42 U.S.C. § 294i (THE PUBLIC HEALTH AND WELFARE)
§ 294i. Program for education and training in pain care
(a) In general
The Secretary may make awards of grants, cooperative agreements, and contracts to health professions schools, hospices, tribal health programs (as defined in section 1603 of title 25), and other public and nonprofit private entities for the development and implementation of programs to provide education and training to health care professionals in pain care.
(b) Certain topics
An entity receiving an award under this section shall develop a comprehensive education and training plan that includes information and education on—
(1) recognized means for assessing, diagnosing, preventing, treating, and managing pain and related signs and symptoms, including non-addictive medical products and non-pharmacologic treatments and the medically appropriate use of controlled substances;
(2) applicable Federal, State, and local laws, regulations, rules, and policies on controlled substances, including opioids;
(3) interdisciplinary approaches to the delivery of pain care, including delivery through specialized centers providing comprehensive pain care treatment expertise, integrated, evidence-based pain management, and, as appropriate, non-pharmacotherapy;
(4) cultural, linguistic, literacy, geographic, and other barriers to care in underserved populations;
(5) recent findings, developments, and advancements in pain care research and the provision of pain care, which may include non-addictive medical products and non-pharmacologic treatments intended to treat pain; and
(6) the dangers of opioid abuse and misuse, detection of early warning signs of opioid use disorders (which may include best practices related to screening for opioid use disorders, training on screening, brief intervention, and referral to treatment), and safe disposal options for prescription medications (including such options provided by law enforcement or other innovative deactivation mechanisms).
(c) Evaluation of programs
The Secretary shall (directly or through grants or contracts) provide for the evaluation of programs implemented under subsection (a) in order to determine the effect of such programs on knowledge and practice of pain care.
(d) Pain care defined
For purposes of this section the term “pain care” means the assessment, diagnosis, prevention, treatment, or management of acute or chronic pain regardless of causation or body location.
(e) Authorization of appropriations
There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of the fiscal years 2019 through 2023. Amounts appropriated under this subsection shall remain available until expended.
(July 1, 1944, ch. 373, title VII, § 759, as added Pub. L. 111–148, title IV, § 4305(c), Mar. 23, 2010, 124 Stat. 586; amended Pub. L. 115–271, title VII, § 7073(a), Oct. 24, 2018, 132 Stat. 4031.)
heading: Editorial Notes
heading: Prior Provisions
text: A prior section 294i, act July 1, 1944, ch. 373, title VII, § 771, as added Pub. L. 102–408, title I, § 102, Oct. 13, 1992, 106 Stat. 2049, authorized grants to educational entities offering programs in health administration, hospital administration, or health policy analysis and planning, prior to the general amendment of this part by Pub. L. 105–392.
Another prior section 294i, act July 1, 1944, ch. 373, title VII, § 736, as added Oct. 12, 1976, Pub. L. 94–484, title IV, § 401(b)(3), 90 Stat. 2265; amended Aug. 1, 1977, Pub. L. 95–83, title III, § 307(d), 91 Stat. 390, related to participation by Federal credit unions in Federal, State, and private student loan insurance programs, prior to the general amendment of this subchapter by Pub. L. 102–408. See section 292k of this title.
A prior section 759 of act July 1, 1944, was classified to section 294aa of this title prior to the general amendment of this subchapter by Pub. L. 102–408.
heading: Amendments
text: 2018—Subsec. (a). Pub. L. 115–271, § 7073(a)(1), substituted “hospices, tribal health programs (as defined in section 1603 of title 25), and other public and nonprofit private entities” for “hospices, and other public and private entities”.
Subsec. (b). Pub. L. 115–271, § 7073(a)(2)(A), substituted “entity receiving an award under this section shall develop a comprehensive education and training plan that includes” for “award may be made under subsection (a) only if the applicant for the award agrees that the program carried out with the award will include” in introductory provisions.
Subsec. (b)(1). Pub. L. 115–271, § 7073(a)(2)(B), inserted “preventing,” after “diagnosing,” and “non-addictive medical products and non-pharmacologic treatments and” after “including”.
Subsec. (b)(2). Pub. L. 115–271, § 7073(a)(2)(C), inserted “Federal, State, and local” after “applicable” and substituted “opioids” for “the degree to which misconceptions and concerns regarding such laws, regulations, rules, and policies, or the enforcement thereof, may create barriers to patient access to appropriate and effective pain care”.
