SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) Together, the misuse of heroin and opioids 
account for approximately 25,000 deaths in the 
United States per year. 
(2) Drug overdose was the leading cause of in-
jury death in the United States in 2013, and among 
people 25 to 64 years old, drug overdose caused 
more deaths than motor vehicle fatalities in 2013. 
(3) According to the Centers for Disease Con-
trol and Prevention, in the United States, fatal 
opioid-related drug overdose rates have more than 
quadrupled since 1990 and have never been higher. 
Each day in the United States, 46 people die from 
an overdose of prescription painkillers. Nearly 
2,000,000 Americans aged 12 or older either abused 
or were dependent on opioids in 2013. 
(4) Naloxone is a safe and effective antidote to 
all opioid-related overdoses, including heroin and 
fentanyl, and is a critical tool in preventing fatal 
opioid overdoses in both health care and at-home 
settings. 
(5) The opioid overdose antidote naloxone has 
reversed more than 26,000 overdose cases between 
1996 and 2014, according to the Centers for Dis-
ease Control and Prevention. 
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SEC. 3. HEALTH CARE PROVIDER TRAINING IN FEDERAL 
HEALTH CARE AND MEDICAL FACILITIES. 
(a) GUIDELINES.— 
(1) HHS 
GUIDELINES.—The Secretary of 
Health and Human Services shall establish health 
care provider training guidelines for all Federal 
health care facilities, including Federally qualified 
health centers (as defined in paragraph (4) of sec-
tion 1861(aa) of the Social Security Act (42 U.S.C. 
1395x(aa))) and facilities of the Indian Health Serv-
ice, and shall provide training to all providers de-
scribed in subsection (b), in accordance with sub-
section (c). 
(2) DEPARTMENT
OF
VETERANS
AFFAIRS 
GUIDELINES.—The Secretary of Veterans Affairs 
shall establish health care provider training guide-
lines for all medical facilities of the Department of 
Veterans Affairs, and shall provide training to all 
providers described in subsection (b), in accordance 
with subsection (c). 
(3) DEPARTMENT OF DEFENSE GUIDELINES.— 
The Secretary of Defense shall establish health care 
provider training guidelines for all medical facilities 
of the Department of Defense, and shall provide 
training to all providers described in subsection (b), 
in accordance with subsection (c). 
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(b) AFFECTED HEALTH CARE PROVIDERS.—The 
guidelines developed under paragraphs (1) through (3) of 
subsection (a) shall ensure that training on the appro-
priate and effective prescribing of opioid medications is 
provided to all health care providers who are— 
(1) Federal employees and who prescribe con-
trolled substances as part of their official respon-
sibilities and duties as Federal employees; 
(2) contractors in a health care or medical facil-
ity of an agency described in paragraph (1), (2), or 
(3) of subsection (a) who— 
(A) spend 50 percent or more of their clin-
ical time under contract with the Federal Gov-
ernment; and 
(B) prescribe controlled substances under 
the terms and conditions of their contract or 
agreement with the Federal Government; or 
(3) clinical residents and other clinical trainees 
who spend 50 percent or more of their clinical time 
practicing in a health care or medical facility of an 
agency described in paragraph (1), (2), or (3) of 
subsection (a). 
(c) TRAINING REQUIREMENTS.— 
(1) TRAINING TOPICS.—The training developed 
under paragraphs (1) through (3) of subsection (a) 
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shall address, at a minimum, best practices for ap-
propriate and effective prescribing of pain medica-
tions, principles of pain management, the misuse po-
tential of controlled substances, identification of po-
tential substance use disorders and referral to fur-
ther evaluation and treatment, and proper methods 
for disposing of controlled substances. 
(2) TRAINING APPROACHES.—The training ap-
proaches developed in accordance with this section 
may include both traditional continuing education 
models and models that pair intensive coaching for 
the highest volume prescribers with case-based 
courses for other prescribers. 
(3) CONSISTENCY
WITH
CONSENSUS
GUIDE-
LINES.—To the extent practicable, training adopted 
under subsection (a) shall be consistent with con-
sensus guidelines on pain medication prescribing de-
veloped by the Centers for Disease Control and Pre-
vention. 
(4) TRAINING FREQUENCY.—Each agency de-
scribed in paragraphs (1) through (3) of subsection 
(a) shall provide training of the health care pro-
viders in accordance with this section not later than 
18 months after the date of enactment of this Act, 
and every 3 years thereafter. 
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(d) DEFINITIONS.—For purposes of this section, the 
term ‘‘controlled substance’’ has the meaning given such 
term in section 102 of the Controlled Substances Act (21 
U.S.C. 802). 
SEC. 4. NALOXONE CO-PRESCRIBING IN FEDERAL HEALTH 
CARE AND MEDICAL FACILITIES. 
(a) NALOXONE CO-PRESCRIBING GUIDELINES.—Not 
later than 180 days after the date of enactment of this 
Act: 
(1) The Secretary of Health and Human Serv-
ices shall establish naloxone co-prescribing guidelines 
applicable to all Federally qualified health centers 
(as defined in paragraph (4) of section 1861(aa) of 
the Social Security Act (42 U.S.C. 1395x(aa))) and 
the health care facilities of the Indian Health Serv-
ice. 
