<section xmlns="http://xml.house.gov/schemas/uslm/1.0" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dcterms="http://purl.org/dc/terms/" style="-uslm-lc:I80" id="ida4f77510-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i"><num value="294i">§ 294i.</num><heading> Program for education and training in pain care</heading><subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4f77511-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/a"><num value="a" class="bold">(a)</num><heading class="bold"> In general</heading><content><p style="-uslm-lc:I11" class="indent0">The Secretary may make awards of grants, cooperative agreements, and contracts to health professions schools, hospices, tribal health programs (as defined in <ref href="/us/usc/t25/s1603">section 1603 of title 25</ref>), 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.</p>
</content>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4f77512-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/b"><num value="b" class="bold">(b)</num><heading class="bold"> Certain topics</heading><chapeau style="-uslm-lc:I11" class="indent0">An entity receiving an award under this section shall develop a comprehensive education and training plan that includes information and education on—</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="ida4f77513-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/b/1"><num value="1">(1)</num><content> 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;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="ida4f77514-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/b/2"><num value="2">(2)</num><content> applicable Federal, State, and local laws, regulations, rules, and policies on controlled substances, including opioids;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="ida4f77515-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/b/3"><num value="3">(3)</num><content> 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;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="ida4f77516-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/b/4"><num value="4">(4)</num><content> cultural, linguistic, literacy, geographic, and other barriers to care in underserved populations;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="ida4f79c27-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/b/5"><num value="5">(5)</num><content> 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</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="ida4f79c28-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/b/6"><num value="6">(6)</num><content> 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).</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4f79c29-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/c"><num value="c" class="bold">(c)</num><heading class="bold"> Evaluation of programs</heading><content><p style="-uslm-lc:I11" class="indent0">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.</p>
</content>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4f79c2a-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/d"><num value="d" class="bold">(d)</num><heading class="bold"> Pain care defined</heading><content><p style="-uslm-lc:I11" class="indent0">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.</p>
</content>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4f79c2b-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s294i/e"><num value="e" class="bold">(e)</num><heading class="bold"> Authorization of appropriations</heading><content><p style="-uslm-lc:I11" class="indent0">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.</p>
</content>
</subsection>
<sourceCredit id="ida4f79c2c-09a0-11eb-a85b-f5cef3d06f4d">(<ref href="/us/act/1944-07-01/ch373">July 1, 1944, ch. 373</ref>, title VII, § 759, as added <ref href="/us/pl/111/148/tIV/s4305/c">Pub. L. 111–148, title IV, § 4305(c)</ref>, <date date="2010-03-23">Mar. 23, 2010</date>, <ref href="/us/stat/124/586">124 Stat. 586</ref>; amended <ref href="/us/pl/115/271/tVII/s7073/a">Pub. L. 115–271, title VII, § 7073(a)</ref>, <date date="2018-10-24">Oct. 24, 2018</date>, <ref href="/us/stat/132/4031">132 Stat. 4031</ref>.)</sourceCredit>
<notes type="uscNote" id="ida4f79c2d-09a0-11eb-a85b-f5cef3d06f4d">
<note style="-uslm-lc:I74" topic="priorProvisions" id="ida4f79c2e-09a0-11eb-a85b-f5cef3d06f4d"><heading class="centered smallCaps">Prior Provisions</heading><p style="-uslm-lc:I21" class="indent0">A prior section 294i, <ref href="/us/act/1944-07-01/ch373/tVII/s771">act July 1, 1944, ch. 373, title VII, § 771</ref>, as added <ref href="/us/pl/102/408/tI/s102">Pub. L. 102–408, title I, § 102</ref>, <date date="1992-10-13">Oct. 13, 1992</date>, <ref href="/us/stat/106/2049">106 Stat. 2049</ref>, 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 <ref href="/us/pl/105/392">Pub. L. 105–392</ref>.</p>
