I 

115TH CONGRESS 

2D SESSION H. R. 5176 

To require the Secretary of Health and Human Services to provide coordinated care to patients who have experienced a non-fatal overdose after 

emergency room discharge, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 6, 2018 

Mr. MCKINLEY (for himself and Mr. MICHAEL F. DOYLE of Pennsylvania) 

introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To require the Secretary of Health and Human Services 

to provide coordinated care to patients who have experienced a non-fatal overdose after emergency room discharge, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Preventing Overdoses 

5 While in Emergency Rooms Act of 2018’’. 


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1 SEC. 2. PROGRAM TO SUPPORT EMERGENCY ROOM DIS2 CHARGE AND CARE COORDINATION FOR 

3 DRUG OVERDOSE PATIENTS. 

4 (a) IN GENERAL.—The Secretary of Health and 

5 Human Services shall establish a program (in this Act re6 ferred to as the ‘‘Program’’) to develop protocols for dis7 charging patients who have presented with a drug over8 dose and enhance the integration and coordination of care 

9 and treatment options for individuals with substance use 

10 disorder after discharge. 

11 (b) GRANT ESTABLISHMENT AND PARTICIPATION.— 

12 (1) IN GENERAL.—In carrying out the Pro13 gram, the Secretary shall award grants on a com14 petitive basis to not more than 20 eligible health 

15 care sites described in paragraph (2). 

16 (2) ELIGIBLE HEALTH CARE SITES.—To be eli17 gible for a grant under this section, a health care 

18 site shall— 

19 (A) submit an application to the Secretary 

20 at such time, in such manner, and containing 

21 such information as specified by the Secretary; 

22 (B) have an emergency department; 

23 (C)(i) have a licensed health care profes24 sional on site who has a waiver under section 

25 303(g) of the Controlled Substances Act (21 


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1 U.S.C. 823(g)) to administer medication-as2 sisted treatment; or 

3 (ii) have a demonstrable plan to hire a full4 time licensed health care professional who has 

5 a waiver described in clause (i) to administer 

6 such treatment on site; 

7 (D) have in place an agreement with a suf8 ficient number and range of entities certified 

9 under applicable State and Federal law, such as 

10 pursuant to registration or a waiver under sec11 tion 303(g) of the Controlled Substances Act 

12 (21 U.S.C. 823(g)) or certification as described 

13 in section 8.2 of title 42 of the Code of Federal 

14 Regulations, to provide treatment for substance 

15 use disorder such that, in combination, the re16 sulting network of entities with an agreement 

17 with the hospital cumulatively are capable of 

18 providing services for all evidence-based services 

19 for the treatment of substance use disorder, as 

20 medically appropriate for the individual in21 volved, including— 

22 (i) medication-assisted treatment; 

23 (ii) withdrawal and detoxification 

24 services that include patient evaluation, 


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1 stabilization, and readiness for and entry 

2 into treatment; and 

3 (iii) counseling; 

4 (E) deploy on-site peer recovery specialists 

5 to help connect patients with treatment and re6 covery support programs; and 

7 (F) include the provision of overdose rever8 sal medication in discharge protocols for opioid 

9 overdose patients. 

10 (3) PREFERENCE.—In awarding grants under 

11 this section, the Secretary shall give preference to el12 igible health care sites that meet either or both of 

13 the following criteria: 

14 (A) The site is a critical access hospital (as 

15 defined in section 1861(mm)(1) of the Social 

16 Security Act (42 U.S.C. 1395x(mm)(1))), a 

17 low-volume hospital (as defined in section 

18 1886(d)(12)(C)(i) of such Act (42 U.S.C. 

19 1395ww(d)(12)(C)(i))), or a sole community 

20 hospital (as defined in section 

21 1886(d)(5)(D)(iii) of such Act (42 U.S.C. 

22 1395ww(d)(5)(D)(iii))). 

