#aaeth ,,congress  #b;d ,session  ,h4   
,r4 #eaig  ,,an ,,act  ,to direct the   
,secretary of ,health and ,human        
,services to conduct a demonstration    
program to test alternative pain        
management protocols to limit the use of
 opioids in emergency departments4  #a4 
,short title ,this ,act may be cited as 
the ,alternatives to ,opioids in the    
,emergency ,department ,act or the      
,,alto ,act4  #b4 ,emergency department 
alternatives to opioids demonstration   
program  7a7 ,demonstration program     
grants ,the ,secretary of ,health and   
,human ,services 7in this section       
referred to as the ,secretary7 shall    
carry out a demonstration program under 
which the ,secretary shall award grants 
to hospitals and emergency departments1 
including freestanding emergency        
departments1 to develop1 implement1     
enhance1 or study alternative pain      
management protocols and treatments that
 limit the use and prescription of      
opioids in emergency departments4  7b7  

,eligibility ,to be eligible to receive 
a grant under subsection 7a71 a hospital
 or emergency department shall submit an
 application to the ,secretary at such  
time1 in such manner1 and containing    
such information as the ,secretary may  
require4  7c7 ,geographic diversity ,in 
awarding grants under this section1 the 
,secretary shall seek to ensure         
geographical diversity among grant      
recipients4  7d7 ,use of funds ,grants  
under subsection 7a7 shall be used to-- 
7#a7 target common painful conditions1  
such as renal colic1 sciatica1          
headaches1 musculoskeletal pain1 and    
extremity fractures2  7#b7 train        
providers and other hospital personnel  
on protocols and the use of treatments  
that limit the use and prescription of  
opioids in the emergency department2 and
  7#c7 provide alternatives to opioids  
to patients with painful conditions1 not
 including patients who present with    
pain related to cancer1 end-of-life     
symptom palliation1 or complex          

multisystem trauma4  7e7 ,consultation  
,the ,secretary shall implement a       
process for recipients of grants under  
subsection 7a7 to consult 7in a manner  
that allows for sharing of              
evidence-based best practices7 with each
 other and with persons having robust   
knowledge1 including emergency          
departments and physicians that have    
successfully deployed alternative pain  
management protocols1 such as non-drug  
approaches studied through the ,national
 ,center for ,complimentary and         
,integrative ,health including          
acupuncture that limit the use of       
opioids4 ,the ,secretary shall offer to 
each recipient of a grant under         
subsection 7a7 technical support as     
necessary4  7f7 ,report to the          
,secretary ,each recipient of a grant   
under this section shall submit to the  
,secretary 7during the period of such   
grant7 annual reports on the progress of
 the program funded through the grant4  
,these reports shall include1 in        

accordance with ,state and ,federal     
statutes and regulations regarding      
disclosure of patient information--     
7#a7 a description of and specific      
information about the alternative pain  
management protocols employed2  7#b7    
data on the alternative pain management 
protocols and treatments employed1      
including--  7,a7 during a baseline     
period before the program began1 as     
defined by the ,secretary2  7,b7 at     
various stages of the program1 as       
determined by the ,secretary2 and  7,c7 
the conditions for which the alternative
 pain management protocols and          
treatments were employed2  7#c7 the     
success of each specific alternative    
pain management protocol2  7#d7 data on 
the opioid prescriptions written1       
including-- 7,a7 during a baseline      
period before the program began1 as     
defined by the ,secretary2  7,b7 at     
various stages of the program1 as       
determined by the ,secretary2 and  7,c7 
the conditions for which the opioids    

were prescribed2  7#e7 the demographic  
characteristics of patients who were    
treated with an alternative pain        
management protocol1 including age1 sex1
 race1 ethnicity1 and insurance status  
and type2  7#f7 data on patients who    
were eventually prescribed opioids after
 alternative pain management protocols  
and treatments were employed2 and  7#g7 
any other information the ,secretary    
deems necessary4  7g7 ,report to        
,congress ,not later than #a year after 
completion of the demonstration program 
under this section1 the ,secretary shall
 submit a report to the ,congress on the
 results of the demonstration program   
and include in the report--  7#a7 the   
number of applications received and the 
number funded2  7#b7 a summary of the   
reports described in subsection 7f71    
including standardized data2 and  7#c7  
recommendations for broader             
implementation of pain management       
protocols that limit the use and        
prescription of opioids in emergency    

departments or other areas of the health
 care delivery system4  7h7             
,authorization of appropriations ,to    
carry out this section1 there is        
authorized to be appropriated           
#aj1jjj1jjj for each of fiscal years    
#bjai through #bjba4  ,passed the ,house
 of ,representatives ,june #ab1         
#bjah4;,clerk4