Public Law 114–198: To authorize the Attorney General and Secretary of Health and Human Services to award grants to address the prescription opioid abuse and heroin use crisis, and for other purposes.

significantly higher than the national average as determined by the Secretary (including appropriate consideration of the results of the Monitoring the Future Survey published by the National Institute on Drug Abuse and the National Survey on Drug Use and Health published by the Substance Abuse and Mental Health Services Administration); or

higher than the national average, as determined by the Secretary (including appropriate consideration of the results of the surveys described in clause (i)), over a sustained period of time.

Amounts received as a demonstration grant under this section shall be used to—

“(1)

Plan.

Upon the completion of the demonstration program under this section, the Secretary shall submit to Congress a report on the program.

No additional funds are authorized to be appropriated for the purpose of carrying out this section. This section shall be carried out using amounts otherwise available for such purpose.

The demonstration program under this section shall not exceed 5 years.”

finds that such a referral is not in the interest of protecting and promoting public health;130 STAT. 703

finds that such a referral is not necessary based on a review of the relevant scientific information; and

submits a notice containing the rationale for such findings to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives.

“(a)

Establishment.—

“(b)

Application.—

“(c)

Use of Funds.—

foster the establishment of State-administered controlled substance monitoring systems in order to ensure that health care providers have access to the accurate, timely prescription history information that they may use as a tool for the early identification of patients at risk for addiction in order to initiate appropriate medical interventions and avert the tragic personal, family, and community consequences of untreated addiction; and”

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in the matter preceding clause (i), by “(a)(1)(B)” and “(a)(1)(B) or (a)(1)(C)”;

in clause (i), by “program to be improved” and “program to be improved or maintained”;

by clauses (iii) and (iv) as clauses (iv) and (v), respectively;

by after clause (ii), the following:130 STAT. 707 ;

in clause (iv) (as so redesignated), by “; and” and the following: “and at least one health information technology system such as electronic health records, health information exchanges, or e-prescribing systems;”;

in clause (v) (as so redesignated)—

by at the end the following:;

by “If a State that submits” and the following:;

by before the period at the end “and include timelines for full implementation of such interoperability. The State shall also describe the manner in which it will achieve interoperability between its monitoring program and health information technology systems, as allowable under State law, and include timelines for the implementation of such interoperability”; and

by at the end the following:; and

by “implement or improve” and “establish, improve, or maintain”; and

by at the end the following: “The Secretary shall redistribute any funds that are so returned among the remaining grantees under this section in accordance with the formula described in subsection (a)(2)(B).”;

by “In implementing or improving” and all that follows through “(a)(1)(B)” and “In establishing, improving, or maintaining a controlled substance monitoring program under this section, a State shall comply, or with respect to a State that applies for a grant under subparagraph (B) or (C) of subsection (a)(1)”; and130 STAT. 708

by “public health” and “public health or safety”; and

adding

in subparagraph (B), by “misuse of a schedule II, III, or IV substance” and “misuse of a controlled substance included in schedule II, III, or IV of section 202(c) of the Controlled Substances Act”; and

in subparagraph (D)—

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“(h)

Education and Access to the Monitoring System.—

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“(a)

Grants to States.—

“(c)

Preference in Making Grants.—

“(d)

Grant Terms.—

“(h)

Authorization of Appropriations.—

“PART LL—

COMPREHENSIVE OPIOID ABUSE GRANT PROGRAM

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such research relative to any unique circumstances (including social and biological circumstances) of adolescents and young adults that may make adolescent-specific and young adult-specific treatment protocols necessary, including any effects that substance use and substance use disorders may have on brain development and the implications for treatment and recovery; and

areas of such research in which greater investment or focus is necessary relative to other areas of such research.

The Secretary shall make grants to States, local governmental entities, and Indian tribes and tribal 130 STAT. 716 organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act) to allow first responders and members of other key community sectors to administer a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.

