Stop Overdose Stat Act or the S.O.S. Act - Requires the Secretary of Health and Human Services (HHS), acting through the Director of the Centers for Disease Control and Prevention (CDC), to: (1) award grants or enter into cooperative agreements to enable eligible entities to reduce deaths occurring from drug overdoses, and (2) give priority to eligible public health agencies or community-based organizations that have expertise in preventing deaths occurring from overdoses in high risk populations.
Conditions receipt of a grant or agreement on an entity agreeing to: (1) use it for purchasing and distributing the drug naloxone, (2) report to the Secretary and the coordinating center (established under this Act) on the results of the activities supported, and (3) make available non-federal contributions of at least 50% of the federal funds provided. Requires a recipient to use such grant or agreement for: (1) educating prescribers and pharmacists about overdose prevention and naloxone prescription; (2) training first responders, other individuals in a position to respond to an overdose, and law enforcement and corrections officials on the effective response to individuals who have overdosed on drugs; (3) implementing and enhancing programs to provide overdose prevention, recognition, treatment, and response; and/or (4) expanding such activities.
Requires the Director to establish and provide for the operation of a coordinating center responsible for: (1) collecting, compiling, disseminating, and evaluating data on such activities; (2) developing best practices for preventing deaths occurring from drug overdoses; and (3) making such best practices specific to the type of community involved.
Requires the Director to award grants or cooperative agreements to improve drug overdose surveillance and reporting capabilities.
Amends the Public Health Service Act to require the Secretary to develop and submit to Congress a plan to reduce the number of deaths occurring from overdoses, to include implementation of a campaign to educate prescribers and the public about overdose prevention and naloxone prescription.
Requires the Director of the National Institute on Drug Abuse to: (1) prioritize and conduct or support research on drug overdose and overdose prevention, and (2) support research on the development of formulations of naloxone and dosage delivery devices specifically intended to be used for the prehospital treatment of unintentional drug overdose.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4169 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4169
To prevent deaths occurring from drug overdoses.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 6, 2014
Ms. Edwards (for herself, Ms. Bass, Mr. Carson of Indiana, Mr.
Cummings, Mr. Ellison, Mr. Keating, Ms. Lee of California, Mr. Lynch,
Mr. Michaud, Mr. Rangel, Mr. Ryan of Ohio, Ms. Schwartz, Mr. Serrano,
Ms. Shea-Porter, Mr. Tierney, Mr. Tonko, Ms. Wilson of Florida, Mr.
Foster, and Mr. Ben Ray Lujan of New Mexico) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To prevent deaths occurring from drug overdoses.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Stop Overdose Stat Act'' or the
``S.O.S. Act''.
SEC. 2. FINDINGS.
The Congress finds the following:
(1) According to the Centers for Disease Control and
Prevention (CDC), each day in the United States more than 100
people die from a drug overdose. Among people 25 to 64 years
old, drug overdose caused more deaths than motor vehicle
accidents.
(2) The CDC reports that more than 38,000 people in the
United States died from a drug overdose in 2010 alone. Seventy-
eight percent of these deaths were due to unintentional drug
overdoses, and many could have been prevented.
(3) Deaths resulting from unintentional drug overdoses
increased more than 400 percent between 1980 and 1999, and more
than doubled between 1999 and 2010.
(4) Ninety-one percent of all unintentional poisoning
deaths are due to drugs. Since 1999, in the United States the
population of Non-Hispanic Whites and the population of
American Indians and Alaska Natives have seen the highest rates
of unintentional drug poisoning deaths.
(5) Opioid medications such as oxycodone and hydrocodone
are involved in 55 percent of all unintentional drug poisoning
deaths.
(6) Between 1999 and 2010, opioid medication overdose
fatalities increased by more than 400 percent among women and
265 percent among men.
(7) Military veterans are at elevated risk of experiencing
a drug overdose. Vietnam, Iraq, and Afghanistan veterans with
combat injuries, posttraumatic stress disorder (PTSD), and
other co-occurring mental health diagnoses are at elevated risk
of fatal drug overdose from opioid medications.
(8) Rural and suburban regions are disproportionately
affected by opioid medication overdoses. Urban centers also
continue to struggle with overdose, which is the leading cause
of death among homeless adults.
(9) In the year 2009 alone, estimated lost productivity and
direct medical costs from opioid medication poisonings exceeded
$20,000,000,000.
(10) Both fatal and nonfatal overdoses place a heavy burden
on public health and public safety resources, yet there is no
coordinated cross-Federal agency response to prevent overdose
fatalities.
