Veterans HOPE Act

I 116TH CONGRESS 2D SESSION H. R. 5774 To direct the Secretary of Veterans Affairs to conduct a review on opioid overdose deaths among veterans, and for other purposes. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 6, 2020 Mr. MURPHY of North Carolina (for himself and Mr. PETERSON) introduced the following bill; which was referred to the Committee on Veterans’ Affairs A BILL To direct the Secretary of Veterans Affairs to conduct a review on opioid overdose deaths among veterans, 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 ‘‘Veterans Heroin Over- 4 dose Prevention Examination Act’’ or the ‘‘Veterans 5 HOPE Act’’. 6 SEC. 2. FINDINGS; SENSE OF CONGRESS. 7 (a) FINDINGS.—Congress finds the following: 8 (1) New research shows that a dramatic rise in 9 opioid overdose deaths among veterans in recent 10 VerDate Sep 11 2014 04:03 Feb 07, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5774.IH H5774 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 5774 IH years has happened increasingly among veterans 1 dying from heroin and synthetic opioids. 2 (2) Furthermore, patients of the Veterans 3 Health Administration of the Department of Vet- 4 erans Affairs are seven more times likely to suffer 5 from an opioid use disorder than commercially in- 6 sured patients. 7 (3) Using records of the Veterans Health Ad- 8 ministration linked to National Death Index data, 9 the veterans’ rate of overdose deaths from all opioids 10 increased by 65 percent from 2010 to 2016, a rate 11 change that includes adjustments for demographic 12 changes in the veteran population over time. 13 (4) Furthermore, among all opioid overdose de- 14 cedents, prescription opioid receipt within three 15 months before death declined from 54 percent in 16 2010 to 26 percent in 2016, yet veteran overdoses 17 resulting in death from heroin, synthetic opioids 18 such as fentanyl, and nonprescription opioids still 19 occurred. 20 (5) In fact, between 2010 and 2016, the vet- 21 eran death rate from heroin or from taking multiple 22 opioids almost quintupled and the death rate from 23 synthetic opioids such as fentanyl increased by more 24 than five-fold. 25 VerDate Sep 11 2014 04:03 Feb 07, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5774.IH H5774 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 5774 IH (6) Trends would suggest that, while the aggre- 1 gate rise in opioid overdose deaths among veterans 2 parallel those seen in the general population, the in- 3 crease occurred mainly because of a rise in deaths 4 from nonprescribed sources such as heroin, fentanyl, 5 other powerful synthetic opioids, or multiple opioids 6 in concurrent use. 7 (b) SENSE OF CONGRESS.—It is the sense of Con- 8 gress that further veterans overdose prevention efforts and 9 research should extend beyond patients actively receiving 10 opioid prescriptions. 11 SEC. 3. REVIEW OF DEATHS OF VETERANS RELATING TO 12 OPIOID USE. 13 (a) REVIEW.—Not later than 18 months after the 14 date of the enactment of this Act, the Secretary of Vet- 15 erans Affairs shall complete a review of the deaths of all 16 covered veterans who died from opioid overdoses during 17 the five-year period preceding the date of the enactment 18 for this Act. 19 (b) MATTERS INCLUDED.—The review under sub- 20 section (a) shall include the following: 21 (1) The total number of covered veterans who 22 died from opioid overdoses during the five-year pe- 23 riod preceding the date of the enactment of this Act. 24 VerDate Sep 11 2014 04:03 Feb 07, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5774.IH H5774 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 5774 IH (2) A summary of such veterans that includes 1 the age, sex, and race, and ethnicity of each such 2 veteran. 3 (3) A comprehensive list of the medications pre- 4 scribed to, and found in the bodies of, such veterans 5 at the time of death, specifically listing any medica- 6 tions that carry a black box warning, are off-label, 7 or are psychotropic. 8 (4) A summary of medical diagnoses by physi- 9 cians of the Department of Veterans Affairs that led 10 to any prescribing of the medications referred to in 11 paragraph (3). 12 (5) The number of instances in which such a 13 veteran was concurrently on multiple medications 14 prescribed by physicians of the Department. 15 (6) A summary of— 16 (A) the average period that elapsed be- 17 tween the last prescription opioid receipt and 18 the date of the death of such a veteran; and 19 (B) the cause of death for each such vet- 20 eran. 21 (7) The percentage of such veterans with com- 22 bat experience or trauma (including military sexual 23 trauma, traumatic brain injury, and post-traumatic 24 stress). 25 VerDate Sep 11 2014 04:03 Feb 07, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5774.IH H5774 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 5774 IH (8) Identification of medical facilities of the De- 1 partment with high prescription and drug abuse 2 treatment rates for patients being treated at those 3 facilities. 4 (9) A description of policies of the Department 5 governing the prescribing of medications referred to 6 in paragraph (3). 7 (10) A description of efforts by the Secretary to 8 electronically track, collect, and properly dispose of 9 prescription opioids that are either unused, past the 10 prescription date, or not in the possession of the 11 properly prescribed patient. 12 (11) A description of any patterns apparent to 13 the Secretary based on the review. 14 (12) Recommendations for further action that 15 would improve the safety and well-being of veterans 16 and reduce opioid overdose rates for veterans, espe- 17 cially concerning research regarding such veterans 18 who had not filed for a opioid prescription in the 19 three months before death by overdose. 20 (c) PUBLIC AVAILABILITY.—Not later than 45 days 21 after the completion of the review under subsection (a), 22 the Secretary shall— 23 (1) submit to Congress a report on the results 24 of the review; 25 VerDate Sep 11 2014 04:03 Feb 07, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5774.IH H5774 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 5774 IH (2) make such report publicly available; and 1 (3) provide to the Committees on Veterans’ Af- 2 fairs of the House of Representatives and the Senate 3 a briefing on such review. 4 (d) DEFINITIONS.—In this section: 5 (1) The term ‘‘black box warning’’ means a 6 warning displayed within a box in the prescribing in- 7 formation for drugs that have special problems, par- 8 ticularly ones that may lead to death or serious in- 9 jury. 10 (2) The term ‘‘covered veteran’’ means any vet- 11 eran who received hospital care or medical services 12 furnished by the Department of Veterans Affairs 13 during the five-year period preceding the death of 14 the veteran. 15 Æ VerDate Sep 11 2014 04:03 Feb 07, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H5774.IH H5774 kjohnson on DSK79L0C42PROD with BILLS