The Pain Management Best Practices Inter-Agency Task Force (hereafter referred to as the Task Force) is required under Section 101 of the Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-198) (CARA). The Task Force is governed by the provisions of the Federal Advisory Committee Act (FACA), Public Law 92-463, as amended (5 U.S.C. App. 2), which sets forth standards for the formation and use of advisory committees.
Objectives and Scope of Activities
The Secretary of Health and Human Services (Secretary), in cooperation with the Secretary of Veterans Affairs and the Secretary of Defense, is required to convene a Task Force to identify, review, and, as appropriate, determine whether there are gaps or inconsistencies between best practices for pain management (including chronic and acute pain) developed or adopted by Federal agencies; propose updates to best practices and recommendations on addressing identified gaps or inconsistencies as appropriate; provide the public with an opportunity to comment on any proposed updates and recommendations; and develop a strategy for disseminating such proposed updates and recommendations to relevant Federal agencies and the general public.
The Task Force will consist of representatives of specific federal agencies and non-federal individuals and entities who represent diverse disciplines and views. The Task Force will provide expert advice and recommendations to relevant Federal agencies and the general public for development of best practices for pain management and prescribing pain medication and a strategy for disseminating such best practices. The functions of the Task Force will be advisory in nature.
Description of Duties
The Task Force shall have the following responsibilities:
- Identify, review, and, as appropriate, determine whether there are gaps in or inconsistencies between best practices for pain management (including chronic and acute pain) developed or adopted by federal agencies;
- Not later than 1 year after the date on which the Task Force is convened, propose updates to best practices and recommendations on addressing gaps or inconsistencies identified under paragraph (1), as appropriate, and submit to relevant federal agencies and the general public such proposed updates and recommendations, taking into consideration—
- existing pain management research and other relevant research;
- recommendations from relevant conferences and existing relevant evidence-based guidelines
- ongoing efforts at the State and local levels and by medical professional organizations to develop improved pain management strategies, including consideration of differences within and between classes of opioids, the availability of opioids with abuse deterrent technology, and pharmacological, non-pharmacological, and medical device alternatives to opioids to reduce opioid monotherapy in appropriate cases;
- the management of high-risk populations who receive opioids in the course of medical care, other than for pain management;
- the 2016 Guideline for Prescribing Opioids for Chronic Pain issued by the Centers for Disease Control and Prevention; and
- private sector, State, and local government efforts related to pain management and prescribing pain medication;
- Provide the public with at least 90 days to submit comments on any proposed updates and recommendations under paragraph (2); and
- Develop a strategy for disseminating information about best practices for pain management (including chronic and acute pain) to stakeholders, if appropriate.
Agency of Official to Whom the Task Force Reports
The Task Force shall provide expert advice and recommendations to the Secretary.
Not later than one year after the date that the Task Force is convened, the Task Force shall submit to relevant federal agencies and the general public proposed updates and recommendations, as stipulated in paragraph (2) under Description of Duties.
Management and support services for the Task Force’s activities shall be provided by staff from within the Office of the Assistant Secretary for Health (OASH). OASH is a staff division within the Office of the Secretary in the Department of Health and Human Services.
Estimated Annual Operating Costs and Staff Years
The estimated annual cost for operating the Task Force including travel expenses for members, but excluding staff support, is $829,333. An allocation of two (2) FTEs has been projected to provide staff support for Task Force activities; the annual cost for the projected human resources is $156,097. The total overall estimated annual cost is approximately $985,430.
Designated Federal Officer (DFO)
The Assistant Secretary for Health (ASH) shall select the Designated Federal Officer (DFO) from among permanent full-time or part-time staff within OASH, who have knowledge of the subject matter and skills and experience necessary to manage the Task Force. The ASH may appoint an Alternate DFO who will carry out these duties in the event that the appointed DFO cannot fulfill the assigned responsibilities for the Task Force. In the absence of the appointed DFO or Alternate DFO, the ASH shall temporarily appoint one or more full-time or permanent part-time program staff to carry out the assigned duties.
The DFO shall schedule and approve all meetings of the Task Force and any subcommittees that have been established to assist the Task Force. The DFO will approve all meeting agendas. The DFO may collaborate with the Task Force Chair in this activity, and when deemed appropriate, with chairs of any existing subcommittees that have been established to assist the Task Force. The DFO, Alternate DFO, or designee shall attend all meetings of the Task Force and all meetings of any subcommittees that have been established to assist the Task Force. The DFO has authority to adjourn meetings, when it is determined to be in the public interest, and the DFO can be directed by the Secretary or designee to chair meetings of the Task Force.
