Second Chance Act, Federal Reentry Legislation, Approved
by the House Judiciary Committee
On July 26th, the full House Judiciary Committee approved H.R. 1704, the Second Chance
Act, legislation that seeks to help communities begin to address the need for alcohol and drug addiction and mental health treatment, job training
and education opportunities, housing and a range of other services for individuals and their families following a period of incarceration and upon
their return to the community. The legislation, approved by a voice vote, is now clear to be reviewed by the full House of
Representatives.
Key provisions of the Second Chance Act include:
- Reauthorization of a Department of Justice grant program for people returning to the
community from incarceration; this program would provide grants to States and local areas to create or strengthen the systems that help adults and
youth transition into the community when they are released from incarceration by providing drug addiction and mental health treatment, job training
and education opportunities, housing and other necessary services.
- Improvement of the Residential Substance Abuse Treatment for State and
Federal Prisoners Programs by requiring that RSAT and RDAP programs have an aftercare component and clarifying that "residential substance abuse
treatment" means a course of individual and group activities and treatment lasting at least 6 months in residential treatment facilities set apart
from the general prison population.
- Establishing grant programs to divert appropriate people with low-level drug offenses
to addiction treatment through a prosecutorially based program, to provide treatment for women and parents with children during incarceration, and to
improve addiction treatment programs provided at prisons, jails and juvenile facilities by supporting addiction treatment and recovery support
services including job training and placement, education, peer support, mentoring and other services.
- Authorizing a grant program to establish pharmacological drug treatment services as
part of the available addiction treatment programs being offered to people with addiction histories who are in prison or jail.
H.R. 1704 currently has 112 bi-partisan co-sponsors; S. 1934, the Senate bill, has 25
bi-partisan co-sponsors. It is unclear when the full House and Senate will consider the legislation, but the Senate Judiciary
Committee is expected to review the bill in the fall. More information about the Second Chance Act can be found at: http://thomas.loc.gov/.
House Subcommittee Holds Hearing on Prescription Drug Abuse
On July 26th the House Committee on Government Reform
Subcommittee on Criminal Justice, Drug Policy, and Human Services held a hearing entitled "Prescription Drug Abuse: What is Being Done to Address
this New Drug Epidemic?" The hearing was co-chaired by Congressman Mark Souder (R-IN), Chairman of the Subcommittee and
Congressman Elijah Cummings (D-MD), Ranking Member of the Subcommittee. Other Members in attendance included: Representatives
Watson (D-CA), Holmes-Norton (D-DC), and Foxx (R-NC). The first panel included: Dr. Bertha Madras, Deputy
Director, Demand Reduction, Office of National Drug Control Policy; Dr. Nora Volkow, Director, National Institute on Drug Abuse; Dr. Sandra Kweder,
Deputy Director, Office of New Drugs, Food and Drug Administration; and Joseph Rannazzisi, Deputy Assistant Administrator, Office of Diversion
Control, Drug Enforcement Agency. Included in the second panel were three mothers who each lost a son to prescription drug misuse,
Misty Fetco, Linda Surks, and Barbara van Rooyan; Mathea Falco, J.D., President, Drug Strategies; Stephen Johnson, Executive Director, Commercial
Planning, Pain Therapeutics, Inc; Dr. Laxmaiah Manchikanti, CEO, American Society for Interventional Pain Physicians; and Steve Pasierb, President
and CEO, the Partnership for a Drug-Free America.
In his opening statement, Representative Souder
remarked that the non-medical use of prescription drugs is not receiving enough attention and expressed his concern that this form of drug use is
increasingly common and serving as a pathway to misuse of other drugs. Rep. Souder stated that the abuse of prescription drugs is
a problem of epidemic proportions that demands focused attention and aggressive action by both the government and the private sectors.
Representative Cummings began by expressing that the non-medical use of prescription and over the counter medications is not a new problem,
and that there is a dangerous misperception that pharmaceuticals are not harmful. Rep. Cummings outlined his ideas for action
steps, which include requiring that purchases for prescriptions from online pharmacies involve a valid prescription and identification of the
purchaser, prescription drug monitoring programs, education of the public, creation of drug formulations that are resistant to abuse, and preventing
illegal diversion.
