Title 42The Public Health and WelfareRelease 119-73

§294i–1 Emergency department alternatives to opioids program

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER V— - HEALTH PROFESSIONS EDUCATION › Part Part D— - Interdisciplinary, Community-Based Linkages › § 294i–1

Last updated Apr 6, 2026|Official source

Summary

The Secretary of Health and Human Services must run a grant program that gives money to hospitals and emergency departments, including freestanding emergency departments, to create, test, or expand ways to manage pain without using opioids. Hospitals and emergency departments must apply to get a grant. The grants must be spread out geographically. Grant money must focus on painful conditions often seen in these settings, train staff on opioid use and non-opioid options, and build or keep programs that use alternatives to opioids. The Secretary may run a similar demonstration program for other acute care settings. Grant winners must share proven approaches and the Secretary must offer technical help. The Secretary will collect and promote best practices that may include non-addictive medicines, non-drug treatments, tools to find patients at risk for opioid use disorder, and approaches for groups like older adults, pregnant women, and children, and share them with hospitals and other acute care sites, including rural and tribal facilities. Each grantee must send the Secretary yearly reports while the grant lasts. Reports must describe the program and patient groups served, give data on the alternative pain treatments used (including counts of opioid prescriptions before the program and at stages during the program), show data on patients who later received opioids after trying alternatives, and any other information the Secretary asks for. By the end of fiscal years 2024 and 2027, the Secretary must report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House on how many applications were received and funded, summarize grantee reports so programs can be compared, and give recommendations for wider use of alternatives to opioids. Congress authorized $10,000,000 per year for each fiscal year 2023 through 2027 for this work.

Full Legal Text

Title 42, §294i–1

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

(a)(1)The Secretary of Health and Human Services (in this section referred to as the “Secretary”) shall carry out a program for purposes of awarding grants to hospitals and emergency departments, including freestanding emergency departments, to develop, implement, enhance, or study alternatives to opioids for pain management in such settings.
(2)To be eligible to receive a grant under paragraph (1), a hospital or emergency department shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.
(3)In awarding grants under this section, the Secretary shall seek to ensure geographical distribution among grant recipients.
(4)Grants under paragraph (1) shall be used to—
(A)target treatment approaches for painful conditions frequently treated in such settings;
(B)train providers and other hospital personnel on protocols or best practices related to the use and prescription of opioids and alternatives to opioids for pain management in the emergency department; and
(C)develop or continue strategies to provide alternatives to opioids, as appropriate.
(b)The Secretary may carry out a demonstration program 11 So in original. Probably should be “a program”. similar to the program under subsection (a) for other acute care settings.
(c)The Secretary shall implement a process for recipients of grants under subsection (a) or (b) to share evidence-based and best practices and promote consultation with persons having robust knowledge, including emergency departments and physicians that have successfully implemented programs that use alternatives to opioids for pain management, as appropriate, such as approaches studied through the National Center for Complimentary and Integrative Health or other institutes and centers at the National Institutes of Health, as appropriate. The Secretary shall offer to each recipient of a grant under subsection (a) or (b) technical assistance as necessary.
(d)The Secretary shall identify or facilitate the development of best practices on alternatives to opioids for pain management and provide technical assistance to hospitals and other acute care settings on alternatives to opioids for pain management. The technical assistance provided shall be for the purpose of—
(1)utilizing information from recipients of a grant under subsection (a) or (b) that have successfully implemented alternatives to opioids programs;
(2)identifying or facilitating the development of best practices on the use of alternatives to opioids, which may include pain-management strategies that involve non-addictive medical products, non-pharmacologic treatments, and technologies or techniques to identify patients at risk for opioid use disorder;
(3)identifying or facilitating the development of best practices on the use of alternatives to opioids that target common painful conditions and include certain patient populations, such as geriatric patients, pregnant women, and children; and
(4)disseminating information on the use of alternatives to opioids to providers in acute care settings, which may include emergency departments, outpatient clinics, critical access hospitals, Federally qualified health centers, Indian Health Service health facilities, and Tribal hospitals.
(e)Each recipient of a grant under this section shall submit to the Secretary (during the period of such grant) annual reports on the progress of the program funded through the grant. These reports shall include, in accordance with all applicable State and Federal privacy laws—
(1)a description of and specific information about the opioid alternative pain management programs, including the demographic characteristics of patients who were treated with an alternative pain management protocol, implemented in hospitals, emergency departments, and other acute care settings;
(2)data on the opioid alternative pain management strategies used, including the number of opioid prescriptions written—
(A)during a baseline period before the program began; or
(B)at various stages of the program; and
(3)data on patients who were eventually prescribed opioids after alternative pain management protocols and treatments were utilized; and
(4)any other information the Secretary determines appropriate.
(f)Not later than the end of each of fiscal years 2024 and 2027, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report on the results of the program and include in the report—
(1)the number of applications received and the number funded;
(2)a summary of the reports described in subsection (e), including data that allows for comparison of programs; and
(3)recommendations for broader implementation of pain management strategies that encourage the use of alternatives to opioids in hospitals, emergency departments, or other acute care settings.
(g)To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2023 through 2027.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

Codification Section was formerly classified as a note under section 294i of this title prior to editorial reclassification and renumbering as this section. Section was enacted as part of the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act, and not as part of the Public Health Service Act which comprises this chapter.

Amendments

2022—Pub. L. 117–328, § 1221(1), struck out “demonstration” before “program” in section catchline. Subsec. (a). Pub. L. 117–328, § 1221(2)(A), amended heading generally. Prior to amendment, heading read as follows: “Demonstration program grants”. Subsec. (a)(1). Pub. L. 117–328, § 1221(2)(B), struck out “demonstration” before “program”. Subsec. (b). Pub. L. 117–328, § 1221(3), struck out “demonstration” before “program” in heading. Subsec. (d)(4). Pub. L. 117–328, § 1221(4), substituted “Tribal” for “tribal”. Subsec. (f). Pub. L. 117–328, § 1221(5), substituted “Reports” for “Report” in heading and “Not later than the end of each of fiscal years 2024 and 2027, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report on the results of the program” for “Not later than 1 year after completion of the demonstration program under this section, the Secretary shall submit a report to the Congress on the results of the demonstration program” in introductory provisions. Subsec. (g). Pub. L. 117–328, § 1221(6), substituted “2023 through 2027” for “2019 through 2021”.

Reference

Citations & Metadata

Citation

42 U.S.C. § 294i–1

Title 42The Public Health and Welfare

Last Updated

Apr 6, 2026

Release point: 119-73