Respond NOW Act

I 116TH CONGRESS 1ST SESSION H. R. 2922 To address the opioid epidemic, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 22, 2019 Ms. KUSTER of New Hampshire (for herself, Mr. FITZPATRICK, Ms. SCAN- LON, Ms. PINGREE, Ms. STEVENS, Ms. JACKSON LEE, Ms. FRANKEL, Mr. TRONE, Mr. TONKO, Mr. RASKIN, Ms. BROWNLEY of California, Mr. DOGGETT, Mr. PAPPAS, Ms. CLARK of Massachusetts, Mrs. TRAHAN, Mr. WELCH, Mr. CASTRO of Texas, Mrs. DINGELL, Ms. SHALALA, Ms. MOORE, Mr. MCNERNEY, Mr. MOULTON, Ms. BLUNT ROCHESTER, Mr. MCGOVERN, Mr. LARSON of Connecticut, Mr. CROW, Ms. MATSUI, Ms. KELLY of Illinois, Ms. BARRAGA´N, Ms. SCHAKOWSKY, Mr. VEASEY, and Ms. BASS) introduced the following bill; which was referred to the Com- mittee on Energy and Commerce, and in addition to the Committees on the Judiciary, Ways and Means, the Budget, and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To address the opioid epidemic, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Respond to the Needs 4 in the Opioid War Act’’ or the ‘‘Respond NOW Act’’. 5 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 2 •HR 2922 IH SEC. 2. TABLE OF CONTENTS. 1 The table of contents of this Act is as follows: 2 Sec. 1. Short title. Sec. 2. Table of contents. TITLE I—OPIOID EPIDEMIC RESPONSE FUND Sec. 101. Opioid Epidemic Response Fund. Sec. 102. Substance Abuse and Mental Health Services Administration. Sec. 103. Centers for Disease Control and Prevention. Sec. 104. Food and Drug Administration. Sec. 105. National Institutes of Health. Sec. 106. Health Resources and Services Administration. Sec. 107. Administration for Children and Families. TITLE II—ADDITIONAL INVESTMENTS IN EXISTING PROGRAMS TO RESPOND TO THE OPIOID EPIDEMIC Sec. 201. Increase in funding for regional partnership grants. Sec. 202. Account for the State and Tribal Response to the Opioid Abuse Cri- sis. TITLE III—EXPANDING ACCESS TO TREATMENT SERVICES Sec. 301. Eliminating time limitation for nurse practitioners, clinical nurse spe- cialists, certified registered nurse anesthetists, certified nurse midwives, and physician assistants To be qualifying practi- tioners. Sec. 302. Coverage of methadone under Medicare part B. TITLE I—OPIOID EPIDEMIC 3 RESPONSE FUND 4 SEC. 101. OPIOID EPIDEMIC RESPONSE FUND. 5 (a) IN GENERAL.—The Secretary of Health and 6 Human Services (referred to in this section as the ‘‘Sec- 7 retary’’) shall use any funds appropriated pursuant to the 8 authorization of appropriations under subsection (c) to 9 carry out the programs and activities described in sub- 10 section (d) to address the opioid and substance use epi- 11 demic. Such funds shall be in addition to any funds which 12 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 3 •HR 2922 IH are otherwise available to carry out such programs and 1 activities. 2 (b) OPIOID EPIDEMIC RESPONSE FUND.— 3 (1) ESTABLISHMENT OF ACCOUNT.—There is 4 established in the Treasury an account, to be known 5 as the Opioid Epidemic Response Fund (referred to 6 in this section as the ‘‘Fund’’), for purposes of fund- 7 ing the programs and activities described in sub- 8 section (d). 9 (2) TRANSFER.—For each of fiscal years 2020 10 through 2024, $5,000,000,000 shall be transferred 11 to the Fund from the general fund of the Treasury. 12 (3) AMOUNTS DEPOSITED.—Any amounts 13 transferred under paragraph (2) shall remain un- 14 available in the Fund until such amounts are appro- 15 priated pursuant to subsection (c). 16 (c) APPROPRIATIONS.— 17 (1) AUTHORIZATION OF APPROPRIATIONS.—For 18 the period of fiscal years 2020 through 2024, there 19 is authorized to be appropriated from the Fund to 20 the Department of Health and Human Services, for 21 the purpose of carrying out the programs and activi- 22 ties described in subsection (d), an amount not to 23 exceed the total amount transferred to the Fund 24 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 4 •HR 2922 IH under subsection (b)(2), to remain available until ex- 1 pended. 2 (2) OFFSETTING FUTURE APPROPRIATIONS.— 3 For any of fiscal years 2020 through 2024, for any 4 discretionary appropriation to the Department of 5 Health and Human Services (or any agency therein) 6 pursuant to the authorization of appropriations 7 under paragraph (1) for the purpose of carrying out 8 the programs and activities described in subsection 9 (d), the total amount of such appropriations for the 10 applicable fiscal year (not to exceed the total amount 11 remaining in the Account) shall be subtracted from 12 the estimate of discretionary budget authority and 13 the resulting outlays for any estimate under the 14 Congressional Budget and Impoundment Control 15 Act of 1974 or the Balanced Budget and Emergency 16 Deficit Control Act of 1985, and the amount trans- 17 ferred to the Fund shall be reduced by the same 18 amount. 