“(1)

In general.—

“(2)

Criteria.—

An entity shall use a grant received under this section to—

The Secretary shall make a grant for the purpose of providing technical assistance and training on the use of a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose, and mechanisms for referral to appropriate treatment for an entity receiving a grant under this section.

In making grants under this section, the Secretary shall ensure that not less than 20 percent of grant funds are awarded to eligible entities that are not located 130 STAT. 717 in metropolitan statistical areas (as defined by the Office of Management and Budget). The Secretary shall take into account the unique needs of rural communities, including communities with an incidence of individuals with opioid use disorder that is above the national average and communities with a shortage of prevention and treatment services.

The Secretary shall conduct an evaluation of grants made under this section to determine—

To carry out this section, there are authorized to be appropriated $12,000,000 for each of fiscal years 2017 through 2021.”

To be eligible for a grant, contract, or cooperative agreement under subsection (a), an entity shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may reasonably require.

An entity that receives a grant, contract, or cooperative agreement under subsection (a) shall submit, in the application for such grant, contract, or agreement a plan for the evaluation of any project undertaken with funds provided under this section. Such entity shall provide the Secretary with periodic evaluations of the progress of such project and an evaluation at the completion of such project as the Secretary determines to be appropriate.

In awarding grants, contracts, and cooperative agreements under this section, the Secretary shall ensure that not less than 15 percent of funds are awarded to eligible entities that are not located in metropolitan statistical areas (as defined by the Office of Management and Budget). The Secretary shall take into account the unique needs of rural communities, including communities with an incidence of individuals with opioid use disorder that is above the national average and communities with a shortage of prevention and treatment services.

In administering grants, contracts, and cooperative agreements under subsection (a), the Secretary shall—

To carry out this section, there are authorized to be appropriated $25,000,000 for each of fiscal years 2017 through 2021.”

In this section, the term ‘’ means an independent nonprofit organization that—

The Secretary shall award grants to recovery community organizations to enable such organizations to develop, expand, and enhance recovery services.

The Federal share of the costs of a program funded by a grant under this section may not exceed 50 percent.

Grants awarded under subsection (b)—

“(2)

There are authorized to be appropriated to carry out this section $1,000,000 for each of fiscal years 2017 through 2021.”

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in clause (ii), by “Upon receiving a notification under subparagraph (B)” and “Upon receiving a determination from the Secretary under clause (iii) finding that a practitioner meets all requirements for a waiver under subparagraph (B)”; and

in clause (iii)—

by clause (ii)(I) to read as follows:;

by clause (ii)(II) to read as follows:;

in clause (ii)(III), by “subspecialty”;130 STAT. 721

by clause (ii)(IV) to read as follows:; and

by at the end the following:; and

in clause (i), by after subclause (II) the following:; and

by clause (ii) to read as follows:.

perform a thorough review of the provision of opioid use disorder treatment services in the United States, including services provided in opioid treatment programs and other specialty and nonspecialty settings; and

submit a report to the Congress on the findings and conclusions of such review.

compliance with the requirements of section 303(g)(2) of the Controlled Substances Act (21 U.S.C. 823(g)(2)), as amended by this section;

the measures taken by the Secretary of Health and Human Services to ensure such compliance;

whether there is further need to increase or decrease the number of patients a practitioner, pursuant to a waiver under section 303(g)(2) of the Controlled Substances Act (21 U.S.C. 823(g)(2)), is permitted to treat;

the extent to which, and proportions with which, the full range of Food and Drug Administration-approved treatments for opioid use disorder are used 130 STAT. 723 in routine health care settings and specialty substance use disorder treatment settings;

access to, and use of, counseling and recovery support services, including the percentage of patients receiving such services;

changes in State or local policies and legislation relating to opioid use disorder treatment;

the use of prescription drug monitoring programs by practitioners who are permitted to dispense narcotic drugs to individuals pursuant to a waiver described in clause (iii);

the findings resulting from inspections by the Drug Enforcement Administration of practitioners described in clause (vii); and

the effectiveness of cross-agency collaboration between Department of Health and Human Services and the Drug Enforcement Administration for expanding effective opioid use disorder treatment.

