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[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5197 Referred in Senate (RFS)]

<DOC>
115th CONGRESS
  2d Session
                                H. R. 5197

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             June 13, 2018

     Received; read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 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 departments.

    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 ``Alternatives to Opioids in the 
Emergency Department Act'' or the ``ALTO Act''.

SEC. 2. EMERGENCY DEPARTMENT ALTERNATIVES TO OPIOIDS DEMONSTRATION 
              PROGRAM.

    (a) Demonstration Program Grants.--The Secretary of Health and 
Human Services (in this section referred to as the ``Secretary'') shall 
carry out a demonstration program under which the Secretary shall award 
grants to hospitals and emergency departments, including freestanding 
emergency departments, to develop, implement, enhance, or study 
alternative pain management protocols and treatments that limit the use 
and prescription of opioids in emergency departments.
    (b) Eligibility.--To be eligible to receive a grant under 
subsection (a), a hospital or emergency department shall submit an 
application to the Secretary at such time, in such manner, and 
containing such information as the Secretary may require.
    (c) Geographic Diversity.--In awarding grants under this section, 
the Secretary shall seek to ensure geographical diversity among grant 
recipients.
    (d) Use of Funds.--Grants under subsection (a) shall be used to--
            (1) target common painful conditions, such as renal colic, 
        sciatica, headaches, musculoskeletal pain, and extremity 
        fractures;
            (2) train providers and other hospital personnel on 
        protocols and the use of treatments that limit the use and 
        prescription of opioids in the emergency department; and
            (3) provide alternatives to opioids to patients with 
        painful conditions, not including patients who present with 
        pain related to cancer, end-of-life symptom palliation, or 
        complex multisystem trauma.
    (e) Consultation.--The Secretary shall implement a process for 
recipients of grants under subsection (a) to consult (in a manner that 
allows for sharing of evidence-based best practices) with each other 
and with persons having robust knowledge, including emergency 
departments and physicians that have successfully deployed alternative 
pain management protocols, such as non-drug approaches studied through 
the National Center for Complimentary and Integrative Health including 
acupuncture that limit the use of opioids. The Secretary shall offer to 
each recipient of a grant under subsection (a) technical support as 
necessary.
    (f) Report to the Secretary.--Each recipient of a grant under this 
section shall submit to the Secretary (during the period of such grant) 
annual reports on the progress of the program funded through the grant. 
These reports shall include, in accordance with State and Federal 
statutes and regulations regarding disclosure of patient information--
            (1) a description of and specific information about the 
        alternative pain management protocols employed;
            (2) data on the alternative pain management protocols and 
        treatments employed, including--
                    (A) during a baseline period before the program 
                began, as defined by the Secretary;
                    (B) at various stages of the program, as determined 
                by the Secretary; and
                    (C) the conditions for which the alternative pain 
                management protocols and treatments were employed;
            (3) the success of each specific alternative pain 
        management protocol;
            (4) data on the opioid prescriptions written, including--
                    (A) during a baseline period before the program 
                began, as defined by the Secretary;
                    (B) at various stages of the program, as determined 
                by the Secretary; and
                    (C) the conditions for which the opioids were 
                prescribed;
            (5) the demographic characteristics of patients who were 
        treated with an alternative pain management protocol, including 
        age, sex, race, ethnicity, and insurance status and type;
            (6) data on patients who were eventually prescribed opioids 
        after alternative pain management protocols and treatments were 
        employed; and
            (7) any other information the Secretary deems necessary.
    (g) Report to Congress.--Not later than 1 year after completion of 
the demonstration program under this section, the Secretary shall 
submit a report to the Congress on the results of the demonstration 
program and include in the report--
            (1) the number of applications received and the number 
        funded;
            (2) a summary of the reports described in subsection (f), 
        including standardized data; and
            (3) 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 system.
    (h) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $10,000,000 for each of fiscal 
years 2019 through 2021.

            Passed the House of Representatives June 12, 2018.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.
```