I 
115TH CONGRESS 
2D SESSION 
H. R. 5176 
To require the Secretary of Health and Human Services to provide coordi-
nated 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 En-
ergy and Commerce 
A BILL 
To require the Secretary of Health and Human Services 
to provide coordinated care to patients who have experi-
enced a non-fatal overdose after emergency room dis-
charge, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Preventing Overdoses 
While in Emergency Rooms Act of 2018’’. 
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SEC. 2. PROGRAM TO SUPPORT EMERGENCY ROOM DIS-
CHARGE AND CARE COORDINATION FOR 
DRUG OVERDOSE PATIENTS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a program (in this Act re-
ferred to as the ‘‘Program’’) to develop protocols for dis-
charging patients who have presented with a drug over-
dose and enhance the integration and coordination of care 
and treatment options for individuals with substance use 
disorder after discharge. 
(b) GRANT ESTABLISHMENT AND PARTICIPATION.— 
(1) IN
GENERAL.—In carrying out the Pro-
gram, the Secretary shall award grants on a com-
petitive basis to not more than 20 eligible health 
care sites described in paragraph (2). 
(2) ELIGIBLE HEALTH CARE SITES.—To be eli-
gible for a grant under this section, a health care 
site shall— 
(A) submit an application to the Secretary 
at such time, in such manner, and containing 
such information as specified by the Secretary; 
(B) have an emergency department; 
(C)(i) have a licensed health care profes-
sional on site who has a waiver under section 
303(g) of the Controlled Substances Act (21 
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U.S.C. 823(g)) to administer medication-as-
sisted treatment; or 
(ii) have a demonstrable plan to hire a full- 
time licensed health care professional who has 
a waiver described in clause (i) to administer 
such treatment on site; 
(D) have in place an agreement with a suf-
ficient number and range of entities certified 
under applicable State and Federal law, such as 
pursuant to registration or a waiver under sec-
tion 303(g) of the Controlled Substances Act 
(21 U.S.C. 823(g)) or certification as described 
in section 8.2 of title 42 of the Code of Federal 
Regulations, to provide treatment for substance 
use disorder such that, in combination, the re-
sulting network of entities with an agreement 
with the hospital cumulatively are capable of 
providing services for all evidence-based services 
for the treatment of substance use disorder, as 
medically appropriate for the individual in-
volved, including— 
(i) medication-assisted treatment; 
(ii) 
withdrawal 
and 
detoxification 
services that include patient evaluation, 
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stabilization, and readiness for and entry 
into treatment; and 
(iii) counseling; 
(E) deploy on-site peer recovery specialists 
to help connect patients with treatment and re-
covery support programs; and 
(F) include the provision of overdose rever-
sal medication in discharge protocols for opioid 
overdose patients. 
(3) PREFERENCE.—In awarding grants under 
this section, the Secretary shall give preference to el-
igible health care sites that meet either or both of 
the following criteria: 
(A) The site 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 defined in section 
1886(d)(12)(C)(i) of such Act (42 U.S.C. 
1395ww(d)(12)(C)(i))), or a sole community 
hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii) of such Act (42 U.S.C. 
1395ww(d)(5)(D)(iii))). 
(B) The site is located in a geographic 
area with an overdose rate higher than the na-
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(B) To develop best practices for treating 
non-fatal drug overdoses, including with respect 
to care coordination and integrated care models 
for long term treatment and recovery options 
for individuals who have experienced a non-fatal 
drug overdose. 
(2) ADDITIONAL PERMISSIBLE USES.—A grant 
awarded under this section to an eligible health care 
site may be used for any of the following purposes: 
(A) To hire emergency department peer re-
covery specialists; counselors; therapists; social 
workers; or other licensed medical professionals 
specializing in the treatment of substance use 
disorder. 
(B) To establish integrated models of care 
for individuals who have experienced a non-fatal 
drug overdose which may include patient as-
sessment, follow up, and transportation to 
treatment facilities. 
(C) To provide for options for increasing 
the availability and access of medication-as-
sisted treatment and other evidence-based treat-
ment for individuals with substance use dis-
orders. 
(e) REPORTING REQUIREMENTS.— 
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(1) REPORTS
BY
GRANTEES.—Each eligible 
health care site awarded a grant under this section 
shall submit to the Secretary an annual report for 
each year for which the site has received such grant 
that includes information on— 
(A) the number of individuals treated at 
the site for non-fatal overdoses in the emer-
gency department; 
(B) the number of individuals administered 
medication-assisted treatment at the site in the 
emergency department; 
(C) the number of individuals referred by 
the site to other treatment facilities after a non- 
fatal overdose, the types of such other facilities, 
and the number of such individuals admitted to 
such other facilities pursuant to such referrals; 
(D) the frequency and number of patient 
readmissions for non-fatal overdoses and sub-
stance abuse disorder; 
(E) for what the grant funding was used; 
and 
(F) the effectiveness of, and any other rel-
evant additional data regarding, having an on-
site health care professional to administer and 
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begin medication-assisted treatment for sub-
stance use disorders. 
(2) REPORT
BY
SECRETARY.—Not less than 
one year after the conclusion of the Program, the 
Secretary shall submit to Congress a report that in-
cludes— 
(A) findings of the Program; 
(B) overall patient outcomes under the 
Program, such as with respect to hospital read-
mission; 
(C) what percentage of patients treated by 
a site receiving a grant under this section were 
readmitted to a hospital for non-fatal or fatal 
overdose; and 
(D) a compilation of voluntary guidelines 
and best practices from the reports submitted 
under paragraph (1). 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this Act 
$50,000,000 for the period of fiscal years 2019 through 
2023. 
Æ 
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