Notwithstanding section 708, nothing in this paragraph shall be construed to preempt any State law that—

by “(referred to in this section as the ‘Director’)” after “Substance Abuse Treatment”;

by “grants, cooperative agreement,” and “grants, including the grants under subsection (r), cooperative agreements”; and

by “for substance abuse” and “for substance use disorders”; and

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in subparagraph (A), by “substance abuse” and “substance use disorders”; and

in subparagraph (B), by “such abuse” and “such a disorder”;

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amending

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in subparagraph (A), by “their children” and “any child of such woman”;

in subparagraph (B), by “; and” and a semicolon;

in subparagraph (C), by the period and “; and”; and

by at the end the following:;

in the matter preceding subparagraph (A), by “substance abuse” and “substance use disorders”; and

in subparagraph (B), by “substance abuse” and “substance use disorders”; and

by “(A) Subject” and the following:;

in subparagraph (B)—

by “(C) With respect” and the following:;

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“(1)

Definitions.—

“(2)

Veterans assistance program.—

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“to ensure the safety and well-being of such infant following release from the care of health care providers, including through—

“(17)

“SEC. 114.

42 USC 5108.

MONITORING AND OVERSIGHT.

In this section:

“(3)

Prescriber of a schedule ii, iii, or iv controlled substance.—

“(2)

Response plan.

Purposes.—

“(5)

Priority considerations.—

“(7)

States with local prescription drug monitoring programs.—

For the purpose of carrying out this section, there are authorized to be appropriated $5,000,000 for each of fiscal years 2017 through 2021.”

“(a)

Definition of Applicable Committees.—

“(b)

Accountability.—

“(c)

Preventing Duplicative Grants.—

applicable committees

the Committee on Health, Education, Labor and Pensions of the Senate; and

the Committee on Energy and Commerce of the House of Representatives.

covered grant

grantee

Secretary

Not later than 1 year after the date of the enactment of this Act, the Secretary, in coordination with the Inspector General of the Department of Health and Human Services, shall submit to the applicable committees a report on the policies and procedures the Department has in place to prevent waste, fraud, and abuse in the administration of covered grants.130 STAT. 739

The policies and procedures referred to in clause (i) shall include policies and procedures that are designed to—

No amounts made available to the Secretary under this Act (or in a provision of law amended by this Act, other than sections 703 through 707) may be used by the Secretary, or by any individual or entity awarded discretionary funds through a cooperative agreement under a program established under this Act (or in a provision of law amended by this Act), to host or support any expenditure for conferences that uses more than $20,000 in funds made available by the Secretary, unless the head of the relevant operating division or program office provides prior written authorization that the funds may be expended to host or support the conference. Such written

Cost estimate.

authorization shall include a written estimate of all costs associated with the conference, including the cost of all food, beverages, audio-visual equipment, honoraria for speakers, and entertainment.

The Secretary (or the Secretary’s designee) shall submit to the applicable committees an annual report on all conference expenditures approved by the Secretary under this subparagraph.

outcomes that are to be achieved by activities funded by the programs described in paragraph (1)(A); and

the metrics by which the achievement of such outcomes shall be determined.

is not an agency of the Federal Government; and

is qualified to conduct and evaluate research pertaining to opioid use and abuse and draw conclusions about overall opioid use and abuse on the basis of that research.