(11) Naloxone is a medication that rapidly reverses
overdose from heroin and opioid medications.
(12) In 2012, the Food and Drug Administration (FDA) held a
public workshop in collaboration with the National Institute on
Drug Abuse (NIDA) and the CDC, and with participation from the
Substance Abuse and Mental Health Services Administration
(SAMHSA) and the Office of National Drug Control Policy
(ONDCP), to discuss making naloxone more widely available
outside of conventional medical settings to reduce the
incidence of opioid overdose fatalities.
(13) Lawmakers in California, Colorado, Connecticut,
Illinois, Kentucky, Massachusetts, Maryland, New Jersey, New
Mexico, New York, North Carolina, Oregon, Rhode Island,
Vermont, Virginia, Washington, and the District of Columbia
have removed legal impediments to increasing naloxone
prescription and its use by bystanders who are in a position to
respond to an overdose.
(14) Health practitioners are often not fully aware of
overdose symptoms and prevention methods, impacting their
ability to adequately inform patients and caregivers on how to
recognize symptoms, respond effectively by seeking emergency
assistance, and provide naloxone and other first aid in order
to save a life.
(15) The American Medical Association (AMA), the Nation's
largest physician organization, supports further implementation
of community-based programs that offer naloxone and other
opioid overdose prevention services.
(16) Community-based overdose prevention programs have
successfully prevented deaths from opioid overdoses by making
rescue trainings and naloxone available to first responders,
parents, and other bystanders who may encounter an overdose.
Over 50,000 potential bystanders have been trained by overdose
prevention programs in the United States. A CDC report credits
overdose prevention programs with saving more than 10,000 lives
since 1996.
(17) At least 188 local overdose prevention programs are
operating in the United States, including in major cities such
as Baltimore, Chicago, Los Angeles, New York City, Boston, San
Francisco, and Philadelphia, and statewide in New Mexico,
Massachusetts, and New York. Between 2006 and 2009, overdose
prevention programs facilitated by the Massachusetts Department
of Public Health trained nearly 3,000 people who reported more
than 300 rescues. Since 2004, a program administered by the
Baltimore City Health Department has trained more than 3,000
people who reported more than 220 rescues. Project Lazarus, an
overdose prevention program in Wilkes County, North Carolina,
reduced overdose deaths 69 percent between 2009 and 2011.
(18) The ONDCP supports equipping first responders to help
reverse overdoses. Police officers on patrol in Quincy,
Massachusetts, have conducted 170 overdose rescues with
naloxone since 2010. The police department has reported a 95-
percent success rate with overdose rescue attempts by police
officers. In Suffolk County, New York, police officers have
saved more than 50 lives with naloxone.
(19) Research shows that the cost per year of life gained
by making naloxone available to reverse overdoses is within the
range of what Americans usually pay for health treatments.
(20) Overdose prevention programs are needed in
correctional facilities, addiction treatment programs, and
other places where people are at higher risk of overdosing
after a period of abstinence.
(21) People affected by drug overdose gather each year in
communities nationwide on August 31st for Overdose Awareness
Day to mourn and pay tribute to loved ones and raise awareness
about overdose risk and prevention.
SEC. 3. OVERDOSE PREVENTION GRANT PROGRAM.
(a) Program Authorized.--The Secretary, acting through the Director
of the CDC, shall award grants or cooperative agreements to eligible
entities to enable the eligible entities to reduce deaths occurring
from overdoses of drugs.
(b) Application.--
(1) In general.--An eligible entity desiring a grant or
cooperative agreement under this section shall submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.
(2) Contents.--An application under paragraph (1) shall
include--
(A) a description of the activities to be funded
through the grant or cooperative agreement; and
(B) a demonstration that the eligible entity has
the capacity to carry out such activities.
(c) Priority.--In awarding grants and cooperative agreements under
subsection (a), the Secretary shall give priority to eligible entities
that--
(1) are a public health agency or community-based
organization; and
(2) have expertise in preventing deaths occurring from
overdoses of drugs in populations at high risk of such deaths.
(d) Eligible Activities.--
(1) Required activity.--As a condition on receipt of a
grant or cooperative agreement under this section, an eligible
entity shall agree to use the grant or cooperative agreement to
purchase and distribute the drug naloxone.
(2) Additional activities.--In addition to the activity
described in paragraph (1), an eligible entity shall use a
grant or cooperative agreement under this section to carry out
one or more of the following activities:
(A) Educating prescribers and pharmacists about
overdose prevention and naloxone prescription.
