---
kind: "section"
citation: "42 U.S.C. § 290dd–4"
title: "42"
title_heading: "The Public Health and Welfare"
number: "290dd–4"
heading: "Program to support coordination and continuation of care for drug overdose patients"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/290dd-4"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter III–A — Substance Abuse and Mental Health Services Administration"
  - "Part D — Miscellaneous Provisions Relating to Substance Abuse and Mental Health"
---

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

- (a) **In general—** The [Secretary](/usc/42/201.md?p=c) of Health and Human [Services](/usc/42/201.md?p=a) (referred to in this section as the “[Secretary](/usc/42/201.md?p=c)”) shall identify or facilitate the development of best [practices](/usc/42/17061.md?p=19) for—
  - (1) emergency [treatment](/usc/42/11851.md?p=11) of known or suspected [drug](/usc/42/11851.md?p=4) overdose;
  - (2) the use of recovery coaches, as appropriate, to encourage individuals who experience a non-fatal overdose to seek [treatment](/usc/42/11851.md?p=11) for substance use disorder and to support coordination and continuation of care;
  - (3) coordination and continuation of care and [treatment](/usc/42/11851.md?p=11), including, as appropriate, through referrals, of individuals after a [drug](/usc/42/11851.md?p=4) overdose; and
  - (4) the provision or prescribing of overdose reversal medication, as appropriate.
- (b) **Grant establishment and participation—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) shall award grants on a competitive basis to eligible entities to support implementation of voluntary [programs](/usc/42/274l–1.md?p=4) for care and [treatment](/usc/42/11851.md?p=11) of individuals after a [drug](/usc/42/11851.md?p=4) overdose, as appropriate, which may include implementation of the best [practices](/usc/42/17061.md?p=19) described in [subsection (a)](#a).
  - (2) **Eligible entity—** In this section, the term “eligible entity” means—
    - (A) a [State](/usc/42/201.md?p=f) substance abuse [agency](/usc/42/8262.md?p=1);
    - (B) an Indian Tribe or tribal organization; or
    - (C) an entity that offers [treatment](/usc/42/11851.md?p=11) or other [services](/usc/42/201.md?p=a) for individuals in response to, or following, [drug](/usc/42/11851.md?p=4) overdoses or a [drug](/usc/42/11851.md?p=4) overdose, such as an emergency department, in consultation with a [State](/usc/42/201.md?p=f) substance abuse [agency](/usc/42/8262.md?p=1).
  - (3) **Application—** An eligible entity desiring a grant under this section shall submit an application to the [Secretary](/usc/42/201.md?p=c), at such time and in such manner as the [Secretary](/usc/42/201.md?p=c) 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-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)](#b-4-A); and
    - (C) such additional information as the [Secretary](/usc/42/201.md?p=c) 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](/usc/42/300z–1.md?p=a-7), such as—
        - (I) [treatment](/usc/42/11851.md?p=11) and recovery support [programs](/usc/42/274l–1.md?p=4);
        - (II) [programs](/usc/42/274l–1.md?p=4) that provide non-clinical recovery support [services](/usc/42/201.md?p=a);
        - (III) peer support networks;
        - (IV) recovery community organizations;
        - (V) [health care providers](/usc/42/300aa–33.md?p=1), including physicians and other [providers](/usc/42/299b–21.md?p=8) of behavioral health and primary care;
        - (VI) education and training [providers](/usc/42/299b–21.md?p=8);
        - (VII) [employers](/usc/42/300gg–91.md?p=d-6);
        - (VIII) housing [services](/usc/42/201.md?p=a); and
        - (IX) child welfare [agencies](/usc/42/8262.md?p=1);
      - (ii) providing education on overdose prevention and overdose reversal to patients and families, as appropriate;
      - (iii) providing follow-up [services](/usc/42/201.md?p=a) for patients after an overdose to ensure continued recovery and connection to support [services](/usc/42/201.md?p=a);
      - (iv) collecting and evaluating outcome data for patients receiving recovery coaching [services](/usc/42/201.md?p=a); and
      - (v) providing other [services](/usc/42/201.md?p=a) the [Secretary](/usc/42/201.md?p=c) determines necessary to help ensure continued connection with recovery support [services](/usc/42/201.md?p=a), including culturally appropriate [services](/usc/42/201.md?p=a), as applicable;