“(1)

Partial fills.—

“(2)

Remaining portions.—

130 STAT. 741

“(5)

Drug management program for at-risk beneficiaries.—

“(6)

Utilization management tool to prevent drug abuse.—

“(j)

Expanding Activities of Medicare Drug Integrity Contractors (MEDICs).—

In conducting a quality or performance assessment of a PDP sponsor, the Secretary shall develop or utilize existing screening methods for reviewing and considering complaints that are received from enrollees in a prescription drug plan offered by such PDP sponsor and that are complaints regarding the lack of access by the individual to prescription drugs due to a drug management program for at-risk beneficiaries.”

the impediments, if any, that impair the ability of individuals described in subparagraph (C) of such section 1860D–4(c)(5) to access clinically appropriate levels of prescription drugs;

the effectiveness of the reasonable access protections under subparagraph (D)(ii) of such section 1860D–4(c)(5), including the impact on beneficiary access and health;

the types of—

other areas determined appropriate by the Comptroller General.

the anticipated impact of drug management programs for at-risk beneficiaries under paragraph (5) of section 1860D–4(c) of the Social Security Act (42 U.S.C. 1395w–104(c)) on cost-sharing and ensuring accessibility to prescription drugs for enrollees in prescription drug plans of PDP sponsors, and enrollees in MA–PD plans, who are at-risk beneficiaries for prescription drug abuse (as defined in subparagraph (C) of such paragraph);

the use of an expedited appeals process under which such an enrollee may appeal an identification of such enrollee as an at-risk beneficiary for prescription drug abuse under such paragraph (similar to the processes established under the Medicare Advantage program under part C of title XVIII of the Social Security Act that allow an automatic escalation to external review of claims submitted under such part);

the types of enrollees that should be treated as exempted individuals, as described in subparagraph (C)(ii) of such paragraph;

the manner in which terms and definitions in such paragraph should be applied, such as the use of clinical appropriateness in determining whether an enrollee is an at-risk beneficiary for prescription drug abuse as defined in subparagraph (C) of such paragraph;

the information to be included in the notices described in subparagraph (B) of such paragraph and the standardization of such notices;

with respect to a PDP sponsor (or Medicare Advantage organization) that establishes a drug management program for at-risk beneficiaries under such paragraph, the responsibilities of such PDP sponsor (or organization) with respect to the implementation of such program;

notices for plan enrollees at the point of sale that would explain why an at-risk beneficiary has been prohibited from receiving a prescription at a location outside of the designated pharmacy;

evidence-based prescribing guidelines for opiates; and

the sharing of claims data under parts A and B of title XVIII of the Social Security Act with PDP sponsors.

“(b)

Applicability.

Limiting Disclosure of Predictive Modeling Technologies.—

“(c)

Covered Algorithm Defined.—

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that such tests occur not less frequently than once each year or as otherwise determined according to treatment protocols; and

that health care providers appropriately order, interpret and respond to the results from such tests to tailor pain therapy, safeguards, and risk management strategies to each patient.

The implementation of and full compliance with the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, including any update to such guideline.

The use of evidence-based pain management therapies and complementary and integrative health services, including cognitive-behavioral therapy, non-opioid alternatives, and non-drug methods and procedures to managing pain and related health conditions including, to the extent practicable, medical devices approved or cleared by the Food and Drug Administration for the treatment of patients with chronic pain and related health conditions.

Screening and identification of patients with substance use disorder, including drug-seeking behavior, before prescribing opioids, assessment of risk potential for patients developing an addiction, and referral of patients to appropriate addiction treatment professionals if addiction is identified or strongly suspected.130 STAT. 757

Communication with patients on the potential harm associated with the use of opioids and other controlled substances, including the need to safely store and dispose of supplies relating to the use of opioids and other controlled substances.

Such other education and training as the Secretary considers appropriate to ensure that veterans receive safe and high-quality pain management care from the Department.

In consultation with the Directors of each Veterans Integrated Service Network, the Secretary shall establish standard protocols for the designation of pain management teams at each medical facility within the Department.