(B) Training first responders, other individuals in
a position to respond to an overdose, and law
enforcement and corrections officials on the effective
response to individuals who have overdosed on drugs.
Training pursuant to this subparagraph may include any
activity that is educational, instructional, or
consultative in nature, and may include volunteer
trainings, awareness building exercises, outreach to
individuals who are at-risk of a drug overdose, and
distribution of educational materials.
(C) Implementing and enhancing programs to provide
overdose prevention, recognition, treatment, and
response to individuals in need of such services.
(D) Expanding activities described in paragraph
(1).
(E) Expanding activities described in subparagraph
(A) or (B).
(e) Coordinating Center.--
(1) Establishment.--The Secretary shall establish and
provide for the operation of a coordinating center responsible
for--
(A) collecting, compiling, and disseminating data
on the programs and activities under this section;
(B) evaluating such data and, based on such
evaluation, developing best practices for preventing
deaths occurring from drug overdoses; and
(C) making such best practices specific to the type
of community involved.
(2) Reports to center.--As a condition on receipt of a
grant or cooperative agreement under this section, an eligible
entity shall agree to prepare and submit, not later than 90
days after the end of the grant or cooperative agreement
period, a report to such coordinating center and the Secretary
describing the results of the activities supported through the
grant or cooperative agreement.
(f) Matching Funds.--
(1) In general.--As a condition on receipt of a grant or
cooperative agreement under this section, an eligible entity
shall agree that, with respect to the costs to be incurred by
the eligible entity in carrying out the activities for which
the grant or cooperative agreement is awarded, the eligible
entity will make available non-Federal contributions in an
amount equal to not less than 50 percent of the Federal funds
provided through the grant or cooperative agreement.
(2) Satisfying matching requirement.--The non-Federal
contributions required under paragraph (1) may be--
(A) in cash or in-kind, including services, fairly
evaluated; and
(B) from--
(i) any private source; or
(ii) a State, tribal, or local agency.
(3) Waiver.--The Secretary may waive or reduce the non-
Federal contribution required by paragraph (1) if the eligible
entity involved demonstrates that the eligible entity cannot
meet the contribution requirement due to financial hardship.
(g) Duration.--The period of a grant or cooperative agreement under
this section shall be 4 years.
(h) Authorization of Appropriations.--There are authorized to be
appropriated $10,000,000 to carry out this section for each of the
fiscal years 2014 through 2018.
SEC. 4. SURVEILLANCE CAPACITY BUILDING.
(a) Program Authorized.--The Secretary, acting through the Director
of the CDC, shall award grants or cooperative agreements to State,
local, or tribal governments, or the National Poison Data System
working in conjunction with State, local, or tribal governments, to
improve fatal and nonfatal drug overdose surveillance and reporting
capabilities, including the following:
(1) Providing training to improve identification of drug
overdose as the cause of death by coroners and medical
examiners.
(2) Establishing, in cooperation with the National Poison
Data System, coroners, and medical examiners, a comprehensive
national program for surveillance of, and reporting to an
electronic database on, drug overdose deaths in the United
States.
(3) Establishing, in cooperation with the National Poison
Data System, a comprehensive national program for surveillance
of, and reporting to an electronic database on, fatal and
nonfatal drug overdose occurrences, including epidemiological
and toxicologic analysis and trends.
(b) Application.--
(1) In general.--A State, local, or tribal government or
the National Poison Data System desiring a grant or cooperative
agreement under this section shall submit to the Secretary an
application at such time, in such manner, and containing such
information as the Secretary may require.
(2) Contents.--The application described in paragraph (1)
shall include--
(A) a description of the activities to be funded
through the grant or cooperative agreement; and
(B) a demonstration that the State, local, or
tribal government or the National Poison Data System
has the capacity to carry out such activities.
(c) Report.--As a condition on receipt of a grant or cooperative
agreement under this section, a State, local, or tribal government or
the National Poison Data System shall agree to prepare and submit, not
later than 90 days after the end of the grant or cooperative agreement
period, a report to the Secretary describing the results of the
activities supported through the grant or cooperative agreement.
(d) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $5,000,000 for each of the
fiscal years 2014 through 2018.
SEC. 5. REDUCING OVERDOSE DEATHS.
Part J of title III of the Public Health Service Act (42 U.S.C.
280b et seq.) is amended by inserting after section 393D (42 U.S.C.
280b-1f) the following:
``SEC. 393F. REDUCING OVERDOSE DEATHS.
