I 

114TH CONGRESS 

2D SESSION H. R. 5842 

To direct the Secretary of Veterans Affairs to carry out a pilot program 

to improve treatment for veterans suffering from opioid addiction and 

chronic pain, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 14, 2016 

Ms. KUSTER (for herself and Mr. COFFMAN) introduced the following bill; 

which was referred to the Committee on Veterans’ Affairs 

A BILL 

To direct the Secretary of Veterans Affairs to carry out 

a pilot program to improve treatment for veterans suffering from opioid addiction and chronic pain, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Helping Our Veterans 

5 with Chronic Pain and Opioid Addiction Act of 2016’’. 

6 SEC. 2. FINDINGS; SENSE OF CONGRESS. 

7 (a) FINDINGS.—Congress makes the following find8 ings: 


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1 (1) Many veterans and their families have been 

2 affected by the national opioid epidemic caused in 

3 part by the prescription of opioid medication to 

4 manage pain. 

5 (2) Prescription opioid overdose rates for vet6 erans receiving medical care furnished by the De7 partment of Veterans Affairs are twice the national 

8 average. 

9 (3) More than 50 percent of veterans receiving 

10 such care are suffering from chronic pain. 

11 (4) Almost one in three veterans receiving such 

12 care are prescribed opioids to manage pain. 

13 (5) Many veterans prescribed opioids for the 

14 management of chronic pain are at risk of devel15 oping a dependency on opioids. 

16 (6) Many veterans receive health care from both 

17 the Department and community providers but the 

18 lack of care coordination among the Department and 

19 community providers when veterans receive pur20 chased care places veterans at risk for poor health 

21 outcomes and results in inefficient use of finite 

22 health care resources. 

23 (7) Veteran-centric care coordination is associ24 ated with improved patient outcomes, as Department 


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1 and non-Department health care teams coordinate 

2 and collaborate to provide the best care for veterans. 

3 (b) SENSE OF CONGRESS.—It is the sense of Con4 gress that— 

5 (1) veterans suffering from opioid dependency 

6 should receive timely access to treatment and social 

7 services at Department of Veterans Affairs facilities 

8 or through qualified community providers and 

9 should have care and services managed and coordi10 nated by the Department of Veterans Affairs; 

11 (2) veterans who are authorized by the Sec12 retary of Veterans Affairs to receive opioid addiction 

13 treatment in the community must not lose the high 

14 quality, safety, care coordination, and other veteran15 centric elements that the health care system of the 

16 Department of Veterans Affairs provides; and 

17 (3) if the Secretary purchases care for veterans 

18 from a community provider, such care must be se19 cured in a cost-effective manner, in a way that com20 plements the larger health care system of the De21 partment by using industry standards for care and 

22 costs. 


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1 SEC. 3. PILOT PROGRAM TO IMPROVE TREATMENT FOR 

2 VETERANS SUFFERING FROM OPIOID ADDIC3 TION AND CHRONIC PAIN. 

4 (a) IN GENERAL.—Beginning not later than 120 

5 days after the date of the enactment of this Act, the Sec6 retary of Veterans Affairs shall conduct a pilot program 

7 under which the Secretary provides health and social serv8 ices and coordination of care and case management to cov9 ered veterans in need of treatment for opioid addiction and 

10 chronic pain through facilities of the Department and 

11 through qualified non-Department health care providers. 

12 (b) PROGRAM LOCATIONS.— 

13 (1) IN GENERAL.—The pilot program shall be 

14 carried out within at least five areas within different 

15 States. 

16 (2) SELECTION.— 

17 (A) IN GENERAL.—The Secretary shall se18 lect five States with Department medical facili19 ties to participate in the pilot program. Each of 

20 the five Department facilities selected shall be 

21 located in States that demonstrate— 

22 (i) the need for additional resources to 

23 provide health care services, including 

24 mental health, chronic pain management 

25 and social services to veterans in need of 

26 treatment for opioid abuse based upon the 


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1 community assessment in subsection (a) of 

2 this section; 

3 (ii) demographic, population, and cen4 sus data showing the highest rates per 

5 capita of opioid addiction in the United 

6 States or greater demand in the veteran 

7 patient population than capacity in facili8 ties of the Department for treatment for 

9 opioid addiction; and 

10 (iii) lack of sufficient Department ca11 pacity to meet the demand of all patients 

12 in need of treatment for opioid addiction. 

13 (B) OTHER REQUIREMENTS.—In addition 

14 to the requirements in subparagraph (A), not 

15 fewer than four of the five selected States shall 

16 include— 

17 (i) at least one highly rural county, as 

18 determined by the Secretary upon consid19 eration of the most recent decennial census 

20 with the highest per capita rate of opioid 

21 addiction; 

22 (ii) an urban county as determined by 

23 the Secretary upon consideration of the 

24 most recent decennial census with the largVerDate Sep 11 2014 22:29 Jul 29, 2016 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5842.IH H5842

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1 est population per capita of opioid addic2 tion; 

3 (iii) a county as determined by the 

4 Secretary in a State with one of the high5 est statistically significant drug and opioid 

6 overdose death rate increases from 2013 to 

7 2014 according to the Centers for Disease 

8 Control and Prevention and a low expendi9 ture of funding per capita on substance 

10 abuse treatment in comparison to other 

11 States; and 

12 (iv) a county as determined by the 

13 Secretary in a State with a high rate per 

14 capita of veterans diagnosed with chronic 

15 pain and prescribed prescription opioids. 

16 (c) PROVISION OF SERVICES THROUGH CON17 TRACT.—The Secretary may provide health care services 

18 to veterans under the pilot program by entering into con19 tracts with non-Department health care providers which 

20 are qualified to provide such services, as determined by 

21 the Secretary. 

