Renewal of Determination that a Public Health Emergency Exists

As a result of the continued consequences of the opioid crisis affecting our nation, on this date and after consultation with public health officials as necessary, I, Alex M. Azar II, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective October 21, 2018, the October 26, 2017, determination by former Acting Secretary Eric D. Hargan, which he previously renewed effective January 24, 2018, and which I previously renewed effective April 24, 2018, and July 23, 2018, that a public health emergency exists nationwide as a result of the consequences of the opioid crisis.

10/18/2018 _____________________________ Date

/s/ _____________________________ Alex M. Azar, II