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provision of overdose reversal medication, the ad-
ministration of all drugs approved by the Food 
and Drug Administration to treat substance use 
disorder, and subsequent continuation of, or re-
ferral to, evidence-based treatment for patients 
with a substance use disorder who have experi-
enced a non-fatal drug overdose, in order to sup-
port long-term treatment, prevent relapse, and 
reduce recidivism and future overdose; and 
(C) establish integrated models of care for 
individuals who have experienced a non-fatal 
drug overdose which may include patient assess-
ment, follow up, and transportation to and from 
treatment facilities. 
(5) ADDITIONAL PERMISSIBLE USES.—In addi-
tion to the uses described in paragraph (4), a grant 
awarded under this section may be used, directly or 
through contractual arrangements, to provide— 
(A) all drugs approved by the Food and 
Drug Administration to treat substance use dis-
orders, pursuant to Federal and State law; 
(B) withdrawal and detoxification services 
that include patient evaluation, stabilization, 
and preparation for treatment of substance use
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disorder, including treatment described in sub-
paragraph (A), as appropriate; or 
(C) mental health services provided by a 
program counselor, social worker, therapist, or 
other certified professional who is licensed and 
qualified by education, training, or experience to 
assess the psychosocial background of patients, to 
contribute to the appropriate treatment plan for 
patients with substance use disorder, and to 
monitor patient progress. 
(6) PREFERENCE.—In awarding grants under 
this section, the Secretary shall give preference to eli-
gible entities that meet any or all of the following cri-
teria: 
(A) The eligible entity is a critical access 
hospital (as defined in section 1861(mm)(1) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395x(mm)(1))), a low volume hospital (as de-
fined in section 1886(d)(12)(C)(i) of such Act 
(42 U.S.C. 1395ww(d)(12)(C)(i))), or a sole com-
munity 
hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii) of such Act (42 U.S.C. 
1395ww(d)(5)(D)(iii))). 
(B) The eligible entity is located in a State, 
or under the jurisdiction of an Indian Tribe,
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with an age-adjusted rate of drug overdose deaths 
that is above the national overdose mortality 
rate, as determined by the Director of the Centers 
for Disease Control and Prevention. 
(C) The eligible entity demonstrates that re-
covery coaches will be placed in both health care 
settings and community settings. 
(7) PERIOD OF GRANT.—A grant awarded to an 
eligible entity under this section shall be for a period 
of not more than 5 years. 
(c) DEFINITIONS.—In this section: 
(1) RECOVERY
COACH.—the term ‘‘recovery 
coach’’ means an individual— 
(A) with knowledge of, or experience with, 
recovery from a substance use disorder; and 
(B) who has completed training from, and 
is determined to be in good standing by, a recov-
ery services organization capable of conducting 
such training and making such determination. 
(2) RECOVERY COMMUNITY ORGANIZATION.—The 
term ‘‘recovery community organization’’ has the 
meaning given such term in section 547(a) of the 
Public Health Service Act (42 U.S.C. 290ee–2(a)). 
(3) STATE ALCOHOL AND DRUG AGENCY.—The 
term ‘‘State alcohol and drug agency’’ means the
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principal agency of a State that is responsible for 
carrying out the block grant for prevention and treat-
ment of substance abuse under subpart II of part B 
of title XIX of the Public Health Service Act (42 
U.S.C. 300x–21 et seq.) 
(d) REPORTING REQUIREMENTS.— 
(1) REPORTS BY GRANTEES.—Each eligible enti-
ty awarded a grant under this section shall submit to 
the Secretary an annual report for each year for 
which the entity has received such grant that includes 
information on— 
(A) the number of individuals treated by the 
entity for non-fatal overdoses, including the 
number of non-fatal overdoses where overdose re-
versal medication was administered; 
(B) the number of individuals administered 
medication-assisted treatment by the entity; 
(C) the number of individuals referred by 
the entity to other treatment facilities after a 
non-fatal overdose, the types of such other facili-
ties, and the number of such individuals admit-
ted to such other facilities pursuant to such refer-
rals; and 
(D) the frequency and number of patients 
with reoccurrences, including readmissions for
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non-fatal overdoses and evidence of relapse re-
lated to substance use disorder. 
(2) REPORT BY SECRETARY.—Not later than 5 
years after the date of enactment of this Act, the Sec-
retary shall submit to Congress a report that includes 
an evaluation of the effectiveness of the grant program 
carried out under this section with respect to long 
term health outcomes of the population of individuals 
who have experienced a drug overdose, the percentage 
of patients treated or referred to treatment by grant-
ees, and the frequency and number of patients who ex-
perienced relapse, were readmitted for treatment, or 
experienced another overdose. 