Each protocol established under subparagraph (A) shall ensure that any health care provider without expertise in prescribing analgesics or who has not completed the education and training under subsection (b), including a mental health care provider, does not prescribe opioids to a patient unless that health care provider—

Not later than one year after the date of enactment of this Act, the director of each medical facility of the Department shall submit to the Under Secretary for Health and the director of the Veterans Integrated Service Network in which the medical facility is located a report identifying the health care professionals that have been designated as members of the pain management team at the medical facility pursuant to paragraph (1).

Each report submitted under subparagraph (A) with respect to a medical facility of the Department shall include—

(iii)

Certification.

ensure access by health care providers of the Department to information on controlled substances, including opioids and benzodiazepines, prescribed to veterans who receive care outside the Department through the prescription drug monitoring program of each State with such a program, including by seeking to enter into memoranda of understanding with States to allow shared access of such information between States and the Department;

include such information in the Opioid Therapy Risk Report tool; and

require health care providers of the Department to submit to the prescription drug monitoring program of each State with such a program information on prescriptions of controlled substances received by veterans in that State under the laws administered by the Secretary.

the key clinical indicators with respect to the totality of opioid use by veterans;

concurrent prescribing by health care providers of the Department of opioids in different health care settings, including data on concurrent prescribing of opioids to treat mental health disorders other than opioid use disorder; and

mail-order prescriptions of opioids prescribed to veterans under the laws administered by the Secretary.

The Secretary shall maximize the availability of opioid receptor antagonists, including naloxone, to veterans.

In carrying out subparagraph (A), not later than 90 days after the date of the enactment of this Act, the Secretary shall—

For purposes of subparagraph (B), veterans who are at risk of opioid overdose include—

information on the most recent time the tool was accessed by a health care provider of the Department with respect to each veteran; and

information on the results of the most recent urine drug test for each veteran.

Enhanced guidance with respect to—

Enhanced guidance with respect to the treatment of patients with behaviors or comorbidities, such as post-traumatic stress disorder or other psychiatric disorders, or a history of substance abuse or addiction, that requires a consultation or co-management of opioid therapy with one or more specialists in pain management, mental health, or addictions.

Enhanced guidance with respect to health care providers—

Guidelines to inform the methodologies used by health care providers of the Department of Veterans Affairs and the Department of Defense to safely taper opioid therapy when adjusting or discontinuing the use of opioid therapy, including—

Guidelines with respect to appropriate case management for patients receiving opioid therapy who transition between inpatient and outpatient health care settings, which may include the use of care transition plans.

Guidelines with respect to appropriate case management for patients receiving opioid therapy who transition from receiving care during active duty to post-military health care networks.

Guidelines with respect to providing options, before initiating opioid therapy, for pain management therapies 130 STAT. 762 without the use of opioids and options to augment opioid therapy with other clinical and complementary and integrative health services to minimize opioid dependence.

Guidelines with respect to the provision of evidence-based non-opioid treatments within the Department of Veterans Affairs and the Department of Defense, including medical devices and other therapies approved or cleared by the Food and Drug Administration for the treatment of chronic pain as an alternative to or to augment opioid therapy.

Guidelines developed by the Centers for Disease Control and Prevention for safely prescribing opioids for the treatment of chronic, non-cancer related pain in outpatient settings.

An assessment of the implementation and monitoring by the Veterans Health Administration of the Opioid Safety Initiative of the Department, including examining, as appropriate, the following:

(i)

Information made available under the Opioid Therapy Risk Report tool with respect to—

An evaluation of processes of the Department in place to oversee opioid use among veterans, including procedures to identify and remedy potential over-prescribing of opioids by health care providers of the Department.

An assessment of the implementation by the Secretary of Veterans Affairs of the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, including any figures or approaches used by the Department to assess compliance with such guidelines by medical centers of the Department and identify any medical centers of the Department operating action plans to improve compliance with such guidelines.