<p style="-uslm-lc:I21" class="indent0">Another prior section 294i, <ref href="/us/act/1944-07-01/ch373/tVII/s736">act July 1, 1944, ch. 373, title VII, § 736</ref>, as added <date date="1976-10-12">Oct. 12, 1976</date>, <ref href="/us/pl/94/484/tIV/s401/b/3">Pub. L. 94–484, title IV, § 401(b)(3)</ref>, <ref href="/us/stat/90/2265">90 Stat. 2265</ref>; amended <date date="1977-08-01">Aug. 1, 1977</date>, <ref href="/us/pl/95/83/tIII/s307/d">Pub. L. 95–83, title III, § 307(d)</ref>, <ref href="/us/stat/91/390">91 Stat. 390</ref>, 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 <ref href="/us/pl/102/408">Pub. L. 102–408</ref>. See <ref href="/us/usc/t42/s292k">section 292k of this title</ref>.</p>
<p style="-uslm-lc:I21" class="indent0">A prior section 759 of act <date date="1944-07-01">July 1, 1944</date>, was classified to <ref href="/us/usc/t42/s294aa">section 294aa of this title</ref> prior to the general amendment of this subchapter by <ref href="/us/pl/102/408">Pub. L. 102–408</ref>.</p>
</note>
<note style="-uslm-lc:I74" topic="amendments" id="ida4f79c2f-09a0-11eb-a85b-f5cef3d06f4d"><heading class="centered smallCaps">Amendments</heading><p style="-uslm-lc:I21" class="indent0">2018—Subsec. (a). <ref href="/us/pl/115/271/s7073/a/1">Pub. L. 115–271, § 7073(a)(1)</ref>, substituted “hospices, tribal health programs (as defined in <ref href="/us/usc/t25/s1603">section 1603 of title 25</ref>), and other public and nonprofit private entities” for “hospices, and other public and private entities”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (b). <ref href="/us/pl/115/271/s7073/a/2/A">Pub. L. 115–271, § 7073(a)(2)(A)</ref>, 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.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (b)(1). <ref href="/us/pl/115/271/s7073/a/2/B">Pub. L. 115–271, § 7073(a)(2)(B)</ref>, inserted “preventing,” after “diagnosing,” and “non-addictive medical products and non-pharmacologic treatments and” after “including”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (b)(2). <ref href="/us/pl/115/271/s7073/a/2/C">Pub. L. 115–271, § 7073(a)(2)(C)</ref>, 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”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (b)(3). <ref href="/us/pl/115/271/s7073/a/2/D">Pub. L. 115–271, § 7073(a)(2)(D)</ref>, inserted “, integrated, evidence-based pain management, and, as appropriate, non-pharmacotherapy” before semicolon.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (b)(5), (6). <ref href="/us/pl/115/271/s7073/a/2/E">Pub. L. 115–271, § 7073(a)(2)(E)</ref>, (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.”</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (d). <ref href="/us/pl/115/271/s7073/a/3">Pub. L. 115–271, § 7073(a)(3)</ref>, inserted “prevention,” after “diagnosis,”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (e). <ref href="/us/pl/115/271/s7073/a/4">Pub. L. 115–271, § 7073(a)(4)</ref>, substituted “2019 through 2023” for “2010 through 2012”.</p>
</note>
<note style="-uslm-lc:I74" topic="miscellaneous" id="ida4f7c340-09a0-11eb-a85b-f5cef3d06f4d"><heading class="centered smallCaps">Emergency Department Alternatives to Opioids Demonstration Program</heading><p><ref href="/us/pl/115/271/tVII/s7091">Pub. L. 115–271, title VII, § 7091</ref>, <date date="2018-10-24">Oct. 24, 2018</date>, <ref href="/us/stat/132/4035">132 Stat. 4035</ref>, provided that:<quotedContent origin="/us/pl/115/271/tVII/s7091">
<subsection style="-uslm-lc:I21" class="indent0"><num value="a">“(a)</num><heading> <inline class="small-caps">Demonstration Program Grants.—</inline></heading><paragraph style="-uslm-lc:I22" class="indent1"><num value="1">“(1)</num><heading> <inline class="small-caps">In general</inline>.—</heading><content>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.</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="2">“(2)</num><heading> <inline class="small-caps">Eligibility</inline>.—</heading><content>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.</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="3">“(3)</num><heading> <inline class="small-caps">Geographic distribution</inline>.—</heading><content>In awarding grants under this section, the Secretary shall seek to ensure geographical distribution among grant recipients.</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="4">“(4)</num><heading> <inline class="small-caps">Use of funds</inline>.—</heading><chapeau>Grants under paragraph (1) shall be used to—</chapeau><subparagraph style="-uslm-lc:I23" class="indent2"><num value="A">“(A)</num><content> target treatment approaches for painful conditions frequently treated in such settings;</content>