23 (B) The site is located in a geographic 

24 area with an overdose rate higher than the naVerDate Sep 11 2014 00:40 Mar 13, 2018 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5176.IH H5176

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1 tional average, based on the most recent data of 

2 the Centers for Disease Control and Prevention. 

3 (4) MEDICATION-ASSISTED TREATMENT DE4 FINED.—For purposes of this section, the term 

5 ‘‘medication-assisted treatment’’ means the use of 

6 medication approved by the Food and Drug Admin7 istration in combination with behavioral health serv8 ices to provide an individualized approach to the 

9 treatment of substance use disorders, including 

10 opioid use disorder. 

11 (c) PERIOD OF GRANT.—A grant awarded to an eligi12 ble health care site under this section shall be for a period 

13 of at least 2 years. 

14 (d) GRANT USES.— 

15 (1) REQUIRED USES.—A grant awarded under 

16 this section to an eligible health care site shall be 

17 used for both of the following purposes: 

18 (A) To establish policies and procedures 

19 that address the provision of overdose reversal 

20 medication, the administration of medication21 assisted treatment to a non-fatal overdose pa22 tient in the emergency department, and the 

23 subsequent referral to evidence-based treatment 

24 upon discharge for patients who have experi25 enced a non-fatal drug overdose. 


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1 (B) To develop best practices for treating 

2 non-fatal drug overdoses, including with respect 

3 to care coordination and integrated care models 

4 for long term treatment and recovery options 

5 for individuals who have experienced a non-fatal 

6 drug overdose. 

7 (2) ADDITIONAL PERMISSIBLE USES.—A grant 

8 awarded under this section to an eligible health care 

9 site may be used for any of the following purposes: 

10 (A) To hire emergency department peer re11 covery specialists; counselors; therapists; social 

12 workers; or other licensed medical professionals 

13 specializing in the treatment of substance use 

14 disorder. 

15 (B) To establish integrated models of care 

16 for individuals who have experienced a non-fatal 

17 drug overdose which may include patient as18 sessment, follow up, and transportation to 

19 treatment facilities. 

20 (C) To provide for options for increasing 

21 the availability and access of medication-as22 sisted treatment and other evidence-based treat23 ment for individuals with substance use dis24 orders. 

25 (e) REPORTING REQUIREMENTS.— 


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1 (1) REPORTS BY GRANTEES.—Each eligible 

2 health care site awarded a grant under this section 

3 shall submit to the Secretary an annual report for 

4 each year for which the site has received such grant 

5 that includes information on— 

6 (A) the number of individuals treated at 

7 the site for non-fatal overdoses in the emer8 gency department; 

9 (B) the number of individuals administered 

10 medication-assisted treatment at the site in the 

11 emergency department; 

12 (C) the number of individuals referred by 

13 the site to other treatment facilities after a non14 fatal overdose, the types of such other facilities, 

15 and the number of such individuals admitted to 

16 such other facilities pursuant to such referrals; 

17 (D) the frequency and number of patient 

18 readmissions for non-fatal overdoses and sub19 stance abuse disorder; 

20 (E) for what the grant funding was used; 

21 and 

22 (F) the effectiveness of, and any other rel23 evant additional data regarding, having an on24 site health care professional to administer and 


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1 begin medication-assisted treatment for sub2 stance use disorders. 

3 (2) REPORT BY SECRETARY.—Not less than 

4 one year after the conclusion of the Program, the 

5 Secretary shall submit to Congress a report that in6 cludes— 

7 (A) findings of the Program; 

8 (B) overall patient outcomes under the 

9 Program, such as with respect to hospital read10 mission; 

11 (C) what percentage of patients treated by 

12 a site receiving a grant under this section were 

13 readmitted to a hospital for non-fatal or fatal 

14 overdose; and 

15 (D) a compilation of voluntary guidelines 

16 and best practices from the reports submitted 

17 under paragraph (1). 

18 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

19 authorized to be appropriated to carry out this Act 

20 $50,000,000 for the period of fiscal years 2019 through 

21 2023. 

Æ 


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