42 U.S.C. § 290dd–4 (THE PUBLIC HEALTH AND WELFARE)
§ 290dd–4. Program to support coordination and continuation of care for drug overdose patients
(a) In general
The Secretary of Health and Human Services (referred to in this section as the “Secretary”) shall identify or facilitate the development of best practices for—
(1) emergency treatment of known or suspected drug overdose;
(2) the use of recovery coaches, as appropriate, to encourage individuals who experience a non-fatal overdose to seek treatment for substance use disorder and to support coordination and continuation of care;
(3) coordination and continuation of care and treatment, including, as appropriate, through referrals, of individuals after a drug overdose; and
(4) the provision or prescribing of overdose reversal medication, as appropriate.
(b) Grant establishment and participation
(1) In general
The Secretary shall award grants on a competitive basis to eligible entities to support implementation of voluntary programs for care and treatment of individuals after a drug overdose, as appropriate, which may include implementation of the best practices described in subsection (a).
(2) Eligible entity
In this section, the term “eligible entity” means—
(A) a State substance abuse agency;
(B) an Indian Tribe or tribal organization; or
(C) an entity that offers treatment or other services for individuals in response to, or following, drug overdoses or a drug overdose, such as an emergency department, in consultation with a State substance abuse agency.
(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 services, 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 primary 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 appropriate;
(iii) providing follow-up services for patients after an overdose to ensure continued recovery and connection to support services;
(iv) collecting and evaluating outcome data for patients receiving recovery coaching services; and
(v) providing other services the Secretary determines necessary to help ensure continued connection with recovery support services, including culturally appropriate services, as applicable;
(B) establish policies and procedures, pursuant to Federal 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 262 of this title 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
(C) establish integrated models of care for individuals who have experienced a non-fatal drug overdose which may include patient assessment, follow up, and transportation 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 262 of this title 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 treatment 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 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 eligible entities that meet any or all of the following criteria:
(A) The eligible entity is a critical access hospital (as defined in section 1395x(mm)(1) of this title), a low volume hospital (as defined in section 1395ww(d)(12)(C)(i) of such title), a sole community hospital (as defined in section 1395ww(d)(5)(D)(iii) of such title), or a hospital that receives disproportionate share hospital payments under section 1395ww(d)(5)(F) of this title.
(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 Prevention, 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 Secretary 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 5304 of title 25.
(2) Recovery coach
the 1 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 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 290ee–2(a) of this title.
(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 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 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 reoccurrences, 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 October 24, 2018, the Secretary 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 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.
(Pub. L. 115–271, title VII, § 7081, Oct. 24, 2018, 132 Stat. 4032.)
heading: Editorial Notes
heading: References in Text
text: The Federal Food, Drug, and Cosmetic Act, referred to in subsec. (b)(4)(B), (5)(A), is act June 25, 1938, ch. 675, 52 Stat. 1040, which is classified generally to chapter 9 (§ 301 et seq.) of Title 21, Food and Drugs. For complete classification of this Act to the Code, see section 301 of Title 21 and Tables.
heading: Codification
text: Section was enacted as part of the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act, and not as part of the Public Health Service Act which comprises this chapter.