19 (d) PROGRAMS AND ACTIVITIES.—Of the total 20 amount authorized to be appropriated from the Fund to 21 the Department of Health and Human Services by sub- 22 section (c)(1), such amount shall be allocated as follows: 23 (1) SAMHSA.—For the Substance Abuse and 24 Mental Health Services Administration to carry out 25 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 5 •HR 2922 IH programs and activities pursuant to section 102, 1 $3,650,000,000 for each of fiscal years 2020 2 through 2024. 3 (2) CDC.—For the Centers for Disease Control 4 and Prevention to carry out programs and activities 5 pursuant to section 103, $500,000,000 for each of 6 fiscal years 2020 through 2024. 7 (3) FDA.—For the Food and Drug Adminis- 8 tration to carry out programs and activities pursu- 9 ant to section 104, $65,000,000 for each of fiscal 10 years 2020 through 2024. 11 (4) NIH.—For the National Institutes of 12 Health to carry out programs and activities pursu- 13 ant to section 105, $500,000,000 for each of fiscal 14 years 2020 through 2024. 15 (5) HRSA.—For the Health Resources and 16 Services Administration to carry out programs and 17 activities pursuant to section 106, $235,000,000 for 18 each of fiscal years 2020 through 2024. 19 (6) ACF.—For the Administration for Children 20 and Families to carry out programs and activities 21 pursuant to section 107, $50,000,000 for each of 22 fiscal years 2020 through 2024. 23 (e) ACCOUNTABILITY AND OVERSIGHT.— 24 (1) WORK PLAN.— 25 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 6 •HR 2922 IH (A) IN GENERAL.—Not later than 180 1 days after the date of enactment of this Act, 2 the Secretary of Health and Human Services 3 shall submit to the Committee on Health, Edu- 4 cation, Labor, and Pensions and the Committee 5 on Appropriations of the Senate and the Com- 6 mittee on Energy and Commerce and the Com- 7 mittee on Appropriations of the House of Rep- 8 resentatives, a work plan including the proposed 9 allocation of funds appropriated pursuant to the 10 authorization of appropriations under subsec- 11 tion (c) for each of fiscal years 2020 through 12 2024 and the contents described in subpara- 13 graph (B). 14 (B) CONTENTS.—The work plan submitted 15 under subparagraph (A) shall include— 16 (i) the amount of money to be obli- 17 gated or expended out of the Fund in each 18 fiscal year for each program and activity 19 described in subsection (d); and 20 (ii) a description and justification of 21 each such program and activity. 22 (2) REPORTS.— 23 (A) ANNUAL REPORTS.—Not later than 24 October 1 of each of fiscal years 2020 through 25 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 7 •HR 2922 IH 2024, the Secretary of Health and Human 1 Services shall submit to the Committee on 2 Health, Education, Labor, and Pensions and 3 the Committee on Appropriations of the Senate 4 and the Committee on Energy and Commerce 5 and the Committee on Appropriations of the 6 House of Representatives, a report including— 7 (i) the amount of money obligated or 8 expended out of the Fund in the prior fis- 9 cal year for each program and activity de- 10 scribed in subsection (d); 11 (ii) a description of all programs and 12 activities using funds provided pursuant to 13 the authorization of appropriations under 14 subsection (c); and 15 (iii) how the programs and activities 16 are responding to the opioid epidemic. 17 (B) ADDITIONAL REPORTS.—At the re- 18 quest of the Committee on Health, Education, 19 Labor, and Pensions or the Committee on Ap- 20 propriations of the Senate, or the Committee on 21 Energy and Commerce or the Committee on 22 Appropriations of the House of Representatives, 23 the Secretary of Health and Human Services 24 shall provide an update in the form of testi- 25 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 8 •HR 2922 IH mony and any additional reports to the respec- 1 tive congressional committee regarding the allo- 2 cation of funding under this section or the de- 3 scription of the programs and activities under- 4 taken with such funding. 5 (f) LIMITATIONS.—Notwithstanding any transfer au- 6 thority authorized by this Act or any appropriations Act, 7 any funds made available pursuant to the authorization 8 of appropriations under subsection (c) may not be used 9 for any purpose other than the programs and activities 10 described in subsection (d) to address the opioid and sub- 11 stance use epidemic. 