Dr. Bertha Madras acknowledged that although
prescription drugs are safe, effective and necessary when used according to doctors' prescriptions and advice, the misuse and abuse of controlled and
certain over-the-counter prescription drugs is a national problem, citing the most recent data from the National Survey on Drug Use and Health which
indicated a higher number of new initiates into non-medical prescription drug use than into marijuana use. According to Dr.
Madras, the Administration is concerned about the increase in the abuse of controlled substance prescription drugs and in response released its first
ever Synthetic Drug Control Strategy in June 2006, which focuses on methamphetamine and prescription drug abuse. Other federal
strategies targeted by Dr. Madras as key to reducing the non-medical use of prescription drugs include: Prescription Drug Monitoring Programs
(PDMPs); DEA investigations of rogue Internet-facilitator Web sites, with the purpose of intercepting controlled substance prescriptions illegally
sent into the United States through the mail system; convening representatives of the medical and pharmaceutical communities to develop a strategy to
address this public health issue; sponsoring a medical conference to focus on medical education on addictions, and specifically on prescription
medications; and education of patients, and where appropriate patient-parents, who are in possession of such drugs. Also mentioned
as important were the establishment of community coalitions, use of student drug testing, the Screening, Brief Intervention, Referral and Treatment
(SBIRT) program that provides early identification and intervention in general medical settings, and funding of drug courts and the President's
Access to Recovery Program.
Dr. Nora Volkow also acknowledged the beneficial uses
of prescription drugs, in particular psychotherapeutics, as well as their substantial abuse potential. She agreed with Rep. Souder
that the problem of non-medical use of prescription drugs is urgent and is not receiving the attention it needs. She noted NIDA's
particular concern with the increase in prescription drug abuse over the past five years among adolescents, the potential misuse or unintentional use
by older Americans as well as potential misuse by women. Dr. Volkow spoke about NIDA's efforts to address this issue including the
work of their 21 Community Epidemiology Work Group (CEWG) sites that provide ongoing community-level surveillance of drug abuse profiles through
analysis of quantitative and qualitative research data. Dr. Volkow spoke to the Subcommittee about NIDA's multi-pronged strategy
aimed at better understanding the prescription drug phenomena, including an initiative on "Prescription Opioid Use and Abuse in the Treatment of
Pain" and conducting a multi-center study through their Clinical Trials Network (CTN) to evaluate treatment regimens using oral
buprenorphine/naloxone. In closing, Dr. Volkow assured the Subcommittee that NIDA's close collaborations with physician's
organizations, the Office of National Drug Control Policy (ONDCP), SAMHSA and other Federal agencies, as well as professional associations would
continue.
Dr. Sandra Kweder spoke about the U.S. Food and Drug
Administration's active role in the Administration's efforts to prevent abuse and misuse of prescription drugs, while making sure that needed drugs
are available for patients. Dr. Kweder testified about the FDA's process for approving a drug, determining if potential for abuse
exists, and their risk management process. Dr. Kweder also emphasized the FDA's concern with the increasing abuse of prescription
drugs, including opioid drugs. Dr. Kweder outlined the following FDA actions to prevent abuse and misuse
of prescription drugs: support of the National Drug Control Strategy; collaboration with government agencies, including regular
meetings with the DEA to discuss new ways to prevent prescription drug abuse and misuse; participation in a number of task forces, including the
Interagency Pharmaceutical Task Force; cooperation in the release of the first National Synthetic Drugs Action Plan and participation in the
Synthetic Drugs Interagency Working Group (SDIWG); and monitoring promotional materials for controlled substances to ensure that claims are not false
or misleading.
Joseph Rannazzisi spoke on behalf of the Drug
Enforcement Agency (DEA) and stated that the growing problem of the diversion and abuse of controlled pharmaceuticals is one of DEA's top
priorities. Mr. Rannazzisi stated the DEA's support of the Administration's Synthetic Drug Control Strategy, which specifically
targets prescription drug abuse. According to Mr. Rannazzisi, the DEA has made it a priority to disrupt and dismantle
organizations that illegally traffic in controlled pharmaceuticals. DEA has developed public service announcements and an
anti-drug website for teens and has met with leading certifying medical boards to encourage them to develop educational programs concerning the
prescribing of controlled substances. Mr. Rannazzisi also expressed DEA's support for the Prescription Drug Monitoring Programs
(PDMPs) by States.
