H. R. 6—140 
(3) APPLICATION.—An eligible entity desiring a grant under 
this section shall submit an application to the Secretary, at 
such time and in such manner as the Secretary may require, 
that includes— 
(A) evidence that such eligible entity carries out, or 
is capable of contracting and coordinating with other 
community entities to carry out, the activities described 
in paragraph (4); 
(B) evidence that such eligible entity will work with 
a recovery community organization to recruit, train, hire, 
mentor, and supervise recovery coaches and fulfill the 
requirements described in paragraph (4)(A); and 
(C) such additional information as the Secretary may 
require. 
(4) USE OF GRANT FUNDS.—An eligible entity awarded a 
grant under this section shall use such grant funds to— 
(A) hire or utilize recovery coaches to help support 
recovery, including by— 
(i) connecting patients to a continuum of care serv-
ices, such as— 
(I) treatment and recovery support programs; 
(II) 
programs 
that 
provide 
non-clinical 
recovery support services; 
(III) peer support networks; 
(IV) recovery community organizations; 
(V) health care providers, including physicians 
and other providers of behavioral health and pri-
mary care; 
(VI) education and training providers; 
(VII) employers; 
(VIII) housing services; and 
(IX) child welfare agencies; 
(ii) providing education on overdose prevention and 
overdose reversal to patients and families, as appro-
priate; 
(iii) providing follow-up services for patients after 
an overdose to ensure continued recovery and connec-
tion to support services; 
(iv) collecting and evaluating outcome data for 
patients receiving recovery coaching services; and 
(v) providing other services the Secretary deter-
mines necessary to help ensure continued connection 
with recovery support services, including culturally 
appropriate services, as applicable; 
(B) establish policies and procedures, pursuant to Fed-
eral and State law, that address the provision of overdose 
reversal medication, the administration of all drugs or 
devices approved or cleared under the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 301 et seq.) and all biological 
products licensed under section 351 of the Public Health 
Service Act (42 U.S.C. 262) to treat substance use disorder, 
and subsequent continuation of, or referral to, evidence- 
based treatment for patients with a substance use disorder 
who have experienced a non-fatal drug overdose, in order 
to support long-term treatment, prevent relapse, and 
reduce recidivism and future overdose; and
H. R. 6—141 
(C) establish integrated models of care for individuals 
who have experienced a non-fatal drug overdose which 
may include patient assessment, follow up, and transpor-
tation to and from treatment facilities. 
(5) ADDITIONAL PERMISSIBLE USES.—In addition 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 or devices approved or cleared under 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 
et seq.) and all biological products licensed under section 
351 of the Public Health Service Act (42 U.S.C. 262) to 
treat substance use disorders or reverse overdose, pursuant 
to Federal and State law; 
(B) withdrawal and detoxification services that include 
patient evaluation, stabilization, and preparation for treat-
ment of substance use disorder, including treatment 
described in subparagraph (A), as appropriate; or 
(C) mental health services provided by a certified 
professional who is licensed and qualified by education, 
training, or experience to assess the psychosocial back-
ground of patients, to contribute to the appropriate treat-
ment 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 eligible entities that 
meet any or all of the following criteria: 
(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 
defined in section 1886(d)(12)(C)(i) of such Act (42 U.S.C. 
1395ww(d)(12)(C)(i))), 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))), or a hospital that receives dispropor-
tionate share hospital payments under section 1886(d)(5)(F) 
of the Social Security Act (42 U.S.C. 1395ww(d)(5)(F)). 
(B) The eligible entity is located in a State 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 Preven-
tion, or under the jurisdiction of an Indian Tribe with 
an age-adjusted rate of drug overdose deaths that is above 
the national overdose mortality rate, as determined 
through appropriate mechanisms as determined by the Sec-
retary in consultation with Indian Tribes. 
(C) The eligible entity demonstrates that recovery 
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) INDIAN
TRIBE; 
TRIBAL
ORGANIZATION.—The terms 
‘‘Indian Tribe’’ and ‘‘tribal organization’’ have the meanings 
given the terms ‘‘Indian tribe’’ and ‘‘tribal organization’’ in 
section 4 of the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 5304).