12 (g) SUNSET.—This section shall expire at the end of 13 fiscal year 2029. 14 SEC. 102. SUBSTANCE ABUSE AND MENTAL HEALTH SERV- 15 ICES ADMINISTRATION. 16 The entirety of the funds made available pursuant to 17 section 101(d)(1) shall be for carrying out subsections (b) 18 and (c) of section 1003 of the 21st Century Cures Act 19 (42 U.S.C. 290ee–3 note). 20 SEC. 103. CENTERS FOR DISEASE CONTROL AND PREVEN- 21 TION. 22 (a) ADDRESSING OPIOID USE DISORDER.—The en- 23 tirety of the funds made available pursuant to section 24 101(d)(2) shall be for the Director of the Centers for Dis- 25 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 9 •HR 2922 IH ease Control and Prevention, pursuant to applicable au- 1 thorities in the Public Health Service Act (42 U.S.C. 201 2 et seq.), to continue and expand programs of the Centers 3 for Disease Control and Prevention to address opioid use 4 disorder, including by— 5 (1) improving the timeliness and quality of data 6 on the opioid epidemic, including improvement of— 7 (A) data on fatal and nonfatal overdoses; 8 (B) syndromic surveillance; 9 (C) data on long-term sequelae (including 10 neonatal abstinence syndrome); and 11 (D) cause of death reporting related to 12 substance abuse or opioid overdose; 13 (2) expanding and strengthening evidence-based 14 prevention and education strategies; 15 (3) supporting responsible prescribing practices, 16 including through development and dissemination of 17 prescriber guidelines; 18 (4) improving access to and use of effective pre- 19 vention, treatment, and recovery support, including 20 through grants and the provision of technical assist- 21 ance to States and localities; 22 (5) strengthening partnerships with first re- 23 sponders, including to protect their safety; 24 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 10 •HR 2922 IH (6) considering the needs of vulnerable popu- 1 lations; 2 (7) addressing infectious diseases linked to the 3 opioid crisis; 4 (8) strengthening prescription drug monitoring 5 programs; and 6 (9) providing financial and technical assistance 7 to State and local health department efforts to treat 8 and prevent substance use disorder. 9 (b) LIMITATION.—Of the funds made available pur- 10 suant to section 101(d)(2) for carrying out this section, 11 not more than 20 percent may be used for intramural pur- 12 poses. 13 SEC. 104. FOOD AND DRUG ADMINISTRATION. 14 The entirety of the funds made available pursuant to 15 section 101(d)(3) shall be for the Commissioner of Food 16 and Drugs, pursuant to applicable authorities in the Pub- 17 lic Health Service Act (42 U.S.C. 201 et seq.) or the Fed- 18 eral Food, Drug, and Cosmetic Act (21 U.S.C. 301 et 19 seq.) and other applicable law, to support widespread inno- 20 vation in non-opioid and non-addictive medical products 21 for pain treatment, access to opioid addiction treatments, 22 appropriate use of approved opioids, and efforts to reduce 23 illicit importation of opioids. Such support may include the 24 following: 25 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2922.IH H2922 kjohnson on DSK79L0C42 with BILLS 11 •HR 2922 IH (1) Facilitating the development of non-opioid 1 and non-addictive pain treatments. 2 (2) Advancing guidance documents for sponsors 3 of non-opioid pain products. 4 (3) Developing evidence to inform the potential 5 for nonprescription overdose therapies. 6 (4) Examining expanded labeling indications for 7 medication-assisted treatment. 8 (5) Conducting public education and outreach, 9 including public workshops or public meetings, re- 10 garding the benefits of medication-assisted treat- 11 ment, and approved non-opioid drug and device 12 treatment options. 13 (6) Exploring the expansion and possible man- 14 datory nature of prescriber education regarding pain 15 management and appropriate opioid prescribing 16 through authorities under section 505–1 of the Fed- 17 eral Food, Drug, and Cosmetic Act (21 U.S.C. 355– 18 1). 19 (7) Examining options to limit the duration of 20 opioid prescriptions for acute pain, including 21 through packaging options. 22 (8) Increasing staff and infrastructure capacity 23 to inspect and analyze packages at international 24 mail facilities and pursue criminal investigations. 25 VerDate Sep 11 2014 02:11 Jun 07, 2019 Jkt 089200 [Text truncated for display. 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