text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Preventing Overdoses While in 
  Emergency Departments Act of 2018''.
  
  SEC. 2. PROGRAM TO SUPPORT EMERGENCY DEPARTMENT DISCHARGE AND CARE 
                COORDINATION FOR DRUG OVERDOSE PATIENTS.
  
      (a) In General.--The Secretary of Health and Human Services shall 
  establish a program (referred to in this Act 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 recovery coaches 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 recovery coaches, 
                  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, 
                  followup, 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) how 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.
target: Preventing Overdoses While in Emergency Departments Act of 2018 This bill requires the Department of Health and Human Services to establish a grant program to: (1) develop protocols for discharging patients who are treated for a drug overdose, and (2) enhance the integration and coordination of postdischarge care and treatment options for individuals with a substance use disorder.
feat_title: Preventing Overdoses While in Emergency Departments Act of 2018