(2) The Secretary of Defense shall establish co- 
prescribing guidelines applicable to all Department 
of Defense medical facilities. 
(3) The Secretary of Veterans Affairs shall es-
tablish co-prescribing guidelines applicable to all De-
partment of Veterans Affairs medical facilities. 
(b) 
REQUIREMENT.—The 
guidelines 
established 
under subsection (a) shall address naloxone co-prescribing 
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for both pain patients receiving chronic opioid therapy and 
patients being treated for opioid use disorders. 
(c) DEFINITIONS.—In this section: 
(1) 
CO-PRESCRIBING.—The 
term 
‘‘co-pre-
scribing’’ means, with respect to an opioid overdose 
reversal drug, the practice of prescribing such drug 
in conjunction with an opioid prescription for pa-
tients at an elevated risk of overdose, or in conjunc-
tion with an opioid agonist approved under section 
505 of the Federal Food, Drug, and Cosmetic Act 
(21 U.S.C. 355) for the treatment of opioid use dis-
orders, or in other circumstances in which a provider 
identifies a patient at an elevated risk for an inten-
tional or unintentional drug overdose from heroin or 
prescription opioid therapies. 
(2) ELEVATED RISK OF OVERDOSE.—The term 
‘‘elevated risk of overdose’’ has the meaning given 
such term by the Secretary of Health and Human 
Services, which— 
(A) may be based on the criteria provided 
in the Opioid Overdose Toolkit published by the 
Substance Abuse and Mental Health Services 
Administration; and 
(B) may include patients on a first course 
opioid treatment, patients using extended-re-
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lease and long-acting opioid analgesic, and pa-
tients with a respiratory disease or other co- 
morbidities. 
SEC. 5. GRANT PROGRAM TO STATE DEPARTMENTS OF 
HEALTH TO EXPAND NALOXONE CO-PRE-
SCRIBING. 
(a) ESTABLISHMENT.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary of 
Health and Human Services (referred to in this section 
as the ‘‘Secretary’’) shall establish a competitive 4-year 
co-prescribing opioid overdose reversal drugs grant pro-
gram to provide State departments of health with re-
sources to develop and apply co-prescribing guidelines, and 
to provide for increased access to naloxone. 
(b) APPLICATION.—To be eligible to receive a grant 
under this section, a State shall submit to the Secretary, 
in such form and manner as the Secretary may require, 
an application that— 
(1) identifies community partners for a co-pre-
scribing program; 
(2) identifies which providers will be trained in 
such program and the criteria that will be used to 
identify eligible patients to participate in such pro-
gram; and 
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(3) describes how the program will seek to iden-
tify State, local, or private funding to continue the 
program after expiration of the grant. 
(c) PRIORITIZATION.—In awarding grants under this 
section, the Secretary shall give priority to eligible State 
departments of health that propose to base State guide-
lines on guidelines on co-prescribing already in existence 
at the time of application, such as guidelines of the De-
partment of Veterans Affairs or national medical societies, 
such as the American Society of Addiction Medicine or 
American Medical Association. 
(d) USE OF FUNDS.—A State department of health 
receiving a grant under this section may use the grant 
for any of the following activities: 
(1) To establish a program for co-prescribing 
opioid overdose reversal drugs, such as naloxone. 
(2) To expand innovative models of naloxone 
distribution, as defined by the Secretary. 
(3) To train and provide resources for health 
care providers and pharmacists on the co-prescribing 
of opioid overdose reversal drugs. 
(4) To establish mechanisms and processes for 
tracking patients participating in the program de-
scribed in paragraph (1) and the health outcomes of 
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such patients, and ensuring that health information 
is de-identified so as to protect patient privacy. 
(5) To purchase opioid overdose reversal drugs 
for distribution under the program described in 
paragraph (1). 
(6) To offset the copayments and other cost- 
sharing associated with opioid overdose reversal 
drugs to ensure that cost is not a limiting factor for 
eligible individuals, as determined by the Secretary 
and the applicable State department of health, giv-
ing priority to individuals not otherwise insured for 
such services. 
(7) To conduct community outreach, in con-
junction with community-based organizations, de-
signed to raise awareness of co-prescribing practices, 
and the availability of opioid overdose reversal 
drugs. 
(8) To establish protocols to connect patients 
who have experienced a drug overdose with appro-
priate treatment, including appropriate counseling 
and behavioral therapies. Such protocols shall be 
consistent with nationally recognized patient place-
ment criteria, such as the criteria of the American 
Society of Addiction Medicine. 
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(e) EVALUATIONS BY RECIPIENTS.—As a condition 
of receipt of a grant under this section, a State depart-
ment of health shall, for each year for which grant funds 
are received, submit to the Secretary information on ap-
propriate outcome measures specified by the Secretary to 
assess the outcomes of the program funded by the grant. 
(f) DEFINITION.—In this section, the term ‘‘co-pre-
scribing’’ has the meaning given such term in section 4. 
SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 
There is authorized to be appropriated to carry out 
this Act $2,500,000 for each of fiscal years 2017 through 
2021. 
Æ 
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