(e) PRIVACY.—The requirements of this section, includ-
ing with respect to data reporting and program oversight, 
shall be subject to all applicable Federal and State privacy 
laws. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section such 
sums as may be necessary for each of fiscal years 2019 
through 2023. 
SEC. 1403. ALTERNATIVES TO OPIOIDS. 
(a) IN GENERAL.—The Secretary shall, directly or 
through grants to, or contracts with, public and private en-
tities, provide technical assistance to hospitals and other
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acute care settings on alternatives to opioids for pain man-
agement. The technical assistance provided shall be for the 
purpose of— 
(1) utilizing information from acute care pro-
viders including emergency departments and other 
providers that have successfully implemented alter-
natives to opioids programs, promoting non-addictive 
protocols and medications while appropriately lim-
iting the use of opioids; 
(2) identifying or facilitating the development of 
best practices on the use of alternatives to opioids, 
which may include pain-management strategies that 
involve non-addictive medical products, non-pharma-
cologic treatments, and technologies or techniques to 
identify patients at risk for opioid use disorder; 
(3) identifying or facilitating the development of 
best practices on the use of alternatives to opioids that 
target common painful conditions and include certain 
patient populations, such as geriatric patients, preg-
nant women, and children; 
(4) disseminating information on the use of al-
ternatives to opioids to providers in acute care set-
tings, which may include emergency departments, 
outpatient clinics, critical access hospitals, Federally
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qualified health centers, Indian Health Service health 
facilities, and tribal hospitals; and 
(5) collecting data and reporting on health out-
comes associated with the use of alternatives to 
opioids. 
(b) PAIN MANAGEMENT AND FUNDING.— 
(1) IN
GENERAL.—The Secretary shall award 
grants to hospitals and other acute care settings relat-
ing to alternatives to opioids for pain management. 
(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated $5,000,000 for 
each of fiscal years 2019 through 2023 for purposes 
of carrying out this section. 
SEC. 1404. BUILDING COMMUNITIES OF RECOVERY. 
Section 547 of the Public Health Service Act (42 
U.S.C. 290ee–2) is amended to read as follows: 
‘‘SEC. 547. BUILDING COMMUNITIES OF RECOVERY. 
‘‘(a) DEFINITION.—In this section, the term ‘recovery 
community organization’ means an independent nonprofit 
organization that— 
‘‘(1) mobilizes resources within and outside of 
the recovery community, which may include through 
a peer support network, to increase the prevalence 
and quality of long-term recovery from substance use 
disorders; and
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‘‘(2) is wholly or principally governed by people 
in recovery for substance use disorders who reflect the 
community served. 
‘‘(b) GRANTS
AUTHORIZED.—The Secretary shall 
award grants to recovery community organizations to en-
able such organizations to develop, expand, and enhance re-
covery services. 
‘‘(c) FEDERAL SHARE.—The Federal share of the costs 
of a program funded by a grant under this section may 
not exceed 85 percent. 
‘‘(d) USE OF FUNDS.—Grants awarded under sub-
section (b)— 
‘‘(1) shall be used to develop, expand, and en-
hance community and statewide recovery support 
services; and 
‘‘(2) may be used to— 
‘‘(A) build connections between recovery net-
works, including between recovery community 
organizations and peer support networks, and 
with other recovery support services, including— 
‘‘(i) behavioral health providers; 
‘‘(ii) primary care providers and phy-
sicians; 
‘‘(iii) 
educational 
and 
vocational 
schools;
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‘‘(iv) employers; 
‘‘(v) housing services; 
‘‘(vi) child welfare agencies; and 
‘‘(vii) other recovery support services 
that facilitate recovery from substance use 
disorders, including non-clinical commu-
nity services; 
‘‘(B) reduce the stigma associated with sub-
stance use disorders; and 
‘‘(C) conduct outreach on issues relating to 
substance use disorders and recovery, includ-
ing— 
‘‘(i) identifying the signs of substance 
use disorder; 
‘‘(ii) the resources available to individ-
uals with substance use disorder and to 
families of an individual with a substance 
use disorder, including programs that men-
tor and provide support services to children; 
‘‘(iii) the resources available to help 
support individuals in recovery; and 
‘‘(iv) related medical outcomes of sub-
stance use disorders, the potential of acquir-
ing an infection commonly associated with 
illicit drug use, and neonatal abstinence
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syndrome among infants exposed to opioids 
during pregnancy. 