An assessment of the data that the Department has developed to review the opioid prescribing practices of health care providers of the Department, as required by this subtitle, including a review of how the Department identifies the practices of individual health care providers that warrant further review based on prescribing levels, health conditions for which the health care provider is prescribing opioids or opioids and benzodiazepines concurrently, or other practices of the health care provider.

the prescription rate at which each health care provider at the facility prescribed benzodiazepines and opioids concurrently to such patients and the aggregate of such prescription rate for all health care providers at the facility;

the prescription rate at which each health care provider at the facility prescribed benzodiazepines or opioids to such patients to treat conditions for which benzodiazepines or opioids are not approved treatment and the aggregate of such prescription rate for all health care providers at the facility;

the prescription rate at which each health care provider at the facility prescribed or dispensed mail-order prescriptions of opioids to such patients while such patients were being treated with opioids on an inpatient-basis and the aggregate of such prescription rate for all health care providers at the facility; and

the prescription rate at which each health care provider at the facility prescribed opioids to such patients who were also concurrently prescribed opioids by a health 130 STAT. 765 care provider that is not a health care provider of the Department and the aggregate of such prescription rates for all health care providers at the facility.

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the purpose of the Program;

the activities carried out under the Program; and

the sufficiency of the Program in achieving the purpose of the Program.

the awareness of the Program among veterans and family members of veterans; and

the use of the Program by veterans and family members of veterans.

“§ 7309A.

38 USC 7309A.

Office of Patient Advocacy

the experience of veterans with the Department of Veterans Affairs when seeking medical assistance for mental health issues through the health care system of the Department;

the experience of veterans with non-Department facilities and health professionals for treating mental health issues;

the preference of veterans regarding available treatment for mental health issues and which methods the veterans believe to be most effective;130 STAT. 770

the experience, if any, of veterans with respect to the complementary and integrative health treatment therapies described in paragraph (3);

the prevalence of prescribing prescription medication among veterans seeking treatment through the health care system of the Department as remedies for addressing mental health issues; and

the outreach efforts of the Secretary regarding the availability of benefits and treatments for veterans for addressing mental health issues, including by identifying ways to reduce barriers to gaps in such benefits and treatments.

music therapy;

equine therapy;

training and caring for service dogs;

yoga therapy;

acupuncture therapy;

meditation therapy;

outdoor sports therapy;

hyperbaric oxygen therapy;

accelerated resolution therapy;

art therapy;

magnetic resonance therapy; and

other therapies the Commission determines appropriate.

the effectiveness of such treatments and resources in decreasing the number of suicides per day by veterans;

the number of veterans who have been diagnosed with mental health issues;

the percentage of veterans using the resources of the Department who have been diagnosed with mental health issues;

the percentage of veterans who have completed counseling sessions offered by the Department; and

the efforts of the Department to expand complementary and integrative health treatments viable to the recovery of veterans with mental health issues as determined by the Secretary to improve the effectiveness of treatments offered by the Department.

Two members appointed by the Speaker of the House of Representatives, at least one of whom shall be a veteran.130 STAT. 771

Two members appointed by the minority leader of the House of Representatives, at least one of whom shall be a veteran.

Two members appointed by the majority leader of the Senate, at least one of whom shall be a veteran.

Two members appointed by the minority leader of the Senate, at least one of whom shall be a veteran.

Two members appointed by the President, at least one of whom shall be a veteran.

are of recognized standing and distinction within the medical community with a background in treating mental health;

have experience working with the military and veteran population; and

do not have a financial interest in any of the complementary and integrative health treatments reviewed by the Commission.

The Commission shall hold its first meeting not later than 30 days after a majority of members are appointed to the Commission.

The Commission shall regularly meet at the call of the Chairman. Such meetings may be carried out through the use of telephonic or other appropriate telecommunication technology if the Commission determines that such technology will allow the members to communicate simultaneously.

The executive director and any personnel of the Commission are employees under section 2105 of title 5, United States Code, for purpose of chapters 63, 81, 83, 84, 85, 87, 89, and 90 of such title.

Subparagraph (A) shall not be construed to apply to members of the Commission.

