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 April 19, 2019, 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, July 23, 2018, October 21, 2018, and January 19, 2019, that a public health emergency exists nationwide as a result of the consequences of the opioid crisis.

April 15, 2019 _____________________________ Date

/s/ _____________________________ Alex M. Azar, II