‘‘(e) SPECIAL CONSIDERATION.—In carrying out this 
section, the Secretary shall give special consideration to the 
unique needs of rural areas, including areas with an age- 
adjusted rate of drug overdose deaths that is above the na-
tional average and areas with a shortage of prevention and 
treatment services. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2019 through 2023.’’. 
SEC. 1405. PEER SUPPORT TECHNICAL ASSISTANCE CEN-
TER. 
(a) ESTABLISHMENT.—The Secretary, acting through 
the Assistant Secretary for Mental Health and Substance 
Abuse, shall establish or operate a National Peer-Run 
Training and Technical Assistance Center for Addiction 
Recovery Support (referred to in this subsection as the 
‘‘Center’’). 
(b) FUNCTIONS.—The Center established under sub-
section (a) shall provide technical assistance and support 
to recovery community organizations and peer support net-
works, including such assistance and support related to— 
(1) training on identifying— 
(A) signs of substance use disorder;
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(B) resources to assist individuals with a 
substance use disorder, or resources for families 
of an individual with a substance use disorder; 
and 
(C) best practices for the delivery of recov-
ery support services; 
(2) the provision of translation services, inter-
pretation, or other such services for clients with lim-
ited English speaking proficiency; 
(3) data collection to support research, including 
for translational research; 
(4) capacity building; and 
(5) evaluation and improvement, as necessary, of 
the effectiveness of such services provided by recovery 
community organizations (as defined in section 547 
of the Public Health Service Act). 
(c) BEST PRACTICES.—The Center established under 
subsection (a) shall periodically issue best practices for use 
by recovery community organizations and peer support net-
works. 
(d) RECOVERY COMMUNITY ORGANIZATION.—In this 
section, the term ‘‘recovery community organization’’ has 
the meaning given such term in section 547 of the Public 
Health Service Act.
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(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section such 
sums as may be necessary for each of fiscal years 2019 
through 2023. 
SEC. 1406. MEDICATION-ASSISTED TREATMENT FOR RECOV-
ERY FROM ADDICTION. 
(a) WAIVERS FOR MAINTENANCE TREATMENT OR DE-
TOXIFICATION.—Section 303(g)(2)(G)(ii) of the Controlled 
Substances Act (21 U.S.C. 823(g)(2)(G)(ii)) is amended by 
adding at the end the following: 
‘‘(VIII) The physician graduated in good 
standing from an accredited school of allopathic 
medicine or osteopathic medicine in the United 
States during the 5-year period immediately pre-
ceding the date on which the physician submits 
to the Secretary a written notification under 
subparagraph (B) and successfully completed a 
comprehensive allopathic or osteopathic medicine 
curriculum or accredited medical residency 
that— 
‘‘(aa) included not less than 24 hours 
of training on treating and managing 
opioid-dependent patients; and 
‘‘(bb) included, at a minimum—
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‘‘(AA) the training described in 
items (aa) through (gg) of subclause 
(IV); and 
‘‘(BB) training with respect to 
any other best practice the Secretary 
determines should be included in the 
curriculum, which may include train-
ing on pain management, including 
assessment and appropriate use of 
opioid and non-opioid alternatives.’’. 
(b) TREATMENT FOR CHILDREN.—The Secretary shall 
consider ways to ensure that an adequate number of physi-
cians who meet the requirements under the amendment 
made by subsection (a) and have a specialty in pediatrics, 
or the treatment of children or of adolescents, are granted 
a waiver under section 303(g)(2) of the Controlled Sub-
stances Act (21 U.S.C. 823(g)(2)) to treat children and ado-
lescents with substance use disorders. 
(c) TECHNICAL AMENDMENT.—Section 102(24) of the 
Controlled Substances Act (21 U.S.C. 802(24)) is amended 
by striking ‘‘Health, Education, and Welfare’’ and insert-
ing ‘‘Health and Human Services’’. 
SEC. 1407. GRANT PROGRAM. 
(a) IN GENERAL.—The Secretary shall establish a 
grant program under which the Secretary may make grants
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to accredited schools of allopathic medicine or osteopathic 
medicine and teaching hospitals located in the United 
States to support the development of curricula that meet 
the requirements under subclause (VIII) of section 
303(g)(2)(G)(ii) of the Controlled Substances Act, as added 
by section 1406(a) of this Act. 
(b) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated for grants under subsection 
(a), $4,000,000 for each of fiscal years 2019 through 2023. 
