115TH CONGRESS 
2D SESSION 
H. R. 5176 
AN ACT 
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’’. 
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 entities 
described in paragraph (2). 
(2) ELIGIBILITY.— 
(A) IN
GENERAL.—To be eligible for a 
grant under this subsection, an entity shall 
be— 
(i) a health care site described in sub-
paragraph (B); or 
(ii) a health care site coordinator de-
scribed in subparagraph (C).
(B) HEALTH CARE SITES.—To be eligible 
for a grant under this section, a health care site 
shall— 
(i) submit an application to the Sec-
retary at such time, in such manner, and 
containing such information as specified by 
the Secretary; 
(ii) have an emergency department; 
(iii)(I) have a licensed health care pro-
fessional onsite who has a waiver under 
section 303(g) of the Controlled Sub-
stances Act (21 U.S.C. 823(g)) to dispense 
or prescribe covered drugs; or 
(II) have a demonstrable plan to hire 
a sufficient number of full-time licensed 
health care professionals who have waivers 
described in subclause (I) to administer 
such treatment onsite; 
(iv) have in place an agreement with 
a sufficient number and range of entities 
certified under applicable State and Fed-
eral law, such as pursuant to registration 
or a waiver under section 303(g) of the 
Controlled Substances Act (21 U.S.C. 
823(g)) or certification as described in sec-
tion 8.2 of title 42 of the Code of Federal 
Regulations, to provide treatment for sub-
stance use disorder such that the entity or 
the resulting network of entities with an 
agreement with the hospital cumulatively 
are capable of providing all evidence-based 
services for the treatment of substance use 
disorder, as medically appropriate for the 
individual involved, including— 
(I) 
medication-assisted 
treat-
ment; 
(II) withdrawal and detoxifica-
tion services that include patient eval-
uation, stabilization, and readiness for 
and entry into treatment; and 
(III) counseling; 
(v) deploy onsite peer recovery special-
ists to help connect patients with treat-
ment and recovery support services; and 
(vi) include the provision of overdose 
reversal medication in discharge protocols 
for opioid overdose patients. 
(C) HEALTH CARE SITE COORDINATORS.— 
To be eligible for a grant under this section, a 
health care site coordinator shall—
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 health care site or the eli-
gible health care site coordinator is located in 
a geographic area with a drug overdose rate 
that is higher than the national rate, or in a ge-
ographic area with a rate of emergency depart-
ment visits for overdoses that is higher than the 
national rate, as determined by the Secretary 
based on the most recent data from the Centers 
for Disease Control and Prevention. 
(4) MEDICATION-ASSISTED
TREATMENT
DE-
FINED.—For purposes of this section, the term 
‘‘medication-assisted treatment’’ means the use of a 
drug approved under section 505 of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 355) or 
a biological product licensed under section 351 of 
the Public Health Service Act (42 U.S.C. 262), in 
combination with behavioral health services, to pro-
vide an individualized approach to the treatment of 
substance use disorders, including opioid use dis-
orders.
(c) PERIOD OF GRANT.—A grant awarded to an eligi-
ble entity under this section shall be for a period of at 
least 2 years. 
(d) GRANT USES.— 
(1) REQUIRED USES.—A grant awarded under 
this section to an eligible entity shall be used for 
both of the following purposes: 
(A) To establish policies and procedures 
that address the provision of overdose reversal 
medication, prescription and dispensing of 
medication-assisted treatment to an emergency 
department patient who has had a non-fatal 
overdose or who is at risk of a drug overdose, 
and the subsequent referral to evidence-based 
treatment upon discharge for patients who have 
experienced a non-fatal drug overdose or who 
are at risk of a drug overdose. 
(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 entity 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. 
(D) To offer consultation with and referral 
to other supportive services that help in treat-
ment and recovery. 
(e) REPORTING REQUIREMENTS.— 
(1) REPORTS BY GRANTEES.—Each eligible en-
tity 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 in-
cludes information on— 
(A) the number of individuals treated at 
the site (or, in the case of an eligible health 
care site coordinator, at sites covered by the 
agreement 
referred 
to 
in 
subsection 
(b)(2)(C)(iii)) for non-fatal overdoses in the 
emergency department; 
(B) the number of individuals administered 
each medication-assisted treatment at such site 
or sites in the emergency department; 
(C) the number of individuals referred by 
such site or sites to other treatment facilities 
after a non-fatal overdose, the types of such 
other facilities, and the number of such individ-
uals admitted to such other facilities pursuant 
to such referrals; 
(D) the frequency and number of patient 
readmissions for non-fatal overdoses and sub-
stance use 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
begin medication-assisted treatment for sub-
stance use disorders. 
(2) REPORT BY SECRETARY.—Not less than 1 
year after the conclusion of the Program, the Sec-
retary 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 funded through a grant under this section 
were readmitted to a hospital for non-fatal or 
fatal overdose; 
(D) an evaluation determining the effec-
tiveness of having a practitioner onsite to ad-
minister and begin medication-assisted treat-
ment for substance use disorder; and 
(E) 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