H. R. 6—142 
(2) 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 deter-
mined to be in good standing by, a recovery services 
organization capable of conducting such training and 
making such determination. 
(3) 
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)). 
(d) REPORTING REQUIREMENTS.— 
(1) REPORTS BY GRANTEES.—Each eligible entity 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 reversal medication was adminis-
tered; 
(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 facilities, and the number of such 
individuals admitted to such other facilities pursuant to 
such referrals; and 
(D) the frequency and number of patients with reoccur-
rences, including readmissions for non-fatal overdoses and 
evidence of relapse related to substance use disorder. 
(2) REPORT BY SECRETARY.—Not later than 5 years after 
the date of enactment of this Act, the Secretary shall submit 
to Congress a report that includes an evaluation of the effective-
ness 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 percent-
age of patients treated or referred to treatment by grantees, 
and the frequency and number of patients who experienced 
relapse, were readmitted for treatment, or experienced another 
overdose. 
(e) PRIVACY.—The requirements of this section, including 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 $10,000,000 for each 
of fiscal years 2019 through 2023. 
Subtitle J—Alternatives to Opioids in the 
Emergency Department 
SEC. 7091. EMERGENCY DEPARTMENT ALTERNATIVES TO OPIOIDS 
DEMONSTRATION PROGRAM. 
(a) DEMONSTRATION PROGRAM GRANTS.— 
(1) IN
GENERAL.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) shall
H. R. 6—143 
carry out a demonstration program for purposes of awarding 
grants to hospitals and emergency departments, including free-
standing emergency departments, to develop, implement, 
enhance, or study alternatives to opioids for pain management 
in such settings. 
(2) ELIGIBILITY.—To be eligible to receive a grant under 
paragraph (1), a hospital or emergency department shall submit 
an application to the Secretary at such time, in such manner, 
and containing such information as the Secretary may require. 
(3) GEOGRAPHIC DISTRIBUTION.—In awarding grants under 
this section, the Secretary shall seek to ensure geographical 
distribution among grant recipients. 
(4) USE OF FUNDS.—Grants under paragraph (1) shall be 
used to— 
(A) target treatment approaches for painful conditions 
frequently treated in such settings; 
(B) train providers and other hospital personnel on 
protocols or best practices related to the use and prescrip-
tion of opioids and alternatives to opioids for pain manage-
ment in the emergency department; and 
(C) develop or continue strategies to provide alter-
natives to opioids, as appropriate. 
(b) ADDITIONAL DEMONSTRATION PROGRAM.—The Secretary may 
carry out a demonstration program similar to the program under 
subsection (a) for other acute care settings. 
(c) CONSULTATION.—The Secretary shall implement a process 
for recipients of grants under subsection (a) or (b) to share evidence- 
based and best practices and promote consultation with persons 
having robust knowledge, including emergency departments and 
physicians that have successfully implemented programs that use 
alternatives to opioids for pain management, as appropriate, such 
as approaches studied through the National Center for Complimen-
tary and Integrative Health or other institutes and centers at 
the National Institutes of Health, as appropriate. The Secretary 
shall offer to each recipient of a grant under subsection (a) or 
(b) technical assistance as necessary. 
(d) TECHNICAL ASSISTANCE.—The Secretary shall identify or 
facilitate the development of best practices on alternatives to opioids 
for pain management and provide technical assistance to hospitals 
and other acute care settings on alternatives to opioids for pain 
management. The technical assistance provided shall be for the 
purpose of— 
(1) utilizing information from recipients of a grant under 
subsection (a) or (b) that have successfully implemented alter-
natives to opioids programs; 
(2) identifying or facilitating the development of best prac-
tices on the use of alternatives to opioids, which may include 
pain-management strategies that involve non-addictive medical 
products, non-pharmacologic treatments, and technologies or 
techniques to identify patients at risk for opioid use disorder; 
(3) identifying or facilitating the development of best prac-
tices on the use of alternatives to opioids that target common 
painful conditions and include certain patient populations, such 
as geriatric patients, pregnant women, and children; and 
(4) disseminating information on the use of alternatives 
to opioids to providers in acute care settings, which may include