Estimated Number and Frequency of Meetings
The Task Force shall meet not less than twice a year, depending upon the availability of funds. These meetings will be in person, but may be conducted by teleconference or videoconference at the discretion of the DFO. The meetings shall be open to the public, except as determined otherwise by the Secretary, or other official to whom authority has been delegated, in accordance with the guidelines under Government in the Sunshine Act, 5 U.S.C. 552b(c). Notice of all meetings shall be provided to the public in accordance with the FACA. Meetings shall be conducted and records of the proceedings shall be kept, as required by applicable laws and departmental policies. A quorum is required for the Task Force to meet to conduct business.
A quorum shall consist of a majority of the Task Force’s members. When the Secretary or
Secretary’s designee determines that a meeting shall be closed or partially closed to the public, in accordance with stipulations of Government in the Sunshine Act, 5 U.S.C. 552b(c), then a report shall be prepared by the DFO that includes, at a minimum, a list of members and their business addresses, the Task Force’s functions, date and place of the meeting, and a summary of the Task Force’s activities and recommendations made during the fiscal year. A copy of the report shall be provided to the Department Committee Management Officer.
Establishment of the Task Force was mandated under Section 101 of the Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-198). The Task Force shall operate pursuant to the stipulations in the authorizing legislation.
Unless extended by Congress, the Task Force shall be terminated on July 22, 2019 three years after the date that the authorizing legislation was enacted. Unless renewed by appropriate action, the charter for the Task Force shall expire two years from the date it is filed.
Membership and Designation
The Task Force shall consist of not more than 30 members. The ASH shall select the Chair. The Chair may select from among committee members a vice-chair. The members shall include currently licensed and practicing physicians, dentists, and non-physicians and prescribers; currently licensed and practicing pharmacists and pharmacies; experts in the fields of pain research and addiction research, including adolescent and young adult addiction; experts on the health of, and prescription opioid use disorders in, members of the Armed Forces and veterans; and experts in the field of minority health. The members shall also include individuals who are appointed to serve under CARA subsection 101(c)(5) as representatives of pain management professional organizations; the mental health treatment community; the addiction treatment community, including individuals in recovery from substance use disorder; pain advocacy groups, including patients; veteran service organizations; groups with expertise on overdose reversal, including first responders; State medical boards; and hospitals. The members shall be appointed by the Secretary. The Secretary shall ensure that the membership of the Task Force includes individuals who represent rural and underserved areas.
The composition of the Task Force shall also include federal members who shall serve as representatives for the following departments and agency: the Department of Health and Human Services, the Department of Veterans Affairs, the Department of Defense, and the Office of National Drug Control Policy.
Members who are not officers or employees of the United States Government and who are not appointed as representative members under CARA subsection 101(c)(5) shall be classified as special government employees (SGEs). Members of the Task Force who are officers or employees of the United States Government shall be appointed to serve at the discretion of the head of the respective federal departments and agency. All members shall be appointed to serve for the duration of time that the Task Force is authorized to operate. Any member who is appointed to fill the vacancy of an unexpired term shall be appointed to serve for the remainder of that term. A member may serve after the expiration of their term until their successor has taken office, but no longer than 180 days.
Pursuant to advance written agreement, members of the Task Force who are not officers or employees of the United States Government shall receive no stipend for the advisory service that they render as members of the Task Force. Members appointed as SGEs shall receive per diem and reimbursement for travel expenses incurred in relation to performing duties for the Task Force, as authorized by law under 5 U.S.C. 5703 for persons who are employed intermittently to perform services for the federal government and in accordance with federal travel regulations. Members appointed as representatives of a designated entity as described in CARA subsection 101(c)(5) may be allowed to receive per diem and reimbursement for travel expenses associated with conducting business related to the Task Force. Federal employees assigned as advisory committee members or staff members remain covered under their current compensation system.
In carrying out its function, the Task Force (with the approval of the DFO) may establish subcommittees composed of members of the Task Force, as well as other individuals who have expertise and knowledge about the topics and issues that are pertinent to the mission of the Task Force. The established subcommittees may consider issues in accordance with the mission of the Task Force, and shall, as appropriate, make recommendations and/or reports to the Task Force for consideration. Recommendations and/or reports of the subcommittee that are provided to the Task Force shall be discussed at an open public meeting that is held by the Task Force. No established subcommittee of the Task Force may report directly to the Secretary or another federal official unless there is specific statutory authority for such reporting. The Department Committee Management Officer shall be notified upon establishment of each subcommittee, and shall be given information regarding its name, membership, function, cost, and estimated frequency of meetings.
Records of the Task Force and any established subcommittee shall be handled in accordance with the General Records Schedule 6.2, Federal Advisory Committee Records or other approved agency records disposition schedule. Applicable records shall be made available to the public for inspection and copying, subject to the Freedom of Information Act, 5 U.S.C. 552.
Establishment Filing Date:
October 24, 2017
Eric D. Hargan
Acting Secretary of Health and Human Services