SEC. 1408. ALLOWING FOR MORE FLEXIBILITY WITH RE-
SPECT 
TO 
MEDICATION-ASSISTED 
TREAT-
MENT FOR OPIOID USE DISORDERS. 
Subclause (II) of section 303(g)(2)(B)(iii) of the Con-
trolled Substances Act (21 U.S.C. 823(g)(2)(B)(iii)) is 
amended to read as follows: 
‘‘(II) The applicable number is— 
‘‘(aa) 100 if, not sooner than 1 year after 
the date on which the practitioner submitted the 
initial notification, the practitioner submits a 
second notification to the Secretary of the need 
and intent of the practitioner to treat up to 100 
patients; or 
‘‘(bb) 275 if the practitioner meets the re-
quirements specified in section 8.610 of title 42,
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Code of Federal Regulations (or successor regula-
tions).’’. 
SEC. 1409. NATIONAL RECOVERY HOUSING BEST PRAC-
TICES. 
(a) BEST PRACTICES
FOR OPERATING RECOVERY 
HOUSING.— 
(1) IN GENERAL.—The Secretary, in consultation 
with the individuals and entities described in para-
graph (2), shall identify or facilitate the development 
of best practices, which may include model laws for 
implementing suggested minimum standards, for op-
erating recovery housing. 
(2) CONSULTATION.—In carrying out the activi-
ties described in paragraph (1) the Secretary shall 
consult with, as appropriate— 
(A) relevant divisions of the Department of 
Health and Human Services, including the Sub-
stance Abuse and Mental Health Services Ad-
ministration, the Office of Inspector General, the 
Indian Health Service, and the Centers for Medi-
care & Medicaid Services; 
(B) the Secretary of Housing and Urban 
Development; 
(C) directors or commissioners, as applica-
ble, of State health departments, tribal health de-
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partments, State Medicaid programs, and State 
insurance agencies; 
(D) representatives of health insurance 
issuers; 
(E) national accrediting entities and rep-
utable providers of, and analysts of, recovery 
housing services, including Indian Tribes, tribal 
organizations, and tribally designated housing 
entities that provide recovery housing services, as 
applicable; 
(F) individuals with a history of substance 
use disorder; and 
(G) other stakeholders identified by the Sec-
retary. 
(b) IDENTIFICATION
OF
FRAUDULENT
RECOVERY 
HOUSING OPERATORS.— 
(1) IN GENERAL.—The Secretary, in consultation 
with the individuals and entities described in para-
graph (2), shall identify or facilitate the development 
of common indicators that could be used to identify 
potentially fraudulent recovery housing operators. 
(2) CONSULTATION.—In carrying out the activi-
ties described in paragraph (1), the Secretary shall 
consult with, as appropriate—
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(A) relevant divisions of the Department of 
Health and Human Services, including the Sub-
stance Abuse and Mental Health Services Ad-
ministration, the Office of Inspector General, the 
Indian Health Service, and the Centers for Medi-
care & Medicaid Services; 
(B) the Attorney General; 
(C) the Secretary of Housing and Urban 
Development; 
(D) directors or commissioners, as applica-
ble, of State health departments, tribal health de-
partments, State Medicaid programs, and State 
insurance agencies; 
(E) representatives of health insurance 
issuers; 
(F) national accrediting entities and rep-
utable providers of, and analysts of, recovery 
housing services, including Indian Tribes, tribal 
organizations, and tribally designated housing 
entities that provide recovery housing services, as 
applicable; 
(G) individuals with a history of substance 
use disorder; and 
(H) other stakeholders identified by the Sec-
retary.
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(3) REQUIREMENTS.— 
(A) PRACTICES
FOR
IDENTIFICATION
AND 
REPORTING.—In carrying out the activities de-
scribed in this subsection, the Secretary shall 
consider how law enforcement, public and pri-
vate payers, and the public can best identify and 
report fraudulent recovery housing operators. 
(B) FACTORS TO BE CONSIDERED.—In car-
rying out the activities described in this sub-
section, the Secretary shall consider identifying 
or developing indicators regarding— 
(i) unusual billing practices; 
(ii) average lengths of stays; 
(iii) excessive levels of drug testing (in 
terms of cost or frequency); 
(iv) unusually high levels of recidi-
vism; and 
(v) any other factors identified by the 
Secretary. 
(c) DISSEMINATION.—The Secretary shall, as appro-
priate, disseminate the best practices identified or developed 
under subsection (a), and the common indicators identified 
or developed under subsection (b), to—