Subsec. (b)(3). Pub. L. 115–271, § 7073(a)(2)(D), inserted “, integrated, evidence-based pain management, and, as appropriate, non-pharmacotherapy” before semicolon.
Subsec. (b)(5), (6). Pub. L. 115–271, § 7073(a)(2)(E), (F), added pars. (5) and (6) and struck out former par. (5) which read as follows: “recent findings, developments, and improvements in the provision of pain care.”
Subsec. (d). Pub. L. 115–271, § 7073(a)(3), inserted “prevention,” after “diagnosis,”.
Subsec. (e). Pub. L. 115–271, § 7073(a)(4), substituted “2019 through 2023” for “2010 through 2012”.
heading: Statutory Notes and Related Subsidiaries
heading: Emergency Department Alternatives to Opioids Demonstration Program
text: Pub. L. 115–271, title VII, § 7091, Oct. 24, 2018, 132 Stat. 4035, provided that:
“(a) Demonstration Program Grants.—
“(1) In general.—
The Secretary of Health and Human Services (in this section referred to as the ‘Secretary’) shall carry out a demonstration program for purposes of awarding grants to hospitals and emergency departments, including freestanding emergency departments, to develop, implement, enhance, or study alternatives to opioids for pain management in such settings.
“(2) Eligibility.—
To be eligible to receive a grant under paragraph (1), 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.
“(3) Geographic distribution.—
In awarding grants under this section, the Secretary shall seek to ensure geographical distribution among grant recipients.
“(4) Use of funds.—
Grants under paragraph (1) shall be used to—
“(A) target treatment approaches for painful conditions frequently treated in such settings;
“(B) train providers and other hospital personnel on protocols or best practices related to the use and prescription of opioids and alternatives to opioids for pain management in the emergency department; and
“(C) develop or continue strategies to provide alternatives to opioids, as appropriate.
“(b) Additional Demonstration Program.—
The Secretary may carry out a demonstration program similar to the program under subsection (a) for other acute care settings.
“(c) Consultation.—
The Secretary shall implement a process for recipients of grants under subsection (a) or (b) to share evidence-based and best practices and promote consultation with persons having robust knowledge, including emergency departments and physicians that have successfully implemented programs that use alternatives to opioids for pain management, as appropriate, such as approaches studied through the National Center for Complimentary and Integrative Health or other institutes and centers at the National Institutes of Health, as appropriate. The Secretary shall offer to each recipient of a grant under subsection (a) or (b) technical assistance as necessary.
“(d) Technical Assistance.—
The Secretary shall identify or facilitate the development of best practices on alternatives to opioids for pain management and provide technical assistance to hospitals and other acute care settings on alternatives to opioids for pain management. The technical assistance provided shall be for the purpose of—
“(1) utilizing information from recipients of a grant under subsection (a) or (b) that have successfully implemented alternatives to opioids programs;
“(2) identifying or facilitating the development of best practices on the use of alternatives to opioids, which may include pain-management strategies that involve non-addictive medical products, non-pharmacologic treatments, and technologies or techniques to identify patients at risk for opioid use disorder;
“(3) identifying or facilitating the development of best practices on the use of alternatives to opioids that target common painful conditions and include certain patient populations, such as geriatric patients, pregnant women, and children; and
“(4) disseminating information on the use of alternatives to opioids to providers in acute care settings, which may include emergency departments, outpatient clinics, critical access hospitals, Federally qualified health centers, Indian Health Service health facilities, and tribal hospitals.
“(e) 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 all applicable State and Federal privacy laws—
“(1) a description of and specific information about the opioid alternative pain management programs, including the demographic characteristics of patients who were treated with an alternative pain management protocol, implemented in hospitals, emergency departments, and other acute care settings;
“(2) data on the opioid alternative pain management strategies used, including the number of opioid prescriptions written—
“(A) during a baseline period before the program began; or
“(B) at various stages of the program; and
“(3) data on patients who were eventually prescribed opioids after alternative pain management protocols and treatments were utilized; and
“(4) any other information the Secretary determines appropriate.
“(f) 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 (e), including data that allows for comparison of programs; and
“(3) recommendations for broader implementation of pain management strategies that encourage the use of alternatives to opioids in hospitals, emergency departments, or other acute care settings.
“(g) 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.”