``(a) Prevention of Drug Overdose.--Not later than 180 days after
the date of the enactment of this section, the Secretary, in
consultation with a task force comprised of stakeholders, shall develop
a plan to reduce the number of deaths occurring from overdoses of drugs
and shall submit the plan to Congress. The plan shall include--
``(1) a plan for implementation of a public health campaign
to educate prescribers and the public about overdose prevention
and naloxone prescription;
``(2) recommendations for improving and expanding overdose
prevention programming; and
``(3) recommendations for such legislative or
administrative action as the Secretary considers appropriate.
``(b) Task Force Representation.--
``(1) Required members.--The task force referred to in
subsection (a) shall include at least one representative of
each of the following:
``(A) Individuals directly impacted by drug
overdose.
``(B) Direct service providers who engage
individuals at risk of a drug overdose.
``(C) Drug overdose prevention advocates.
``(D) The NIDA.
``(E) The Center for Substance Abuse Treatment.
``(F) The CDC.
``(G) The Health Resources and Services
Administration.
``(H) The Food and Drug Administration.
``(I) The Office of National Drug Control Policy.
``(J) The American Medical Association.
``(K) The American Association of Poison Control
Centers.
``(L) The Bureau of Prisons.
``(M) The Centers for Medicare & Medicaid Services.
``(N) The Department of Justice.
``(2) Additional members.--In addition to the
representatives required by paragraph (1), the task force
referred to in subsection (a) may include other representatives
of individuals or entities with expertise relating to drug
overdoses.''.
SEC. 6. OVERDOSE PREVENTION RESEARCH.
(a) Overdose Research.--The Director of the NIDA shall prioritize
and conduct or support research on drug overdose and overdose
prevention. The primary aims of this research shall include--
(1) examination of circumstances that contribute to drug
overdose and identification of drugs associated with fatal
overdose;
(2) evaluation of existing overdose prevention methods;
(3) pilot programs or research trials on new overdose
prevention strategies or programs that have not been studied in
the United States;
(4) scientific research concerning the effectiveness of
overdose prevention programs, including how to effectively
implement and sustain such programs; and
(5) comparative effectiveness research on overdose
prevention programs.
(b) Formulations of Naloxone.--The Director of the NIDA shall
support research on the development of formulations of naloxone and
dosage delivery devices specifically intended to be used by lay persons
or first responders for the prehospital treatment of unintentional drug
overdose.
(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $5,000,000 for each of the
fiscal years 2014 through 2018.
SEC. 7. OFFSET OF COSTS AND PERSONNEL.
Notwithstanding any other provision of law, the Secretary shall--
(1) eliminate such initiatives, positions, and programs as
the Secretary deems necessary to ensure any and all costs
incurred to carry out the provisions of this Act, and the
amendments made by this Act, are entirely offset;
(2) ensure no net increase in personnel are added to carry
out the provisions of this Act, with any new full- or part-time
employees or equivalents offset by eliminating an equivalent
number of existing staff;
(3) not later than 60 days after the date of the enactment
of this Act, report to the Congress on the actions taken to
ensure compliance with paragraphs (1) and (2), including the
specific initiatives, positions, and programs that have been
eliminated to ensure that the costs of carrying out this Act
will be offset; and
(4) not implement any other provision of this Act (other
than paragraphs (1), (2), and (3)) or any amendment made by
this Act until the Secretary has certified that the actions
specified in paragraphs (1), (2), and (3) have been completed.
SEC. 8. DEFINITIONS.
In this Act:
(1) CDC.--The term ``CDC'' means the Centers for Disease
Control and Prevention.
(2) Drug.--The term ``drug''--
(A) means a drug (as that term is defined in
section 201 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 321)); and
(B) includes any controlled substance (as that term
is defined in section 102 of the Controlled Substances
Act (21 U.S.C. 802)).
(3) Eligible entity.--The term ``eligible entity'' means an
entity that is a State, local, or tribal government, a
correctional institution, a law enforcement agency, a community
agency, a professional organization in the field of poison
control and surveillance, or a private nonprofit organization.
(4) National poison data system.--The term ``National
Poison Data System'' means the system operated by the American
Association of Poison Control Centers, in partnership with the
CDC, for real-time local, State, and national electronic
reporting, and the corresponding database network.
(5) NIDA.--The term ``NIDA'' means the National Institute
on Drug Abuse.
(6) ONDCP.--The term ``ONDCP'' means the Office of National
Drug Control Policy.
(7) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(8) State.--The term ``State'' means any of the several
States, the District of Columbia, Puerto Rico, the Northern
Mariana Islands, the United States Virgin Islands, Guam,
American Samoa, and any other territory or possession of the
United States.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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