     
facilities ( ! ,indian ,heal? ,s]vice1 &
 %all provide tra9+ to all provid]s     
describ$ 9 subsection 7b71 9 accordance 
) subsection 7c74  7#b7 ,dep>tm5t (     
,vet]ans ,affairs guidel9es ,! ,secret>y
 ( ,vet]ans ,affairs %all e/abli% heal? 
c>e provid] tra9+ guidel9es = all m$ical
 facilities ( ! ,dep>tm5t ( ,vet]ans    
,affairs1 & %all provide tra9+ to all   
provid]s describ$ 9 subsection 7b71 9   
accordance ) subsection 7c74  7#c7      
,dep>tm5t ( ,def5se guidel9es ,!        
,secret>y ( ,def5se %all e/abli% heal?  
c>e provid] tra9+ guidel9es = all m$ical
 facilities ( ! ,dep>tm5t ( ,def5se1 &  
%all provide tra9+ to all provid]s      
describ$ 9 subsection 7b71 9 accordance 
) subsection 7c74  7b7 ,affect$ heal?   
c>e provid]s ,! guidel9es develop$ "u   
p>agraphs 7#a7 ?r\gh 7#c7 ( subsection  
7a7 %all ensure t tra9+ on ! appropriate
 & effective prescrib+ ( opioid         
m$ications is provid$ to all heal? c>e  
provid]s :o are--  7#a7 ,f$]al employees

 & :o prescribe controll$ sub/ances z "p
 ( _! (ficial responsibilities & duties 
z ,f$]al employees2  7#b7 contractors 9 
a heal? c>e or m$ical facility ( an     
ag5cy describ$ 9 p>agraph 7#a71 7#b71 or
 7#c7 ( subsection 7a7 :o--  7,a7 sp5d  
#ej p]c5t or m ( _! cl9ical "t "u       
contract ) ! ,f$]al ,gov]nm5t2 &  7,b7  
prescribe controll$ sub/ances "u ! t]ms 
& conditions ( _! contract or agreem5t )
 ! ,f$]al ,gov]nm5t2 or  7#c7 cl9ical   
resid5ts & o!r cl9ical tra9ees :o sp5d  
#ej p]c5t or m ( _! cl9ical "t practic+ 
9 heal? c>e or m$ical facility ( an     
ag5cy describ$ 9 p>agraph 7#a71 7#b71 or
 7#c7 ( subsection 7a74  7c7 ,tra9+     
requirem5ts  7#a7 ,tra9+ topics ,! tra9+
 develop$ "u p>agraphs 7#a7 ?r\gh 7#c7 (
 subsection 7a7 %all address1 at a      
m9imum1 be/ practices = appropriate &   
effective prescrib+ ( pa9 m$ications1   
pr9ciples ( pa9 managem5t1 ! misuse     
pot5tial ( controll$ sub/ances1         
id5tification ( pot5tial sub/ance use   
disord]s & ref]ral to fur!r evaluation &

 treatm5t1 & prop] me?ods = dispos+ (   
controll$ sub/ances4  7#b7 ,tra9+       
approa*es ,! tra9+ approa*es develop$ 9 
accordance ) ?is section may include bo?
 traditional cont9u+ education models & 
models t pair int5sive coa*+ = ! highe/ 
volume prescrib]s ) case-bas$ c\rses =  
o!r prescrib]s4  7#c7 ,consi/5cy )      
cons5sus guidel9es ,to ! ext5t          
practicable1 tra9+ adopt$ "u subsection 
7a7 %all be consi/5t ) cons5sus         
guidel9es on pa9 m$ication prescrib+    
develop$ by ! ,c5t]s = ,disease ,control
 & ,prev5tion4  7#d7 ,tra9+ frequ5cy    
,ea* ag5cy describ$ 9 p>agraphs 7#a7    
?r\gh 7#c7 ( subsection 7a7 %all provide
 tra9+ ( ! heal? c>e provid]s 9         
accordance ) ?is section n lat] ?an #ah 
mon?s aft] ! date ( enactm5t ( ?is ,act1
 & e #c ye>s !reaft]4  7d7 ,def9itions  
,= purposes ( ?is section1 ! t]m        
controll$ sub/ance has ! mean+ giv5 su* 
t]m 9 section #ajb ( ! ,controll$       
,sub/ances ,act 7#ba ,u4,s4,c4 #hjb74   
#d4 ,naloxone co-prescrib+ 9 ,f$]al     

