[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5176 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 5176

   To require the Secretary of Health and Human Services to provide 
coordinated 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 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To require the Secretary of Health and Human Services to provide 
coordinated care to patients who have experienced a non-fatal overdose 
        after emergency room discharge, and for other purposes.

    Be it enacted by the Senate and House of Representatives 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 DISCHARGE AND CARE 
              COORDINATION FOR DRUG OVERDOSE PATIENTS.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a program (in this Act referred to as the ``Program'') to 
develop protocols for discharging patients who have presented with a 
drug overdose 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 Program, the Secretary 
        shall award grants on a competitive basis to not more than 20 
        eligible health care sites described in paragraph (2).
            (2) Eligible health care sites.--To be eligible 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 professional on 
                site who has a waiver under section 303(g) of the 
                Controlled Substances Act (21 U.S.C. 823(g)) to 
                administer medication-assisted 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 sufficient 
                number and range of entities certified under applicable 
                State and Federal 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 section 8.2 of title 42 of the Code of 
                Federal Regulations, to provide treatment for substance 
                use disorder such that, in combination, the resulting 
                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 involved, including--
                            (i) medication-assisted treatment;
                            (ii) withdrawal and detoxification services 
                        that include patient evaluation, 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 recovery 
                support programs; and
                    (F) include the provision of overdose reversal 
                medication in discharge protocols for opioid overdose 
                patients.
            (3) Preference.--In awarding grants under this section, the 
        Secretary shall give preference to eligible 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 national average, 
                based on the most recent data of the Centers for 
                Disease Control and Prevention.
            (4) Medication-assisted treatment defined.--For purposes of 
        this section, the term ``medication-assisted treatment'' means 
        the use of medication approved by the Food and Drug 
        Administration in combination with behavioral health services 
        to provide an individualized approach to the treatment of 
        substance use disorders, including opioid use disorder.
    (c) Period of Grant.--A grant awarded to an eligible health care 
site 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 health care site shall be used for both of the 
        following purposes:
                    (A) To establish policies and procedures that 
                address the provision of overdose reversal medication, 
                the administration of medication-assisted treatment to 
                a non-fatal overdose patient in the emergency 
                department, and the subsequent referral to evidence-
                based treatment upon discharge for patients who have 
                experienced a non-fatal 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 health care site may be used for 
        any of the following purposes:
                    (A) To hire emergency department peer recovery 
                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 assessment, follow 
                up, and transportation to treatment facilities.
                    (C) To provide for options for increasing the 
                availability and access of medication-assisted 
                treatment and other evidence-based treatment for 
                individuals with substance use disorders.
    (e) Reporting Requirements.--
            (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 emergency 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 substance 
                abuse disorder;
                    (E) for what the grant funding was used; and
                    (F) the effectiveness of, and any other relevant 
                additional data regarding, having an onsite health care 
                professional to administer and begin medication-
                assisted treatment for substance 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 includes--
                    (A) findings of the Program;
                    (B) overall patient outcomes under the Program, 
                such as with respect to hospital readmission;
                    (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.
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