Not later than 60 days after the date on which the Commission first meets, and each 30-day period thereafter ending on the date on which the 130 STAT. 773 Commission submits the final report under paragraph (2), the Commission shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate and the President a report detailing the level of cooperation the Secretary of Veterans Affairs (and the heads of other departments or agencies of the Federal Government) has provided to the Commission.

In carrying out its duties, at times that the Commission determines appropriate, the Commission shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate and any other appropriate entities an interim report with respect to the findings identified by the Commission.

Recommendations to implement in a feasible, timely, and cost-efficient manner the solutions and remedies identified within the findings of the Commission pursuant to subsection (b).

An analysis of the evidence-based therapy model used by the Secretary of Veterans Affairs for treating veterans with mental health care issues, and an examination of the prevalence and efficacy of prescription drugs as a means for treatment.

The findings of the patient-centered survey conducted within each of the Veterans Integrated Service Networks pursuant to subsection (b)(2).

An examination of complementary and integrative health treatments described in subsection (b)(3) and the potential benefits of incorporating such treatments in the therapy models used by the Secretary for treating veterans with mental health issues.

An action plan for implementing the recommendations established by the Commission on such solutions and remedies for improving wellness-based outcomes for veterans with mental health care issues.

A feasible timeframe on when the complementary and integrative health treatments described in subsection (b)(3) can be implemented Department-wide.

With respect to each recommendation established by the Commission, including any complementary and integrative health treatment, that the Secretary determines is not appropriate or feasible to implement, a justification for such determination and an alternative solution to improve the efficacy of the therapy models used by the Secretary for treating veterans with mental health issues.130 STAT. 774

The effectiveness of various complementary and integrative health services, including the effectiveness of such services integrated with clinical services.

Approaches to integrating complementary and integrative health services into other health care services provided by the Department of Veterans Affairs.

Complementary and integrative health services selected by the Secretary for purposes of the plan.

Appropriate uses of such services.

Integration of such services into the delivery of health care to veterans.

The Director of the National Center for Complementary and Integrative Health of the National Institutes of Health.

The Commissioner of Food and Drugs.

Institutions of higher education, private research institutes, and individual researchers with extensive experience in complementary and integrative health and the integration of complementary and integrative health practices into the delivery of health care.

Nationally recognized providers of complementary and integrative health.

Such other officials, entities, and individuals with expertise on complementary and integrative health as the Secretary considers appropriate.130 STAT. 775

To develop the plan.

To identify specific complementary and integrative health practices that, on the basis of research findings or promising clinical interventions, are appropriate to include as services to veterans.

To identify barriers to the effective provision and integration of complementary and integrative health services into the delivery of health care to veterans, and to identify mechanisms for overcoming such barriers.

Means of improving coordination between Federal, State, local, and community providers of health care in the provision of pain management and related health care services to veterans.

Means of enhancing outreach, and coordination of outreach, by and among providers of health care referred to in subparagraph (A) on the pain management and related health care services available to veterans.

Means of using complementary and integrative health and wellness-based programs of providers of health care referred to in subparagraph (A) as complements to the provision by the Department of Veterans Affairs of pain management and related health care services to veterans.

Whether complementary and integrative health and wellness-based programs described in subparagraph (C)—

Covered services shall be administered by professionals or other instructors with appropriate training and expertise in complementary and integrative health services who are employees of the Department or with whom the Department enters into an agreement to provide such services.

Covered services shall be included as part of the Patient Aligned Care Teams initiative of the Office of Patient Care Services, Primary Care Program Office, in coordination with the Office of Patient Centered Care and Cultural Transformation.

Covered services shall be made available to—

The findings and conclusions of the Secretary with respect to the pilot program under subsection (a)(1), including with respect to—

Identification of any unresolved barriers that impede the ability of the Secretary to incorporate complementary and integrative health services with other health care services provided by the Department.

Such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate.

“(a)

Limitation.—