heal? c>e & m$ical facilities  7a7      
,naloxone co-,prescrib+ guidel9es ,n    
lat] ?an #ahj days aft] ! date (        
enactm5t ( ?is ,act3  7#a7 ,! ,secret>y 
( ,heal? & ,human ,s]vices %all e/abli% 
naloxone co-prescrib+ guidel9es         
applicable to all ,f$]ally qualifi$     
heal? c5t]s 7z def9$ 9 p>agraph 7#d7 (  
section #ahfa7;aa7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciex7aa777 & !   
heal? c>e facilities ( ! ,indian ,heal? 
,s]vice4  7#b7 ,! ,secret>y ( ,def5se   
%all e/abli% co-prescrib+ guidel9es     
applicable to all ,dep>tm5t ( ,def5se   
m$ical facilities4  7#c7 ,! ,secret>y ( 
,vet]ans ,affairs %all e/abli%          
co-prescrib+ guidel9es applicable to all
 ,dep>tm5t ( ,vet]ans ,affairs m$ical   
facilities4  7b7 ,requirem5t ,!         
guidel9es e/abli%$ "u subsection 7a7    
%all address naloxone co-prescrib+ = bo?
 pa9 pati5ts receiv+ *ronic opioid !rapy
 & pati5ts be+ treat$ = opioid use      
disord]s4  7c7 ,def9itions ,9 ?is       
section3 7#a7 ,co-prescrib+ ,! t]m      

co-prescrib+ means1 ) respect to an     
opioid ov]dose rev]sal drug1 ! practice 
( prescrib+ su* drug 9 conjunction ) an 
opioid prescription = pati5ts at an     
elevat$ risk ( ov]dose1 or 9 conjunction
 ) an opioid agoni/ approv$ "u section  
#eje ( ! ,f$]al ,food1 ,drug1 &         
,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 = ! 
treatm5t ( opioid use disord]s1 or 9 o!r
 circum/ances 9 :i* a provid] id5tifies 
a pati5t at an elevat$ risk = an        
int5tional or un9t5tional drug ov]dose f
 h]o9 or prescription opioid !rapies4   
7#b7 ,elevat$ risk ( ov]dose ,! t]m     
elevat$ risk ( ov]dose has ! mean+ giv5 
su* t]m by ! ,secret>y ( ,heal? & ,human
 ,s]vices1 :i*-- 7,a7 may be bas$ on !  
crit]ia provid$ 9 ! ,opioid ,ov]dose    
,toolkit publi%$ by ! ,sub/ance ,abuse &
 ,m5tal ,heal? ,s]vices ,adm9i/ration2 &
  7,b7 may include pati5ts on a fir/    
c\rse opioid treatm5t1 pati5ts us+      
ext5d$-release & long-act+ opioid       
analgesic1 & pati5ts ) a respiratory    
disease or o!r co-morbidities4  #e4     

,grant program to ,/ate dep>tm5ts (     
heal? to exp& naloxone co-prescrib+  7a7
 ,e/abli%m5t ,n lat] ?an #ahj days aft] 
! date ( ! enactm5t ( ?is ,act1 !       
,secret>y ( ,heal? & ,human ,s]vices    
7ref]r$ to 9 ?is section z ! ,secret>y7 
%all e/abli% a competitive #d-ye>       
co-prescrib+ opioid ov]dose rev]sal     
drugs grant program to provide ,/ate    
dep>tm5ts ( heal? ) res\rces to develop 
& apply co-prescrib+ guidel9es1 & to    
provide = increas$ access to naloxone4  
7b7 ,application ,to be eligible to     
receive a grant "u ?is section1 a ,/ate 
%all submit to ! ,secret>y1 9 su* =m &  
mann] z ! ,secret>y may require1 an     
application t--  7#a7 id5tifies         
community p>tn]s = a co-prescrib+       
program2  7#b7 id5tifies :i* provid]s w 
be tra9$ 9 su* program & ! crit]ia t w  
be us$ to id5tify eligible pati5ts to   
p>ticipate 9 su* program2 &  7#c7       
describes h[ ! program w seek to id5tify
 ,/ate1 local1 or private fund+ to      
cont9ue ! program aft] expiration ( !   