    - (B) establish policies and procedures, pursuant to Federal and [State](/usc/42/201.md?p=f) law, that address the provision of overdose reversal medication, the administration of all [drugs](/usc/42/11851.md?p=4) or devices approved or cleared under the Federal Food, [Drug](/usc/42/11851.md?p=4), and Cosmetic Act ([21 U.S.C. 301](/usc/21/301.md) et seq.) and all biological products licensed under [section 262 of this title](/usc/42/262.md) to treat substance use disorder, and subsequent continuation of, or referral to, evidence-based [treatment](/usc/42/11851.md?p=11) for patients with a substance use disorder who have experienced a non-fatal [drug](/usc/42/11851.md?p=4) overdose, in order to support long-term [treatment](/usc/42/11851.md?p=11), prevent relapse, and reduce recidivism and future overdose; and
    - (C) establish integrated models of care for individuals who have experienced a non-fatal [drug](/usc/42/11851.md?p=4) overdose which may include patient assessment, follow up, and transportation to and from [treatment](/usc/42/11851.md?p=11) facilities.
  - (5) **Additional permissible uses—** In addition to the uses described in [paragraph (4)](#b-4), a grant awarded under this section may be used, directly or through contractual arrangements, to provide—
    - (A) all [drugs](/usc/42/11851.md?p=4) or devices approved or cleared under the Federal Food, [Drug](/usc/42/11851.md?p=4), and Cosmetic Act ([21 U.S.C. 301](/usc/21/301.md) et seq.) and all biological products licensed under [section 262 of this title](/usc/42/262.md) to treat substance use disorders or reverse overdose, pursuant to Federal and [State](/usc/42/201.md?p=f) law;
    - (B) withdrawal and detoxification [services](/usc/42/201.md?p=a) that include patient evaluation, stabilization, and preparation for [treatment](/usc/42/11851.md?p=11) of substance use disorder, including [treatment](/usc/42/11851.md?p=11) described in [subparagraph (A)](#b-5-A), as appropriate; or
    - (C) mental health [services](/usc/42/201.md?p=a) 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](/usc/42/11851.md?p=11) plan for patients with substance use disorder, and to monitor patient progress.
  - (6) **Preference—** In awarding grants under this section, the [Secretary](/usc/42/201.md?p=c) shall give preference to eligible entities that meet any or all of the following criteria:
    - (A) The eligible entity is a critical access [hospital](/usc/42/300s–3.md?p=1) (as defined in [section 1395x(mm)(1) of this title](/usc/42/1395x.md?p=mm-1)), a low volume [hospital](/usc/42/300s–3.md?p=1) (as defined in [section 1395ww(d)(12)(C)(i)](/usc/42/1395ww.md?p=d-12-C-i) of such title), a sole community [hospital](/usc/42/300s–3.md?p=1) (as defined in [section 1395ww(d)(5)(D)(iii)](/usc/42/1395ww.md?p=d-5-D-iii) of such title), or a [hospital](/usc/42/300s–3.md?p=1) that receives disproportionate share [hospital](/usc/42/300s–3.md?p=1) payments under [section 1395ww(d)(5)(F) of this title](/usc/42/1395ww.md?p=d-5-F).
    - (B) The eligible entity is located in a [State](/usc/42/201.md?p=f) with an age-adjusted rate of [drug](/usc/42/11851.md?p=4) overdose deaths that is above the national overdose mortality rate, as determined by the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention, or under the jurisdiction of an Indian Tribe with an age-adjusted rate of [drug](/usc/42/11851.md?p=4) overdose deaths that is above the national overdose mortality rate, as determined through appropriate mechanisms as determined by the [Secretary](/usc/42/201.md?p=c) 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](/usc/25/5304.md).
  - (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](/usc/42/201.md?p=a) 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](/usc/42/290ee–2.md?p=a).
- (d) **Reporting Requirements—**
  - (1) **Reports by grantees—** Each eligible entity awarded a grant under this section shall submit to the [Secretary](/usc/42/201.md?p=c) 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](/usc/42/11851.md?p=11) by the entity;
    - (C) the number of individuals referred by the entity to other [treatment](/usc/42/11851.md?p=11) 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](/usc/42/201.md?p=c) shall submit to Congress a report that includes an evaluation of the effectiveness of the grant [program](/usc/42/274l–1.md?p=4) carried out under this section with respect to long term health outcomes of the population of individuals who have experienced a [drug](/usc/42/11851.md?p=4) overdose, the percentage of patients treated or referred to [treatment](/usc/42/11851.md?p=11) by grantees, and the frequency and number of patients who experienced relapse, were readmitted for [treatment](/usc/42/11851.md?p=11), or experienced another overdose.
- (e) **Privacy—** The requirements of this section, including with respect to data reporting and [program](/usc/42/274l–1.md?p=4) oversight, shall be subject to all applicable Federal and [State](/usc/42/201.md?p=f) 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.

## Footnotes

[^1]: So in original. Probably should be capitalized.

## Source credit

(Pub. L. 115–271, title VII, § 7081, Oct. 24, 2018, 132 Stat. 4032.)

## Notes

### 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.