22 (d) EXCHANGE OF MEDICAL INFORMATION.—In con23 ducting the pilot program under this section, the Secretary 

24 shall develop and use a functional capability to provide for 

25 the exchange of appropriate medical information between 


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1 the Department and any non-Department provider with 

2 which the Secretary enters into a contract under sub3 section (c). 

4 (e) REPORT.—Not later than the 30 days after the 

5 end of each year in which the pilot program under this 

6 section is conducted, the Secretary shall submit to the 

7 Committee on Veterans’ Affairs of the Senate and the 

8 Committee on Veterans’ Affairs of the House of Rep9 resentatives a report which includes— 

10 (1) the assessment of the Secretary of the pilot 

11 program during the preceding year, including its 

12 cost, volume, quality, patient satisfaction, benefit to 

13 veterans, and such other findings and conclusions 

14 with respect to the pilot program as the Secretary 

15 considers appropriate; and 

16 (2) such recommendations as the Secretary con17 siders appropriate regarding— 

18 (A) the continuation of the pilot program; 

19 (B) extension of the pilot program to addi20 tional Veterans Integrated Service Networks of 

21 the Department; and 

22 (C) making the pilot program permanent. 

23 (f) COVERED VETERAN.—In this section, the term 

24 ‘‘covered veteran’’ means a veteran who— 


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1 (1) is enrolled in the system of patient enroll2 ment established under section 1705(a) of title 38, 

3 United States Code, as of the date of the commence4 ment of the pilot program under subsection (a)(2); 

5 (2) is eligible for health care under section 

6 1710(e)(3)(C) of title 38, United States Code; or 

7 (3) is determined by the Secretary to be in need 

8 of treatment for opioid addiction and chronic pain. 

9 (g) TERMINATION.—The authority to carry out a 

10 pilot program under this section shall terminate on the 

11 date that is three years after the date of the commence12 ment of the pilot program. 

13 SEC. 4. ASSESSMENT OF DEPARTMENT AND NON-DEPART14 MENT CAPABILITIES TO TREAT OPIOID DE15 PENDENCY AND ENSURE ACCESS TO NEEDED 

16 HEALTH CARE SERVICES. 

17 (a) ASSESSMENT OF DEPARTMENT CAPABILITIES.— 

18 The Secretary shall conduct an assessment of the capabili19 ties of the Department of Veterans Affairs, using such 

20 data, including demographic data and patient access data, 

21 as the Secretary determines necessary to provide— 

22 (1) health care services related to the treatment 

23 of opioid dependency and abuse, including mental 

24 health, opioid agonist treatment, social services, and 

25 non-opioid chronic pain management necessary for 


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1 treating opioid addiction nationally, regionally, and 

2 locally; 

3 (2) management of chronic pain without the 

4 long-term use of opioids, including alternative thera5 pies such as physical therapy, chiropractic care, acu6 puncture, massage, exercise programs, and other 

7 such evidence-based and experimental treatments; 

8 (3) evidence-based methods for safely reducing 

9 the dose and duration of the prescription of opioids 

10 for patients; 

11 (4) methods by which health care services are 

12 coordinated by the Department when care is pro13 vided by community providers; and 

14 (5) the manner by which the Department en15 sures placement of veterans in need of treatment for 

16 opioid dependency in treatment programs within a 

17 clinically sufficient time period according to pub18 lished practice guidelines for the treatment of pa19 tients with opioid dependency. 

20 (b) ASSESSMENT OF NON-DEPARTMENT CAPABILI21 TIES.—In addition to the assessment required under sub22 section (a), the Secretary shall concurrently conduct an 

23 assessment of community providers to provide health care, 

24 mental health, social services, and alternative chronic pain 

25 management treatments necessary for the treatment of 


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1 veterans diagnosed with an opioid addiction and for the 

2 treatment of veterans suffering from chronic pain. 

3 (c) COMMUNITY PROVIDERS.—In this section, the 

4 term ‘‘community provider’’ means a non-Department of 

5 Veterans Affairs health care provider or social services 

6 provider determined by the Secretary as capable of pro7 viding health care services related to the treatment of 

8 opioid dependency and abuse, including mental health, 

9 opioid agonist treatment, social services, and non-opioid 

10 chronic pain management. 

11 (d) REPORT.—At the conclusion of the assessments 

12 conducted under this section, and not later than one year 

13 after the date of the enactment of this Act, the Secretary 

14 shall submit to the Committees on Veterans’ Affairs of 

15 the Senate and House of Representatives a comprehensive 

16 summary of the results of the assessments, including any 

17 implementation plans resulting from such assessments, 

18 and any recommendations for ways to better enable the 

19 Department to provide health care services within the pro20 grams and facilities of the Department and in coordina21 tion with community providers to veterans needing treat22 ment for pain management and opioid addiction. 


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1 SEC. 5. INCREASED ACCESS TO NALOXONE AND OTHER 

2 TREATMENTS FOR REVERSING OPIOID OVER3 DOSE. 

4 (a) IN GENERAL.—The Secretary of Veterans Affairs 

5 shall require all appropriate health care facilities of the 

6 Department of Veterans Affairs, and all Vet Centers and 

7 other Department facilities providing mental health and 

8 social services to veterans, to have a supply of naloxone 

9 or other medication for reversing opioid overdose. 

10 (b) TRAINING ON USE OF MEDICATION.—The Sec11 retary shall ensure that all appropriate employees of the 

12 Department who are employed at facilities referred to in 

13 subsection (a) receive training on the administration of 

14 naloxone or other medication for reversing opioid overdose. 

Æ 


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