Overdose Response Policy

  • In 2016, the Pennsylvania Department of Drug and Alcohol Programs began implementing a warm handoff process intended to help overdose survivors who appear in emergency departments receive counseling and a referral to treatment. As part of the implementation, the Department incorporated contractual changes in its grant agreements with the Single County Authorities (“SCA”), which are publicly funded organizations responsible for planning and evaluating community drug and alcohol prevention, intervention, and treatment services. The contractual changes establish overdose survivors as a priority population and require each SCA to create a process whereby such patients receive a direct treatment referral from the emergency department.
  • In February 2017, the Department and the Pennsylvania Department of Health developed a list of local treatment providers and a flowchart designed to help health care providers in emergency departments implement warm handoffs.
  • According to the Department’s policy (outlined in the flowchart above), if a patient presents to the emergency department with an opioid overdose or other signs and symptoms of opioid abuse, then the patient should receive a screening for opioid use disorder, a physical exam, and laboratory testing, and the patient’s history should be documented. If the provider considers the patient to be safe for discharge but believes the patient has OUD, then a physician, registered nurse, or advance care practitioner orders and documents a warm handoff in the electronic medical record. Then, per SCA protocol, a designated emergency department staff member contacts a “drug and alcohol assessor,” and the patient meets confidentially with the assessor. If the patient agrees to further treatment, the initial provider facilitates a warm handoff to an addiction treatment provider, and the patient’s primary care physician receives notification through discharge notes. If the patient refuses the warm handoff, then the provider discharges the patient with a naloxone prescription and information on local treatment and resources.


PA HR216

  • The legislature shall establish a task force on overdose recovery, which shall conduct a study on warm handoff for individuals with SUD.
  • The Joint State Government Commission shall establish an advisory committee to provide recommendations on implementing warm handoff centers, including:
    • Addressing needs of survivors’ families
    • Identifying patients who should be immediately referred to a hospital ED
    • Expanding current crisis health care facilities into warm handoff centers
  • The advisory committee shall also:
    • Establish criteria to evaluate the effectiveness, financial impact, and availability of EMS resources that utilize a warm handoff center
    • Establish criteria to evaluate the effectiveness of the Department of Health’s warm handoff training curriculum and protocols

PA HB1699

Enacted on November 2, 2016 and codified as 35 Pa. Cons. Stat. §873.

  • A health care practitioner shall refer an individual for treatment if the individual is believed to be at risk for substance misuse while seeking treatment in an emergency department or urgent care center or when in observation status in a health care facility.
  • A health care practitioner who violates any provision of this act commits unprofessional conduct and shall be subject to review and disciplinary action under the licensure, certification, registration or permit provisions of law and regulation governing the respective health care practitioner.
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