grant4  7c7 ,prioritization ,9 aw>d+    
grants "u ?is section1 ! ,secret>y %all 
give priority to eligible ,/ate         
dep>tm5ts ( heal? t propose to base     
,/ate guidel9es on guidel9es on         
co-prescrib+ already 9 exi/5ce at ! "t (
 application1 su* z guidel9es ( !       
,dep>tm5t ( ,vet]ans ,affairs or        
national m$ical societies1 su* z !      
,am]ican ,society ( ,addiction ,m$ic9e  
or ,am]ican ,m$ical ,association4  7d7  
,use ( funds ,a ,/ate dep>tm5t ( heal?  
receiv+ a grant "u ?is section may use !
 grant = any ( ! foll[+ activities3     
7#a7 ,to e/abli% a program =            
co-prescrib+ opioid ov]dose rev]sal     
drugs1 su* z naloxone4  7#b7 ,to exp&   
innovative models ( naloxone            
di/ribution1 z def9$ by ! ,secret>y4    
7#c7 ,to tra9 & provide res\rces = heal?
 c>e provid]s & ph>maci/s on !          
co-prescrib+ ( opioid ov]dose rev]sal   
drugs4  7#d7 ,to e/abli% me*anisms &    
processes = track+ pati5ts p>ticipat+ 9 
! program describ$ 9 p>agraph 7#a7 & !  

heal? outcomes ( su* pati5ts1 & ensur+ t
 heal? in=mation is de-id5tifi$ s z to  
protect pati5t privacy4  7#e7 ,to       
pur*ase opioid ov]dose rev]sal drugs =  
di/ribution "u ! program describ$ 9     
p>agraph 7#a74  7#f7 ,to (fset !        
copaym5ts & o!r co/-%>+ associat$ )     
opioid ov]dose rev]sal drugs to ensure t
 co/ is n a limit+ factor = eligible    
individuals1 z det]m9$ by ! ,secret>y & 
! applicable ,/ate dep>tm5t ( heal?1    
giv+ priority to individuals n o!rwise  
insur$ = su* s]vices4  7#g7 ,to conduct 
community outrea*1 9 conjunction )      
community-bas$ organizations1 design$ to
 raise aw>5ess ( co-prescrib+ practices1
 & ! availability ( opioid ov]dose      
rev]sal drugs4  7#h7 ,to e/abli%        
protocols to connect pati5ts :o h       
exp]i5c$ a drug ov]dose ) appropriate   
treatm5t1 includ+ m$ication assi/$      
treatm5t & appropriate c\nsel+ &        
behavioral !rapies4 ,su* protocols %all 
be consi/5t ) nationally recogniz$      
pati5t placem5t crit]ia1 su* z ! crit]ia

 ( ! ,am]ican ,society ( ,addiction     
,m$ic9e4  7e7 ,evaluations by recipi5ts 
,z a condition ( receipt ( a grant "u   
?is section1 a ,/ate dep>tm5t ( heal?   
%all1 = ea* ye> = :i* grant funds are   
receiv$1 submit to ! ,secret>y in=mation
 on appropriate outcome measures        
specifi$ by ! ,secret>y to assess !     
outcomes ( ! program fund$ by ! grant4  
7f7 ,def9ition ,9 ?is section1 ! t]m    
co-prescrib+ has ! mean+ giv5 su* t]m 9 
section #d4  #f4 ,au?orization (        
appropriations ,!re is au?oriz$ to be   
appropriat$ to c>ry out ?is ,act        
#b1ejj1jjj = ea* ( fiscal ye>s #bjaf    
?r\gh #bjbj4