Ms. Fetko, Ms. Surks, and Ms. van Rooyan each spoke
about their personal tragedies of losing a son to prescription drug misuse, including the impact it had on their lives, and thanked the Subcommittee
for holding a hearing to raise awareness about the issue. Each mother detailed her efforts to educate herself and others on the
issue of prescription drug misuse and what can be done to prevent it. In addition, they spoke about how difficult and confusing it
can be to see clear signs related to this type of drug use and hoped that by sharing their stories other parents and family members would be made more
aware of the extent and danger of the non-medical use of prescription drugs.
Mathea Falco testified about the "Keep Internet
Neighborhoods Safe" collaboration undertaken by Drug Strategies, the Treatment Research Institute at the University of Pennsylvania, the Center for
International Criminal Justice at Harvard Law School, and the Weill Medical Center at Cornell University, to address the growing tragedy of addiction
and death from powerful narcotic painkillers bought without prescriptions over the internet. In conjunction with leaders of
internet commerce, officials at key U.S. Government agencies, and senior staff from Senate and House Committees, the goal of the collective effort is
to develop new strategies to curtail Internet drug trafficking to youth.
Stephen Johnson testified on behalf of Pain
Therapeutics, Inc., a biopharmaceutical company that specializes in research and development of safe drugs for use in pain management.
Mr. Johnson agreed that urgent action is needed to more adequately address the problem but that any efforts to prevent prescription drug
misuse should not unduly restrict appropriate access to effective pain therapies for the patients who need them.
Dr. Laxmaiah Manchikanti testified on behalf of the
American Society of Interventional Pain Physicians (ASIPP) and expressed its support for implementation and funding of the National All Schedules
Prescription Electronic Reporting Act (NASPER) in all States, as well as increased scrutiny of methadone clinics, increased availability of
outpatient detoxification and rehabilitation, and elimination of internet pharmacies.
Stephen Pasierb testified on behalf of the Partnership
for a Drug Free America® and expressed the Partnership's concern with the use of methamphetamine, inhalants, prescription drugs and
over-the-counter drugs by young people. In response, they have launched a comprehensive, multi-year prevention communications
effort targeting the abuse of prescription and over-the-counter medications. The media campaign targets both young people and
their parents or guardians and is similar to past media campaigns conducted by the Partnership that have proven effective in reducing drug use in
America.
Key issues raised by the Subcommittee Members included
prevention efforts as well as the stigma associated with the use of drugs and addiction. Rep. Watson (D-CA) asked a specific
question about what efforts were being undertaken in the schools and the courts to prevent addiction, and whether more access to treatment and
education is necessary. Dr. Volkow stated that she is a strong believer in prevention and that it is a high priority for
NIDA. She stated that prevention is a multi-level approach and should involve parents and the medical community, including
pediatricians, who often do not evaluate youth for signs of drug use. Dr. Madras responded by stating that ONDCP's student drug
testing programs are prevention programs because they give youths a reason not to use drugs and identifies those who are using drugs and in need of
assistance. Dr. Madras also spoke about the need for medical schools to teach students how to screen and refer those individuals
to treatment who may be in need of assistance and highlighted the work of their 14 Screening, Brief Intervention, Referral, Treatment (SBIRT) sites,
which have produced promising results.
Rep. Foxx (R-NC) expressed her concern with panel
testimony that indicated that the stigma associated with drug use and addiction should be eliminated; she stated that in her opinion stigmatizing
drug abuse is necessary, comparing it to smoking cigarettes, which she indicated reduced significantly in recent years because of the stigma
associated with smoking. Dr. Volkow responded that she does not believe in stigmatizing the drug addict regardless of the drug of
choice and stated that addiction is a disease that needs to be treated. Dr. Volkow stated that in her experience people who are
addicted to drugs do not want to be addicted and that by stigmatizing addicts they are less likely to get the help they
need.