</subparagraph>
<subparagraph style="-uslm-lc:I23" class="indent2"><num value="B">“(B)</num><content> 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</content>
</subparagraph>
<subparagraph style="-uslm-lc:I23" class="indent2"><num value="C">“(C)</num><content> develop or continue strategies to provide alternatives to opioids, as appropriate.</content>
</subparagraph>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I21" class="indent0"><num value="b">“(b)</num><heading> <inline class="small-caps">Additional Demonstration Program</inline>.—</heading><content>The Secretary may carry out a demonstration program similar to the program under subsection (a) for other acute care settings.</content>
</subsection>
<subsection style="-uslm-lc:I21" class="indent0"><num value="c">“(c)</num><heading> <inline class="small-caps">Consultation</inline>.—</heading><content>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.</content>
</subsection>
<subsection style="-uslm-lc:I21" class="indent0"><num value="d">“(d)</num><heading> <inline class="small-caps">Technical Assistance</inline>.—</heading><chapeau>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—</chapeau><paragraph style="-uslm-lc:I22" class="indent1"><num value="1">“(1)</num><content> utilizing information from recipients of a grant under subsection (a) or (b) that have successfully implemented alternatives to opioids programs;</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="2">“(2)</num><content> 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;</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="3">“(3)</num><content> 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</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="4">“(4)</num><content> 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.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I21" class="indent0"><num value="e">“(e)</num><heading> <inline class="small-caps">Report to the Secretary</inline>.—</heading><chapeau>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—</chapeau><paragraph style="-uslm-lc:I22" class="indent1"><num value="1">“(1)</num><content> 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;</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="2">“(2)</num><chapeau> data on the opioid alternative pain management strategies used, including the number of opioid prescriptions written—</chapeau><subparagraph style="-uslm-lc:I23" class="indent2"><num value="A">“(A)</num><content> during a baseline period before the program began; or</content>
</subparagraph>
<subparagraph style="-uslm-lc:I23" class="indent2"><num value="B">“(B)</num><content> at various stages of the program; and</content>
</subparagraph>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="3">“(3)</num><content> data on patients who were eventually prescribed opioids after alternative pain management protocols and treatments were utilized; and</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="4">“(4)</num><content> any other information the Secretary determines appropriate.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I21" class="indent0"><num value="f">“(f)</num><heading> <inline class="small-caps">Report to Congress</inline>.—</heading><chapeau>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—</chapeau><paragraph style="-uslm-lc:I22" class="indent1"><num value="1">“(1)</num><content> the number of applications received and the number funded;</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="2">“(2)</num><content> a summary of the reports described in subsection (e), including data that allows for comparison of programs; and</content>
</paragraph>
<paragraph style="-uslm-lc:I22" class="indent1"><num value="3">“(3)</num><content> 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.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I21" class="indent0"><num value="g">“(g)</num><heading> <inline class="small-caps">Authorization of Appropriations</inline>.—</heading><content>To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2019 through 2021.”</content>
</subsection>
</quotedContent>
</p>
</note>
</notes>
</section>