§290dd–4 — Title 42 The Public Health and Welfare | U.S. Code

§290dd–4 Program to support coordination and continuation of care for drug overdose patients

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER III–A— - SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION › Part Part D— - Miscellaneous Provisions Relating to Substance Abuse and Mental Health › § 290dd–4

Last updated Apr 6, 2026|Official source

Summary

The Secretary of Health and Human Services must find or help create best ways to care for people after a drug overdose. That includes how to handle emergency treatment, how to use recovery coaches to get people into treatment and keep them connected to services, how to coordinate follow-up care, and how to give or prescribe overdose-reversal medicine. The Secretary must run a competitive grant program to fund voluntary post-overdose care. Grants go to state substance abuse agencies, Indian Tribes or tribal organizations, or treatment providers (like emergency departments) that work with a state agency. Grant money must hire recovery coaches to connect patients to a range of services (treatment, non-clinical supports, peer networks, health care, housing, jobs, child welfare, etc.), teach overdose prevention and reversal, provide follow-up and data tracking, and set up policies for giving reversal medicines and linking patients to long-term, evidence-based treatment. Grants may also pay for approved drugs or devices to treat substance use or reverse overdoses, withdrawal/detox services, and licensed mental health care. Preference is given to certain small or safety-net hospitals, to places in states or tribal areas with age-adjusted overdose death rates above the national rate (as determined by the CDC or appropriate tribal mechanisms), and to programs that place coaches in both health care and community settings. Grants last no more than 5 years. Recipients must send yearly reports with counts of non-fatal overdoses treated (and reversals), medication-assisted treatment given, referrals and admissions, and repeat overdoses or relapses. The Secretary must report to Congress not later than 5 years after October 24, 2018 on program effectiveness. All data must follow federal and state privacy laws. Funding authorized: $10,000,000 for each fiscal year 2019 through 2023. Definitions in brief: Indian Tribe/tribal organization — meanings in 25 U.S.C. section 5304. Recovery coach — a person with recovery experience who completed approved training and is in good standing. Recovery community organization — defined in 42 U.S.C. section 290ee–2(a).

Title 42, §290dd–4

The Public Health and Welfare — Source: USLM XML via OLRC

(a)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)(1)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)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)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)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)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)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)A grant awarded to an eligible entity under this section shall be for a period of not more than 5 years.

(c)In this section:

(1)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)the 11 So in original. Probably should be capitalized. 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)The term “recovery community organization” has the meaning given such term in section 290ee–2(a) of this title.

(d)(1)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)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)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)There is authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2019 through 2023.

Notes & Related Subsidiaries

Editorial Notes

References in 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. Codification 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.