For more information regarding the hearing, including the full
testimony of the panelists please visit: http://reform.house.gov/CJDPHR/News/DocumentSingle.aspx?DocumentID=47907
Legislation to Reform Emergency Management Systems Approved by Senate Committee; Bill Includes Provisions Authorizing
Substance Abuse Treatment and Mental Health Services
Following a Major Disaster
On July 27th, the Senate Homeland Security and
Government Affairs Committee approved S. 3721, the "Post-Katrina Emergency Management Reform Act of 2006." S. 3721 would
strengthen the Federal Emergency Management Agency (FEMA) and permit an enhanced Federal role in emergency management. In
addition, S. 3721 contains a number of provisions to ensure that individuals receive necessary substance abuse treatment and mental health services
following a major disaster.
S. 3721 would change the current law to authorize the provision of
substance abuse treatment and mental health services to individuals affected by a major disaster, including children and other vulnerable populations
and emergency response providers, to relieve or prevent substance abuse or mental health problems attributed to the disaster and its
aftermath. Types of assistance provided could include financial assistance to Federal, State, or local government agencies, or to
private substance abuse or mental health organizations to provide services or to train individuals to provide such services.
Awards of financial assistance by the President could last for no more than nine months; the President could extend the period of the award
for an additional 90 days in extraordinary circumstances or, where there has been catastrophic disaster, for an additional period of
time.
S. 3721 requires the Substance Abuse and Mental Health Services
Administration (SAMHSA) and other Federal agencies providing substance abuse treatment or mental health services to coordinate with State and local
government officials who oversee substance abuse prevention and treatment services to: conduct a survey of substance abuse or mental health services
to determine which applicable support services would be available to individuals affected by major disasters and to emergency response providers; and
to develop a strategy for the adequate provision of substance abuse and mental health services to individuals affected by major disasters and to
emergency response providers.
S. 3721, introduced by Committee Chairwoman Susan Collins (R-ME)
and Ranking Member Joseph Lieberman (D-CT), is now cleared for review by the full Senate. Additional information about S. 3721 can
be found at: http://thomas.loc.gov/.
House Approves Health Information Technology Bill; Legislation Would Require
a Study on Confidentiality Laws that Could Lead to
Changes to State and
Federal Law
On July 27th, the full House of
Representatives approved H.R. 4157, legislation which promotes the use of health information technology, with a 270 to 148 vote.
H.R. 4157, the Health Information Technology Promotion Act, would make a number of changes to current law and would require a review of
whether the State and Federal security and confidentiality laws should be made more consistent to better protect or strengthen the security and
confidentiality of individually identifiable health information.
H.R. 4157, the Health Information Technology Promotion
Act, would require the Secretary of the Department of Health and Human Services (HHS) to conduct a study on State security and confidentiality laws
and Federal security and confidentiality standards to determine how much they vary, how these differences may negatively impact the security and
confidentiality of individually identifiable health information, and the strengths and weaknesses of these state and federal laws.
The Secretary of HHS would be required to report back to Congress on findings from the study within 18 months; the report would be required to
include an analysis of whether there is a need for greater commonality of the requirements of State security and confidentiality laws and federal
security and confidentiality standards, recommendations for how the current Federal security and confidentiality standards should be changed to
provide greater commonality should the Secretary determine that greater commonality among the laws is needed, and specific recommendations on
legislative changes that should be made in the form of "greater commonality legislation," specifically on the extent to which and how such standards
should supersede State laws. The legislation defines greater commonality legislation as providing the commonality needed to
better protect, strengthen or otherwise improve the secure, confidential, and timely exchange of health information. In addition,
H.R. 4157 includes language requiring that pieces of legislation with the report's recommendations be introduced in both chambers of Congress
following completion of the report.
H.R. 4157 would also require the Secretary of HHS to develop a
strategic plan on the need for coordination in implementing health information technology and would create an Office of the National Coordinator for
Health Information Technology within HHS which would be charged with maintaining, directing and overseeing this strategic plan; the Director of this
Office would also be charged with coordinating federal government activities related to health information technology.
