WASHINGTON, D.C. — U.S. Sen. Sherrod Brown (D-OH) joined colleagues in a letter to the Government Accountability Office (GAO) this week requesting a review of the actions taken by President Donald Trump’s Administration to address the opioid epidemic since the White House declared it a public health emergency last October. Earlier this month, the Trump Administration announced an extension of the opioid public health emergency following calls from Brown and Senate colleagues for renewal. Brown called on the Trump Administration to follow through on the extension with concrete action and funding.
“Given the severity of the crisis, we have grown increasingly concerned by reports that the President has done little to make use of his public health emergency declaration, leaving state and local communities without the resources they need to fight the opioid epidemic,” wrote the Senators in the letter.
Brown’s letter points to President Trump’s statements following the initial declaration in October 2017, including proposals to expand telemedicine services for addiction treatment and Department of Labor grants for workers displaced by the addiction epidemic. Telemedicine initiatives the President discussed have not been implemented, and the Department of Labor has yet to issue grants for dislocated workers.
To ensure the federal government utilizes all available resources to prevent and treat opioid addiction, as well as utilize available resources efficiently and effectively, the senators requested a GAO review on the resources available to the executive branch to combat the opioid epidemic and the steps the Trump Administration has taken since declaring the crisis a public health emergency.
Earlier this month, Brown’s bipartisan bill to keep illegal fentanyl out of Ohio, the INTERDICT Act, was signed into law by President Trump. The law will provide U.S. Customs and Border Protection (CBP) with additional hi-tech screening equipment and lab resources to detect fentanyl before it enters the U.S.
Full text of the letter can be found below:
Dear Mr. Dodaro,
We are writing to request that the U.S. Government Accountability Office (GAO) conduct a review of the actions that the Trump Administration has taken to “reduce the number of deaths and minimize the devastation the drug demand and opioid crisis inflicts upon American communities” since the October 26, 2017 declaration that the opioid crisis is a public health emergency.[1]
Section 319 of the Public Health Service Act allows the Secretary of Health and Human Services (Secretary) to declare that “a disease or disorder presents a public health emergency” or that “a public health emergency, including significant outbreaks of infectious diseases or bioterrorist attacks, otherwise exists.”[2] The declaration of a public health emergency is designed to facilitate the provision of supplemental resources to state, local, and federal responders. Upon declaring a public health emergency, the Secretary can issue grants, enter contracts, and conduct investigations “into the cause, treatment, or prevention of the disease or disorder”; access the Public Health Emergency Fund; and temporarily hire public health specialists, among other actions. Public health emergencies last for 90 days, unless extended by the Secretary.[3]
On October 26, 2017, President Trump directed the Department of Health and Human Services to declare the opioid crisis a public health emergency.[4] President Trump stated that the emergency declaration would “allow for [the] expanded access to telemedicine services” for addiction treatment; permit the Department of Health and Human Services (HHS) to hire temporary “specialists with the tools and talent needed to respond effectively” to the opioid crisis; allow “the Department of Labor to issue dislocated worker grants to help workers…displaced from the workforce because of the opioid crisis”; and enable the “shifting of resources within HIV/AIDS programs to help people eligible…receive substance abuse treatment.”[5] In compliance with the President’s request, the Acting Secretary Eric Hargan declared a public health emergency.[6]
The declaration of a public health emergency is a potentially important step towards combatting the opioid crisis, which continues to wreak havoc on American communities. The declaration was the “first and most urgent recommendation” of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, which noted that such a declaration would “empower [President Trump’s] cabinet to take bold steps” in tackling the crisis.[7] An estimated 2.6 million Americans suffer from opioid use disorder, with rates rising nationwide.[8] According to the Centers for Disease Control and Prevention, more than 42,000 people died from opioid-involved overdoses in 2016, up from around 33,000 in 2015[9]—yet only one in ten people in need of specialty treatment for substance use disorders are able to access it.[10] Nearly half of all adults in the United States have a friend or family member who has struggled with addiction.[11]
Given the severity of the crisis, we have grown increasingly concerned by reports that the President has done little to make use of his public health emergency declaration, leaving state and local communities without the resources they need to fight the opioid epidemic. The Administration has yet to officially allocate new funds to address the epidemic, in spite of bipartisan calls from governors and legislators that it do so.[12] Despite saying that it would work with Congress, the White House has put forward no proposals for authorizing new funding. Instead, the President again plans to cut funding for the White House Office of National Drug Control Policy (ONDCP)—slashing $340 million from the Administration’s opioid response budget.[13] Meanwhile, key leadership positions that require a deep understanding of this public health crisis—including the Drug Enforcement Administration (DEA) Administrator, and the Director of the ONDCP remain empty. Telemedicine initiatives the President supports have not been implemented, and the Department of Labor has yet to issue grants for dislocated workers.[14]
The President’s initial emergency declaration expired on January 23, 2018. On January 24th, Acting Secretary Hargan extended the emergency for an additional 90 days.[15] This emergency extension provides the Administration with a second opportunity to use its emergency powers to combat the opioid epidemic.
It is critical that the federal government utilize all available resources to prevent and treat opioid addiction, as well as utilize available resources efficiently, and effectively. Therefore, to help us better understand the resources available to the executive branch to combat the opioid epidemic and the steps the Trump Administration has taken since declaring the crisis a public health emergency, we request that the GAO conduct a review of the following issues:
1. What supplemental authorities and resources are available to the executive branch upon the declaration of a public health emergency? Please summarize all of the options available to the Departments of Health, Labor, and other executive branch agencies as a result of such a declaration. In addition, please provide a description of how the federal government’s public health authorities affect the declaration of public health emergencies, or equivalent policy decisions, on the state level.
2. Which of the supplemental authorities described above has the Administration used since declaring a public health emergency on October 26, 2017? Please summarize the actions that the Administration took during the first 90-day emergency period—as well as during the second 90-day emergency period—to augment its response to the opioid crisis; the processes that the Administration used to track all of its actions to implement the declaration; and to the extent possible, any information that the agencies may have that describes the impact of their actions.
3. Upon declaring a public health emergency, the Administration gained access to the Public Health Emergency Fund. Please provide details on the Public Health Emergency Fund’s balance, describe how much the Administration accessed the fund, and how the agencies have spent this money.
4. What analyses, if any, has the Administration conducted in order to assess the need for renewing a public health emergency declaration related to the opioid crisis?