Introduced in October, H.R. 4157 currently has 58 bipartisan
co-sponsors. Health information technology legislation was also approved by the Senate in November; once the House and Senate
return from the August recess, it is possible that Members will meet to reconcile the differences between the two pieces of legislation or that the
Senate will consider H.R. 4157. Timing and process for the legislation, however, is uncertain at this time. The text and status of
H.R. 4157 can be found at: http://thomas.loc.gov/.
Legislation to Establish a Commission to
Review the Need for and
Possibly Recommend Abolishment of
Federal Agencies Approved by House Committee
Recently, two pieces of legislation that would create a Federal
Commission to periodically review the efficiency and need for Federal agencies, have been moving forward in Congress. This month,
the House Government Reform Committee approved H.R. 5766 and H.R. 3282, two pieces of legislation that would establish a Commission charged with
evaluating all current Federal programs and agencies and, following this evaluation, with recommending whether certain Federal agencies and programs
should be eliminated, consolidated or reorganized.
H.R. 5766, the "Government Efficiency Act of 2006," would require
that a Federal Review Commission be established to review and make recommendations on improving the operations, effectiveness and efficiency of
Federal programs and agencies. H.R. 5766 would require, within one year of establishment of the Federal Review Commission,
that the Commission submit to the President an assessment of the Federal programs and agencies, and a legislative proposal, if appropriate, to
reorganize, consolidate, abolish, expand or transfer the Federal programs and agencies reviewed by the Commission. The
President would then be required to submit those recommendations, along with the President's own recommendations, to
Congress. Members of the Commission would be appointed by the President; the Commission would be empowered to hold
hearings and to obtain official information from any Federal department or agency necessary to the Commission's work.
H.R. 3282, the "Abolishment of Obsolete Agencies and
Federal Sunset Act" would also establish a Federal Commission that would be required to submit to Congress a schedule for review by the Commission,
at least once every 12 years, of the abolishment or reorganization of each agency. Agencies that perform similar or related
functions would be required to be reviewed at the same time to promote efficiency and consolidation. Under H.R. 3282, each agency
would be reviewed according to the Commission's schedule and would be abolished within a year of the Commission's review unless the agency is
reauthorized by Congress. Congress can also vote to extend the deadline for abolishing an agency for an additional two
years.
Under H.R. 3282, members of the Commission would be appointed in
equal numbers by the Speaker of the House of Representatives and the Senate Majority Leader; the Commission would be empowered to hold hearings,
obtain necessary information from Federal departments or agencies, and issue subpoenas to require the attendance and testimony of witnesses and the
production of evidence. H.R. 3282 would require yearly reports by the Commission to Congress and the President that include an assessment of the
Federal agencies reviewed, recommendations on whether each of the reviewed agencies should be abolished or reorganized, recommendations on whether
the functions of any other agencies should be reorganized, consolidated, or transferred to another reviewed agency, and recommendations for
administrative and legislative action with respect to each agency. The Commission would be required to submit to the President and
Congress draft legislation that encompasses the Commission's recommendations each year. The legislation sets up a process for
agencies that the Commission recommends be abolished; the Commission would be required to conduct public hearings on the abolishment of each agency
and to provide an opportunity for public comment. Among the criteria used to evaluate the efficiency and public need for each
agency includes the effectiveness of the agency's programs, whether the agency's programs are cost-effective, whether the agency's work can be
consolidated with another agency, and the number and types of beneficiaries served by the agency's programs.
H.R. 5766, introduced by Congressman Todd Tiahrt (R-KS), has 81
bipartisan cosponsors. Introduced by Congressman Kevin Brady (R-TX), H.R. 3282 currently has 111 bipartisan
cosponsors. Following approval by the House Government Reform Committee, both H.R. 5766 and H.R. 3282 await approval by the full
House. Since the House has adjourned for the August recess, it is unclear when or whether either of these bills will be considered
by the full House before the end of the Congressional session. Although legislation with similar goals was introduced in the Senate
last summer it has been stalled in Committee. Additional information about H.R. 5766 and H.R. 3282, including bill text and status, can be found at:
http://thomas.loc.gov/.
